The Effectiveness Of Fordyce Happiness Model Training On Life Expectancy In Candidate Patients For Coronary Artery Bypass Surgery

@#Objective: The purpose of this randomized control trial study was to understand the effects of happiness training by Fordyce method on life expectancy in patient’s candidates for heart surgery. This study was conducted on 66 patients who were candidates for heart surgery referred to Heshmat Heart Hospital in Rasht. Patients were randomly divided into two groups of intervention (n=34) and control (n=32) via blocked randomized method. The instrument included a standard Miller questionnaire. The intervention method of Fordyce Happiness Model was implemented via face-to-face sessions within 7 days before surgery every day for 20 to 30 minutes. Data analysis was conducted, based on the results obtained before the intervention, there was no significant difference between the two groups in terms of mean life expectancy score (p=0.643). Life expectancy score after the intervention in the case group was significantly higher than the control group (p=0.032). The findings of this study indicate that Fordyce happiness training can effect on life expectancy in patients undergoing heart surgery.

Effects of cardiac resynchronization therapy on mitral regurgitation in heart failure patients

Cardiac resynchronization therapy [CRT] has been introduced as a promising therapeutic choice in heart failure [HF] patients with ventricular dyssynchrony, shown with a wide QRS. In previous study, we showed a positive effect of CRT on ejection fraction. This study aimed to evaluate the effect of CRT on the severity of mitral regurgitation [MR] quantitatively using the volumetric Doppler method in HF patients. In this prospective before-after survey, 22 HF patients with wide QRS [>/=120 ms] and NYHA class III who were included. All patients were evaluated initially for QRS width, NYHA class, MR volume, MR fraction and mitral valve area [MV area]. Biventricular pacing was done through cardiac-resynchronization device along with three pacing leads and same evaluations were done after CRT. The mean [SD] QRS width and NYHA class were significantly decreased after CRT in HF patients [p<0.001]. Also MR volume [46.9 +/- 30.2 mL vs. 27.0 +/- 26.4 mL, p<0.001] and fraction [40.1 +/- 25.5% vs. 26.8 +/- 22.7%, p=0.002] were improved following CRT. The decrease of MV area after CRT was also significant [10.6 +/- 3.0 cm[2] vs. 8.6 +/- 2.6 cm[2], p<0.001]. As MR is associated with morbidity and mortality in HF patients and the standard surgical therapy may not be practical for a majority of them, this novel treatment may improve their disease condition significantly

Evaluation of left ventricular systolic function after cardiac resynchronization therapy in heart failure patients

Cardiac resynchronization therapy [CRT] has introduced as new treatment strategy in heart failure [HF] patients and some of its effects have been investigated. The aim of this study was to study the effectiveness of CRT in the improvement of left ventricular systolic function indicated by left ventricular ejection fraction [LVEF] in HF patients. In our prospective study 22 HF patients with NYHA class III and above, QRS duration>120 ms and EF [ejection fraction]

assessment of left ventricular time-varying radius using tissue doppler imaging

Left ventricular twist/torsion is believed to be a sensitive indicator of systolic and diastolic performance. To obtain circumferential rotation using tissue Doppler imaging, we need to estimate the time-varying radius of the left ventricle throughout the cardiac cycle to convert the tangential velocity into angular velocity. The aim of this study was to investigate accuracy of measured LV radius using tissue Doppler imaging throughout the cardiac cycle compared to two-dimensional [2D] imaging. A total of 35 subjects [47 +/- 12 years old] underwent transthoracic echocardiographic standard examinations. Left ventricular radius during complete cardiac cycle measured using tissue Doppler and 2D-imaging at basal and apical short axis / levels. For this reason, the 2D-images and velocity-time data derived and transferred to a personal computer for off-line analysis. 2D image frames analyzed via a program written in the MATLAB software. Velocity-time data from anteroseptal at basal level [or anterior wall at apical level] and posterior walls transferred to a spreadsheet Excel program for the radius calculations. Linear correlation and Bland-Altman analysis were calculated to assess the relationships and agreements between the tissue Doppler and 2D-measured radii throughout the cardiac cycle. There was significant correlation between tissue Doppler and 2D-measured radii and the Pearson correlation coefficients were 0.84 to 0.97 [P<0.05]. Bland-Altman analysis by constructing the 95% limits of agreement showed that the good agreements existed between the two methods. It can be concluded from our experience that the tissue Doppler imaging can reasonably estimate radius of the left ventricle throughout the cardiac cycle

