Pub Date : 2001-07-01DOI: 10.1111/J.1527-5299.2001.00253.X
T. Ramahi, R. Rohlfs, N. Sheynberg, K. M. Engle, M. Longo
Beta blockers improve survival and reduce morbidity of patients with chronic heart failure. Stringent dosing guidelines calling for a 1-hour observation period after initiation or up-titration of beta-blocker therapy might limit the use of beta blockers and increase the expense involved. This study was conducted to determine the usefulness of this observation period. Data were collected from 130 in-clinic postdosing observation periods for 34 stable chronic heart failure patients started on carvedilol. The mean left ventricular ejection fraction was 0.22±0.09, and the mean functional class was 2.5±0.6. No patient had greater than first-degree heart block. Carvedilol was started at 3.125 or 6.25 mg b.i.d., and the dose was doubled every 1-3 weeks. All patients were observed for 1-2 hours after initiation or dosage increase, and blood pressure and heart rate were measured hourly. The maximal daily dose was 50±31 mg. In none of the observation periods was there a decrease in the dose of beta blockers administered in the clinic. The predosing mean blood pressure was 110±15/71±10 mm Hg, and the mean heart rate was 78±13 bpm; the 1-hour postdosing mean blood pressure was 101±14/67±10 mm Hg (p is less than 0.001), and the heart rate was 78±13 bpm. The dose was decreased in six patients and medication was discontinued in three, all consequent to symptoms reported several days after dosage increase. Beta blockers can be safely initiated and up-titrated at home in properly selected and evaluated stable patients with chronic heart failure and severe left ventricular dysfunction resulting in mild or moderate impairment of functional capacity. (c)2001 by CHF, Inc.
-受体阻滞剂提高慢性心力衰竭患者的生存率并降低发病率。严格的剂量指南要求在β受体阻滞剂治疗开始或增加剂量后1小时的观察期，这可能会限制β受体阻滞剂的使用，并增加相关费用。进行这项研究是为了确定这一观察期的有用性。收集了34例开始服用卡维地洛的稳定型慢性心力衰竭患者的130个临床给药后观察期的数据。左室射血分数平均值为0.22±0.09，功能评分平均值为2.5±0.6。没有患者有超过一级的心脏传导阻滞。卡维地洛起始剂量为3.125或6.25 mg b.i.d，每1-3周加倍剂量。所有患者在起始或增加剂量后观察1-2小时，每小时测量血压和心率。最大日剂量为50±31 mg。在所有的观察期内，临床使用的受体阻滞剂的剂量都没有减少。给药前平均血压为110±15/71±10 mm Hg，平均心率为78±13 bpm;给药后1小时平均血压为101±14/67±10 mm Hg (p < 0.001)，心率为78±13 bpm。6名患者减少剂量，3名患者停药，所有这些都是由于在剂量增加后几天报告的症状。慢性心力衰竭和严重左心室功能障碍导致轻度或中度功能障碍的稳定患者可以在家中安全地开始使用-受体阻滞剂并提高剂量。(c)2001年，CHF, Inc。
{"title":"Clinic dosing of beta blockers in chronic heart failure.","authors":"T. Ramahi, R. Rohlfs, N. Sheynberg, K. M. Engle, M. Longo","doi":"10.1111/J.1527-5299.2001.00253.X","DOIUrl":"https://doi.org/10.1111/J.1527-5299.2001.00253.X","url":null,"abstract":"Beta blockers improve survival and reduce morbidity of patients with chronic heart failure. Stringent dosing guidelines calling for a 1-hour observation period after initiation or up-titration of beta-blocker therapy might limit the use of beta blockers and increase the expense involved. This study was conducted to determine the usefulness of this observation period. Data were collected from 130 in-clinic postdosing observation periods for 34 stable chronic heart failure patients started on carvedilol. The mean left ventricular ejection fraction was 0.22±0.09, and the mean functional class was 2.5±0.6. No patient had greater than first-degree heart block. Carvedilol was started at 3.125 or 6.25 mg b.i.d., and the dose was doubled every 1-3 weeks. All patients were observed for 1-2 hours after initiation or dosage increase, and blood pressure and heart rate were measured hourly. The maximal daily dose was 50±31 mg. In none of the observation periods was there a decrease in the dose of beta blockers administered in the clinic. The predosing mean blood pressure was 110±15/71±10 mm Hg, and the mean heart rate was 78±13 bpm; the 1-hour postdosing mean blood pressure was 101±14/67±10 mm Hg (p is less than 0.001), and the heart rate was 78±13 bpm. The dose was decreased in six patients and medication was discontinued in three, all consequent to symptoms reported several days after dosage increase. Beta blockers can be safely initiated and up-titrated at home in properly selected and evaluated stable patients with chronic heart failure and severe left ventricular dysfunction resulting in mild or moderate impairment of functional capacity. (c)2001 by CHF, Inc.","PeriodicalId":10536,"journal":{"name":"Congestive heart failure","volume":"78 1","pages":"196-200"},"PeriodicalIF":0.0,"publicationDate":"2001-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84050587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-07-01DOI: 10.1111/J.1527-5299.2001.01010.X
L. S. Greci, A. Rashkow
The authors describe a case of high-output cardiac failure in a patient with rapidly progressing prostate cancer for which no previously described cause could be found. His new onset and increasingly worsening heart failure corresponded to the rapid spread of his prostate cancer. The authors hypothesize that a cytokine released from the neoplastic cells or the bone was responsible for the high-output cardiac failure observed in this patient. (c)2001 CHF, Inc.
