ABSTRACT
Aim of this study was to define the prognostic value of Tei index compared with other clinical and instrumental parameters in elderly patients with chronic heart failure (CHF) observed in outpatient conditions. A total of 97 patients aged 60 to 85 years with symptoms of CHF NYHA class II--IV due to coronary heart disease or hypertension were included. Clinical examination, a 6-minute walk test, echocardiography with determination of Tei index were carried out. There was statistically significant difference between survival among patients with Tei index > or = 0.6 and patients with Tei index < 0.6 (p < 0.001). Among patients with preserved left ventricular ejection fraction (LV EF) survival of patients with Tei index <0.6 was higher compared to those with Tei index > or = 0.6 (p < 0.05). Independent predictors of acute myocardial infarction and mortality in elderly patients with CHF were detected. The greatest risk (odds ratio 11.6, 95% CI 2.50 - 53.70) compared with other clinical and instrumental parameters was associated with Tei index > or = 0.6. Among patients with preserved LVEF (LVEF > 45%) prognostic value of Tei index was similar to that of LV EF.
Subject(s)
Electrocardiography , Heart Failure/diagnosis , Heart Ventricles/physiopathology , Myocardial Contraction/physiology , Stroke Volume/physiology , Ventricular Function, Left/physiology , Aged , Aged, 80 and over , Echocardiography , Female , Follow-Up Studies , Heart Failure/mortality , Heart Failure/physiopathology , Heart Ventricles/diagnostic imaging , Humans , Male , Middle Aged , Outpatients , Prognosis , Prospective Studies , Russia/epidemiology , Severity of Illness Index , Survival Rate/trends , Time FactorsABSTRACT
AIM: To evaluate diagnostic value of Tei index in detection of chronic heart failure (CHF) in elderly outpatients. MATERIAL AND METHODS: Examination of 101 CHD patients of the study group and 46 control patients free of heart disease aged over 60 years included registration of doppler spectra and calculation of the Tei index which is a ratio of isovolumic contraction time plus isovolumic relaxation time to left ventricular (LV) ejection time and can be calculated using dopplerography. RESULTS: Mean Tei index in CHF patients was significantly higher than in control patients. The Tei index significantly exceeded that in the controls in CHD patients with both low and normal LV ejection fraction. In healthy controls over 60 years of age Tei index varied from 0.40 to 0.59 and averaged 0.5 +/- 0.05. Optimal diagnostic ability to detect CHF in the elderly is shown for Tei index 0.56. For this value sensitivity of the index reached 90%, specificity - 87%. CONCLUSION: Calculation of the Tei index is possible in all the patients irrespective of quality of heart and LV endocardium visualization in echocardiography.
Subject(s)
Echocardiography, Doppler/methods , Heart Failure/diagnostic imaging , Myocardial Contraction/physiology , Ventricular Function, Left/physiology , Age Factors , Aged , Aged, 80 and over , Chronic Disease , Diastole , Female , Follow-Up Studies , Heart Failure/physiopathology , Humans , Male , Middle Aged , Prognosis , Reproducibility of Results , Severity of Illness Index , Stroke Volume/physiologyABSTRACT
AIM: To evaluate results of long-term outpatient use of caposide in patients with cardiac failure. MATERIAL AND METHODS: 74 patients (59 males and 15 females aged 40-76 years) with chronic cardiac failure (CCF) received caposide in individual doses. CCF was caused by ischemic heart disease (IHD) and dilated cardiomyopathy in 65 and 9 patients, respectively. The treatment effect was assessed by changes in clinical symptoms, quality of life and physical activity. RESULTS: Clinical symptoms, functional class of IHD, exercise tolerance and quality of life improved. Serious side effects were absent. CONCLUSION: Caposide can be considered as first-line therapy in outpatient treatment of patients with CCF of different severity as monotherapy and adjuvant in combined treatment.
Subject(s)
Captopril/therapeutic use , Cardiac Output, Low/drug therapy , Hydrochlorothiazide/therapeutic use , Aged , Ambulatory Care , Captopril/adverse effects , Drug Combinations , Female , Humans , Hydrochlorothiazide/adverse effects , Male , Middle AgedABSTRACT
Olicard-Retard, isosorbide-5-mononitrate drug, has been tried in a single daily dose 40 mg in 60 outpatients with angina pectoris. The drug reduced the frequency of anginal attacks and nitroglycerine intake in most of the patients. The antianginal properties were combined with anti-ischemic effects as shown by echocardiography. Side effects (head ache) were mild. Olicard-Retard proved effective in angina of effort both in monotherapy and combined treatment.