Factors influencing pre-hospital delay among patients with acute myocardial infarction in Iran / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Acute myocardial infarction (AMI) is the leading cause of morbidity and disability among Iranian population. Pre-hospital delay is an important cause of increasing early and also late mortality in AMI. Thus the aim of the present study was to identify the factors influencing pre-hospital delay among patients with AMI in Iran.</p><p><b>METHODS</b>Between August 2010 and May 2011, a cross-sectional and single-center survey was conducted on 162 consecutive patients with ST-elevation myocardial infarction (STEMI) admitted to Cardiac Care Unit (CCU) of Dr. Heshmat Hospital, Rasht. All patients were interviewed by the third author within 7 days after admission by using a four-part questionnaire including socio-demographic, clinical, situational and cognitive factors. Data were analyzed by descriptive and Logistic regression model at P < 0.05 using SPSS 16.</p><p><b>RESULTS</b>Mean age was (60.11 ± 12.29) years in all patients. Majority of patients (65.4%) were male. The median of pre-hospital delay was 2 hours, with a mean delay of 7.4 hours (± 16.25 hours). Regression analysis showed that admission in weekend (P < 0.04, OR = 1.033, 95%CI = 1.187 - 2.006) and misinterpretation of symptoms as cardiac origin (P < 0.002, OR = 1.986, 95%CI = 1.254 - 3.155) and perceiving symptoms to not be so serious (P < 0.003, OR = 3.264, 95%CI = 1.492 - 7.142) were factors influencing pre-hospital delay > 2 hours.</p><p><b>CONCLUSIONS</b>Our findings highlight the importance of cognitive factors on decision-making process and pre-hospital delays. Health care providers can educate the public on AMI to enable them recognize the signs and symptoms of AMI correctly and realize the benefits of early treatment.</p>

Effect of exercise-based cardiac rehabilitation on ejection fraction in coronary artery disease patients: a randomized controlled trial

Exercise training as a part of cardiac rehabilitation aims to restore patient with heart disease to health. However, left ventricular ejection fraction [LVEF] is clinically used as a predictor of long-term prognosis in coronary artery disease [CAD] patients, there is a scarcity of data on the effectiveness of exercise-based cardiac rehabilitation on LVEF. To investigate the effectiveness of exercise-based cardiac rehabilitation on LVEF in early post-event CAD patients. In a single blinded, randomized controlled trial, post-coronary event CAD patients from the age group of 3575 years, surgically [Coronary artery bypass graft or percutaneous coronary angioplasty] or conservatively treated, were recruited from Golsar Hospital, Iran. Exclusion criteria were high-risk group [AACVPR-99] patients and contraindications to exercise testing and training. Forty-two patients were randomized either into Study or Control. The study group underwent a 12-week structured individually tailored exercise program either in the form of Center-based [CExs] or Home-based [HExs] according to the ACSM-2005 guidelines. The control group only received the usual cardiac care without any exercise training. LVEF was measured before and after 12 weeks of exercise training for all three groups. Differences between and within groups were analyzed using the general linear model, two-way repeated measures at alpha=0.05. Mean age of the subjects was 60.5 +/- 8.9 years. There was a significant increase in LVEF in the study [46.9 +/- 5.9 to 61.5 +/- 5.3] group compared with the control [47.9 +/- 7.0 to 47.6 +/- 6.9] group [P=0.001]. There was no significant difference in changes in LVEF between the HExs and CExs groups [P=1 .0]. A 12-week early [within 1 month post-discharge] structured individually tailored exercise training could significantly improve LVEF in post-event CAD patients