{"title":"High-output cardiac failure in a patient with prostate cancer.","authors":"L. S. Greci, A. Rashkow","doi":"10.1111/J.1527-5299.2001.01010.X","DOIUrl":"https://doi.org/10.1111/J.1527-5299.2001.01010.X","url":null,"abstract":"The authors describe a case of high-output cardiac failure in a patient with rapidly progressing prostate cancer for which no previously described cause could be found. His new onset and increasingly worsening heart failure corresponded to the rapid spread of his prostate cancer. The authors hypothesize that a cytokine released from the neoplastic cells or the bone was responsible for the high-output cardiac failure observed in this patient. (c)2001 CHF, Inc.","PeriodicalId":10536,"journal":{"name":"Congestive heart failure","volume":"32 1","pages":"220-222"},"PeriodicalIF":0.0,"publicationDate":"2001-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85143158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-07-01DOI: 10.1111/J.1527-5299.2001.00251.X
P. Vandergoten, J. Vijgen, P. Timmermans, P. Dendale
Chronotropic incompetence is generally defined as an inadequate heart rate response to exercise, but manifestations can vary. The incidence depends on underlying cardiac pathology and, to a lesser degree, on the cut-off value of the predicted heart rate during exercise. Different pathologies induce chronotropic incompetence. Its presence indicates an adverse outcome and is strongly correlated with coronary artery disease. Treatment consists of rate-responsive pacemakers; dual-sensor, adaptive pacemakers are superior to single-sensor, rate-augmenting pacemakers. This case report illustrates the negative effect of chronotropic incompetence on daily activities and its amelioration by implantation of a rate-responsive pacemaker. (c)2001 by CHF, Inc.
{"title":"Chronotropic incompetence: a case report.","authors":"P. Vandergoten, J. Vijgen, P. Timmermans, P. Dendale","doi":"10.1111/J.1527-5299.2001.00251.X","DOIUrl":"https://doi.org/10.1111/J.1527-5299.2001.00251.X","url":null,"abstract":"Chronotropic incompetence is generally defined as an inadequate heart rate response to exercise, but manifestations can vary. The incidence depends on underlying cardiac pathology and, to a lesser degree, on the cut-off value of the predicted heart rate during exercise. Different pathologies induce chronotropic incompetence. Its presence indicates an adverse outcome and is strongly correlated with coronary artery disease. Treatment consists of rate-responsive pacemakers; dual-sensor, adaptive pacemakers are superior to single-sensor, rate-augmenting pacemakers. This case report illustrates the negative effect of chronotropic incompetence on daily activities and its amelioration by implantation of a rate-responsive pacemaker. (c)2001 by CHF, Inc.","PeriodicalId":10536,"journal":{"name":"Congestive heart failure","volume":"471 1","pages":"202-204"},"PeriodicalIF":0.0,"publicationDate":"2001-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75121364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-07-01DOI: 10.1111/J.1527-5299.2001.01011.X
A. Bhan, C. Brody
The symptoms of propionic acidemia, an autosomal recessive disorder involving deficiency of the enzyme propionyl-coenzyme A carboxylase, are highly varied and may present at any time in the patient's life. Cardiomyopathy, a rare complication of this disorder, has been reported in only a small number of pediatric patients. The authors describe a case of adult-onset cardiomyopathy in a 23-year-old female with propionic acidemia diagnosed in early childhood and associated with multiple long-standing comorbidities. The possible mechanisms of propionic acidemia-associated cardiomyopathy, and the importance of early recognition and appropriate management, are discussed. (c)2001 CHF, Inc.
{"title":"Propionic acidemia: a rare cause of cardiomyopathy.","authors":"A. Bhan, C. Brody","doi":"10.1111/J.1527-5299.2001.01011.X","DOIUrl":"https://doi.org/10.1111/J.1527-5299.2001.01011.X","url":null,"abstract":"The symptoms of propionic acidemia, an autosomal recessive disorder involving deficiency of the enzyme propionyl-coenzyme A carboxylase, are highly varied and may present at any time in the patient's life. Cardiomyopathy, a rare complication of this disorder, has been reported in only a small number of pediatric patients. The authors describe a case of adult-onset cardiomyopathy in a 23-year-old female with propionic acidemia diagnosed in early childhood and associated with multiple long-standing comorbidities. The possible mechanisms of propionic acidemia-associated cardiomyopathy, and the importance of early recognition and appropriate management, are discussed. (c)2001 CHF, Inc.","PeriodicalId":10536,"journal":{"name":"Congestive heart failure","volume":"05 1","pages":"218-219"},"PeriodicalIF":0.0,"publicationDate":"2001-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81366305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-07-01DOI: 10.1111/J.1527-5299.2001.00252.X
T. Fülöp, I. Hegedüs, I. Edes
Detection of left ventricular contractile reserve by means of dobutamine stress echocardiography is a well known technique. The aim of the present study was to detect velocity changes during the administration of dobutamine, to establish if Doppler myocardial imaging is a suitable method for determining left ventricular contractile reserve, and to determine if the technique provides more information than traditional stress echocardiography. Twenty-five patients (all males; mean age, 53.4 years) were examined for a clinical diagnosis of idiopathic dilated cardiomyopathy with a poor left ventricular systolic function (ejection fraction less than 30%). Doses of 5-10 and 20 mg/kg/min dobutamine were administered and elevated at 4-minute intervals. Ejection fraction was calculated using the Simpson rule. The peak systolic and the early and late diastolic velocities were measured in the basal segment of the septum and the inferior wall at baseline and at full dose of dobutamine. Results indicated that peak systolic velocity increased significantly, both in the septum (0.11±0.03 vs. 0.20±0.05 m/sec; p=0.001) and in the inferior wall (0.10±0.05 vs. 0.17±0.06 m/sec; p=0.03). Late diastolic velocities also increased significantly, both in the septum (0.17±0.05 vs. 0.22±0.07 m/sec; p=0.01) and in the inferior wall (0.18±0.08 vs.0.21±0.02 m/sec; p=0.01). There was a significant linear correlation between the relative increases in basal ejection fraction value and in peak systolic velocity upon dobutamine stimulation. Patients were divided into responders and nonresponders based on responses in either ejection fraction (25% relative increase) or peak systolic velocity (5 cm/s increase). This study concludes that 1) Doppler myocardial imaging is an adequate and simple technique to examine left ventricular contractile reserve; and 2) measurement of peak systolic velocity during dobutamine stimulation seems to be a simple and good indicator of left ventricular contractile reserve. (c)2001 CHF, Inc.
利用多巴酚丁胺应激超声心动图检测左心室收缩储备是一种众所周知的技术。本研究的目的是检测多巴酚丁胺给药期间的速度变化，确定多普勒心肌成像是否适合用于确定左心室收缩储备，并确定该技术是否比传统的应激超声心动图提供更多信息。25例患者(均为男性;平均年龄53.4岁)，诊断为特发性扩张型心肌病，左心室收缩功能差(射血分数小于30%)。给予5-10和20 mg/kg/min多巴酚丁胺剂量，每隔4分钟增加一次。采用辛普森法则计算射血分数。在基线和全剂量多巴酚丁胺时，分别测量了室间隔基底段和下壁的收缩峰值、舒张早期和晚期速度。结果显示，两组心脏间隔收缩速度峰值均显著升高(0.11±0.03 vs. 0.20±0.05 m/sec);P =0.001)和下壁(0.10±0.05 vs. 0.17±0.06 m/sec;p = 0.03)。舒张后期速度也显著增加，在隔膜(0.17±0.05 vs. 0.22±0.07 m/sec);P =0.01)和下壁(0.18±0.08 vs.0.21±0.02 m/sec;p = 0.01)。多巴酚丁胺刺激后基底射血分数值的相对升高与收缩速度峰值呈显著的线性相关。根据射血分数(相对增加25%)或峰值收缩速度(增加5cm /s)的反应，将患者分为反应者和无反应者。本研究认为:1)多普勒心肌显像是一种检查左心室收缩储备的适当且简单的技术;2)多巴酚丁胺刺激时的峰值收缩速度测量似乎是左心室收缩储备的一个简单而良好的指标。(c)2001 CHF, Inc。
{"title":"Examination of left ventricular contractile reserve by Doppler myocardial imaging in patients with dilated cardiomyopathy.","authors":"T. Fülöp, I. Hegedüs, I. Edes","doi":"10.1111/J.1527-5299.2001.00252.X","DOIUrl":"https://doi.org/10.1111/J.1527-5299.2001.00252.X","url":null,"abstract":"Detection of left ventricular contractile reserve by means of dobutamine stress echocardiography is a well known technique. The aim of the present study was to detect velocity changes during the administration of dobutamine, to establish if Doppler myocardial imaging is a suitable method for determining left ventricular contractile reserve, and to determine if the technique provides more information than traditional stress echocardiography. Twenty-five patients (all males; mean age, 53.4 years) were examined for a clinical diagnosis of idiopathic dilated cardiomyopathy with a poor left ventricular systolic function (ejection fraction less than 30%). Doses of 5-10 and 20 mg/kg/min dobutamine were administered and elevated at 4-minute intervals. Ejection fraction was calculated using the Simpson rule. The peak systolic and the early and late diastolic velocities were measured in the basal segment of the septum and the inferior wall at baseline and at full dose of dobutamine. Results indicated that peak systolic velocity increased significantly, both in the septum (0.11±0.03 vs. 0.20±0.05 m/sec; p=0.001) and in the inferior wall (0.10±0.05 vs. 0.17±0.06 m/sec; p=0.03). Late diastolic velocities also increased significantly, both in the septum (0.17±0.05 vs. 0.22±0.07 m/sec; p=0.01) and in the inferior wall (0.18±0.08 vs.0.21±0.02 m/sec; p=0.01). There was a significant linear correlation between the relative increases in basal ejection fraction value and in peak systolic velocity upon dobutamine stimulation. Patients were divided into responders and nonresponders based on responses in either ejection fraction (25% relative increase) or peak systolic velocity (5 cm/s increase). This study concludes that 1) Doppler myocardial imaging is an adequate and simple technique to examine left ventricular contractile reserve; and 2) measurement of peak systolic velocity during dobutamine stimulation seems to be a simple and good indicator of left ventricular contractile reserve. (c)2001 CHF, Inc.","PeriodicalId":10536,"journal":{"name":"Congestive heart failure","volume":"7 1","pages":"191-195"},"PeriodicalIF":0.0,"publicationDate":"2001-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87506904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-07-01DOI: 10.1111/J.1527-5299.2001.00256.X
G. Miller, M. Mills, E. Havranek, J. Taylor, D. Ordin
This column is the sixth in a series describing Health Care Financing Administration (HCFA) initiatives to improve care for Medicare beneficiaries with heart failure. The fourth column addressed the Heart Failure Practice Improvement Effort, HCFA's pilot project to test the feasibility of assessing and improving heart failure care in the outpatient setting through the activities of HCFA-contracted peer review organizations in eight states. This column is dedicated to illustrating the progress of the Heart Failure Practice Improvement Effort project at an individual state and practice level, focusing on the quality improvement activities in outpatient heart failure care conducted by the Colorado peer review organization. (c)2001 CHF, Inc.
{"title":"Improving heart failure care in the office setting.","authors":"G. Miller, M. Mills, E. Havranek, J. Taylor, D. Ordin","doi":"10.1111/J.1527-5299.2001.00256.X","DOIUrl":"https://doi.org/10.1111/J.1527-5299.2001.00256.X","url":null,"abstract":"This column is the sixth in a series describing Health Care Financing Administration (HCFA) initiatives to improve care for Medicare beneficiaries with heart failure. The fourth column addressed the Heart Failure Practice Improvement Effort, HCFA's pilot project to test the feasibility of assessing and improving heart failure care in the outpatient setting through the activities of HCFA-contracted peer review organizations in eight states. This column is dedicated to illustrating the progress of the Heart Failure Practice Improvement Effort project at an individual state and practice level, focusing on the quality improvement activities in outpatient heart failure care conducted by the Colorado peer review organization. (c)2001 CHF, Inc.","PeriodicalId":10536,"journal":{"name":"Congestive heart failure","volume":"8 1","pages":"208-211"},"PeriodicalIF":0.0,"publicationDate":"2001-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79210031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-07-01DOI: 10.1111/J.1527-5299.2001.01009.X
L. Nikolaidis
The authors describe the case of a 41-year-old man with end-stage, nonischemic dilated cardiomyopathy of 11 years' duration. The patient had been deemed ineligible for transplantation, despite his young age, when he was diagnosed with non-Hodgkin's lymphoma 7 years previously. Since he had survived the lymphoma without significant chemotherapy, while his cardiovascular and renal status continued to deteriorate, the issue was revisited. In an attempt to at least render him eligible for an assist device, a novel, promising, and reportedly nontoxic immunomodulation therapy for his lymphoma was employed. This consisted of infusion of the monoclonal antibody rituximab, specifically targeting the CD20 antigen on B cells. Despite testimonials concerning the benign nature of the treatment, the patient was unable to tolerate it and his clinical condition deteriorated rapidly, eventually leading to his death. The authors discuss potential mechanisms that might have accounted for the patient's cardiorenal compromise, with a focus on a very rare "cytokine release" syndrome attributed to this type of monoclonal antibody therapy and the probable interplay of cytokines in advanced heart failure. (c)2001 CHF, Inc.
{"title":"When cancer and heart failure cross paths: a case report of severe cardiorenal compromise associated with the anti-CD20 monoclonal antibody rituximab in a patient with dilated cardiomyopathy.","authors":"L. Nikolaidis","doi":"10.1111/J.1527-5299.2001.01009.X","DOIUrl":"https://doi.org/10.1111/J.1527-5299.2001.01009.X","url":null,"abstract":"The authors describe the case of a 41-year-old man with end-stage, nonischemic dilated cardiomyopathy of 11 years' duration. The patient had been deemed ineligible for transplantation, despite his young age, when he was diagnosed with non-Hodgkin's lymphoma 7 years previously. Since he had survived the lymphoma without significant chemotherapy, while his cardiovascular and renal status continued to deteriorate, the issue was revisited. In an attempt to at least render him eligible for an assist device, a novel, promising, and reportedly nontoxic immunomodulation therapy for his lymphoma was employed. This consisted of infusion of the monoclonal antibody rituximab, specifically targeting the CD20 antigen on B cells. Despite testimonials concerning the benign nature of the treatment, the patient was unable to tolerate it and his clinical condition deteriorated rapidly, eventually leading to his death. The authors discuss potential mechanisms that might have accounted for the patient's cardiorenal compromise, with a focus on a very rare \"cytokine release\" syndrome attributed to this type of monoclonal antibody therapy and the probable interplay of cytokines in advanced heart failure. (c)2001 CHF, Inc.","PeriodicalId":10536,"journal":{"name":"Congestive heart failure","volume":"8 1","pages":"223-227"},"PeriodicalIF":0.0,"publicationDate":"2001-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87527902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-07-01DOI: 10.1111/J.1527-5299.2001.00258.X
I. Bukharovich, E. Harrison, T. L. Le Jemtel
Peripartum cardiomyopathy, an uncommon cause of chronic heart failure, may present during the third trimester of pregnancy, but most often develops within 2 months postpartum. The etiologies of heart failure during pregnancy and postpartum are numerous, however. The authors describe the case of a 25-year-old woman who developed severe, symptomatic heart failure following delivery and discuss their initial consideration of peripartum cardiomyopathy and the differential diagnostic features of this case. (c)2001 CHF, Inc.
{"title":"Difficult cases in heart failure: Left ventricular dysfunction related to septic shock masquerading as postpartum cardiomyopathy.","authors":"I. Bukharovich, E. Harrison, T. L. Le Jemtel","doi":"10.1111/J.1527-5299.2001.00258.X","DOIUrl":"https://doi.org/10.1111/J.1527-5299.2001.00258.X","url":null,"abstract":"Peripartum cardiomyopathy, an uncommon cause of chronic heart failure, may present during the third trimester of pregnancy, but most often develops within 2 months postpartum. The etiologies of heart failure during pregnancy and postpartum are numerous, however. The authors describe the case of a 25-year-old woman who developed severe, symptomatic heart failure following delivery and discuss their initial consideration of peripartum cardiomyopathy and the differential diagnostic features of this case. (c)2001 CHF, Inc.","PeriodicalId":10536,"journal":{"name":"Congestive heart failure","volume":"25 1","pages":"205-207"},"PeriodicalIF":0.0,"publicationDate":"2001-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75451851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-07-01DOI: 10.1111/J.1527-5299.2001.00241.X
S. Aikat, G. Francis
Trastuzumab (Herceptin®), a monoclonal HER2 receptor blocker, was approved by the Food and Drug Administration in September, 1998 for the treatment of advanced breast carcinoma. It is rapidly emerging as an important drug for the treatment of metastatic breast cancer. The results of a pivotal trial revealed a 53% improvement in the response rate when trastuzumab was added to the standard chemotherapeutic regimen. However, a greater than four-fold increase in the occurrence of congestive heart failure was also noted. This novel agent has ushered in hope for thousands of women, but its use mandates that a clear understanding of its effects and relative risks be appreciated. Careful patient selection for the use of trastuzumab is critically important. It is prudent that cardiologists be aware of its cardiotoxicity, and that the risk/benefit ratio be clarified before its use in less invasive forms of breast cancer. (c)2001 CHF, Inc.
{"title":"Trastuzumab therapy and the heart: palliation at what cost?","authors":"S. Aikat, G. Francis","doi":"10.1111/J.1527-5299.2001.00241.X","DOIUrl":"https://doi.org/10.1111/J.1527-5299.2001.00241.X","url":null,"abstract":"Trastuzumab (Herceptin®), a monoclonal HER2 receptor blocker, was approved by the Food and Drug Administration in September, 1998 for the treatment of advanced breast carcinoma. It is rapidly emerging as an important drug for the treatment of metastatic breast cancer. The results of a pivotal trial revealed a 53% improvement in the response rate when trastuzumab was added to the standard chemotherapeutic regimen. However, a greater than four-fold increase in the occurrence of congestive heart failure was also noted. This novel agent has ushered in hope for thousands of women, but its use mandates that a clear understanding of its effects and relative risks be appreciated. Careful patient selection for the use of trastuzumab is critically important. It is prudent that cardiologists be aware of its cardiotoxicity, and that the risk/benefit ratio be clarified before its use in less invasive forms of breast cancer. (c)2001 CHF, Inc.","PeriodicalId":10536,"journal":{"name":"Congestive heart failure","volume":"14 1","pages":"188-190"},"PeriodicalIF":0.0,"publicationDate":"2001-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78427013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-05-01DOI: 10.1111/J.1527-5299.2001.00244.X
J. Suppan
Heart failure is a significant health problem that requires a multidisciplinary approach for successful intervention. Five million Americans currently suffer from heart failure, resulting in an annual expenditure estimated at $20-$40 billion. However, with early identification and intervention, the progression of heart failure can be stopped. Change in lifestyle and adherence to a prescribed plan of care recommended for heart failure treatment can lead to improved quality of life. The Transtheoretical Model provides a framework for facilitating the behavioral changes necessary for the optimal treatment of heart failure. Future research is suggested to evaluate outcomes of behavioral changes in heart failure populations upon implementation of this model. (c)2001 by CHF, Inc.
{"title":"Using the transtheoretical approach to facilitate change in the heart failure population.","authors":"J. Suppan","doi":"10.1111/J.1527-5299.2001.00244.X","DOIUrl":"https://doi.org/10.1111/J.1527-5299.2001.00244.X","url":null,"abstract":"Heart failure is a significant health problem that requires a multidisciplinary approach for successful intervention. Five million Americans currently suffer from heart failure, resulting in an annual expenditure estimated at $20-$40 billion. However, with early identification and intervention, the progression of heart failure can be stopped. Change in lifestyle and adherence to a prescribed plan of care recommended for heart failure treatment can lead to improved quality of life. The Transtheoretical Model provides a framework for facilitating the behavioral changes necessary for the optimal treatment of heart failure. Future research is suggested to evaluate outcomes of behavioral changes in heart failure populations upon implementation of this model. (c)2001 by CHF, Inc.","PeriodicalId":10536,"journal":{"name":"Congestive heart failure","volume":"31 1","pages":"151-155"},"PeriodicalIF":0.0,"publicationDate":"2001-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87547479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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