Validation of the English Version of the HeartQoL Health-Related Quality of Life Questionnaire in Patients With Coronary Heart Disease.

PURPOSE: The aim of this study was to validate the English version of the HeartQoL health-related quality of life questionnaire for use in patients with angina or myocardial infarction. METHODS: Patients living in the United States and referred, either for percutaneous coronary intervention or to cardiac rehabilitation, completed the HeartQoL, the Short Form-36 Health Survey, and the Hospital Anxiety and Depression Scale at baseline and 3-months later. The data were analyzed for validity, reliability, and responsiveness. RESULTS: Patients (n = 313 with angina and n = 97 with myocardial infarction) who were referred either for percutaneous coronary intervention (n = 164) or to cardiac rehabilitation (n = 246) completed baseline questionnaires. Patients with angina had significantly lower HeartQoL scores (poorer health-related quality of life) compared with patients with myocardial infarction. Exploratory factor analysis largely supported the 2-factor structure of the HeartQoL in both diagnoses, but further investigation is warranted. Internal consistency reliability was adequate, convergent validity correlations were significant, and discriminative validity was fully confirmed in patients with angina and largely confirmed in patients with myocardial infarction. Responsiveness was largely confirmed in patients who underwent percutaneous coronary intervention (n = 67) and those referred to cardiac rehabilitation (n = 167) with conventional statistical tests and clinically with the effect size, a standardized measure of change. CONCLUSIONS: The English HeartQoL health-related quality of life questionnaire is valid, reliable, and responsive in patients with angina and myocardial infarction allowing (1) assessment of baseline, (2) between-diagnosis comparisons, and (3) evaluation of change over time.

Nitroglycerin prescription and potency in patients participating in exercise-based cardiac rehabilitation.

PURPOSE: Current guidelines call for nitroglycerin to be prescribed in patients with coronary heart disease, including those with stable angina and those recovering from acute coronary syndromes and myocardial infarction. These patients are at risk for coronary events, and nitroglycerin may be required to treat acute symptoms of myocardial ischemia. Nitroglycerin rapidly loses potency when stored improperly, compromising effectiveness. Previous studies indicate that patients frequently fail to store nitroglycerin properly. Accordingly, pharmacists routinely advise patients to renew nitroglycerin tablets every 6 months. The purpose of this study was to determine frequency of prescription of nitroglycerin and the relationship to potency in patients participating in exercise-based cardiac rehabilitation programs. METHODS: A survey was performed over a 3-month period of 617 patients enrolled in 9 exercise-based cardiac rehabilitation centers in New York, Michigan, and Rhode Island. Patient data were evaluated according to cardiac diagnoses and the use of sublingual nitroglycerin. RESULTS: A total of 38% of patients did not have a prescription for nitroglycerin. Patients with potentially subpotent nitroglycerin tablets included 23% whose prescription was older than 1 year and an additional 15% whose tablets were between 6 and 12 months old. CONCLUSIONS: The prescription of nitroglycerin is frequently omitted in patients with coronary heart disease. Those who are prescribed nitroglycerin frequently carry a potentially subpotent medication. Education is necessary for both patients and physicians. The findings have implications for counseling patients who are enrolled in exercise-based cardiac rehabilitation programs.

Synthesis, electrochemistry and luminescence of [Pt{4'-(R)trpy}(CN)](+) (R = Ph, o-CH(3)C(6)H(4), o-ClC(6)H(4) or o-CF(3)C(6)H(4); trpy = 2,2':6',2''-terpyridine): crystal structure of [Pt{4'-(Ph)trpy}(CN)]BF(4) x CH(3)CN.

The synthesis and characterization of [Pt{4'-(R)trpy}(CN)]X (R = Ph, X = BF(4) or SbF(6); R = o-CH(3)C(6)H(4), X = SbF(6); R = o-ClC(6)H(4), X = SbF(6); or R = o-CF(3)C(6)H(4), X = SbF(6)) are described where trpy = 2,2':6',2''-terpyridine. Single crystals of [Pt{4'-(Ph)trpy}(CN)]BF(4).CH(3)CN were grown by vapour diffusion of diethyl ether into an acetonitrile solution of [Pt{4'-(Ph)trpy}(CN)]BF(4). An X-ray crystal structure determination of the solvated complex confirms the near linear coordination of the cyanide ligand to the platinum centre. The cation is almost planar as evidenced by a twist of only 1.9 degrees of the phenyl group out of the plane of the terpyridyl moiety. Cyclic voltammograms were recorded in DMF/0.1 M TBAH for the [Pt{4'-(R)trpy}(CN)](+) cations. Two quasi-reversible one-electron reduction (cathodic) waves are observed with E(1/2) values that show the trend expected for an increasingly lower energy of the trpy-based LUMO of the complex i.e., [Pt{4'-(Ph)trpy}(CN)](+) approximately [Pt{4'-(o-CH(3)C(6)H(4))trpy}(CN)](+) < [Pt{4'-(o-ClC(6)H(4))trpy}(CN)](+) < [Pt{4'-(o-CF(3)C(6)H(4))trpy}(CN)](+). All the [Pt(4'-(R)trpy}(CN)](+) cations are photoluminescent in dichloromethane. Emission by [Pt{4'-(Ph)trpy}(CN)](+) is from an excited state with largely (3)MLCT orbital parentage, but with some intraligand (3)pi-pi* character mixed-in (tau = 0.1 micros). In contrast, the other three cations display emission that appears exclusively intraligand (3)pi-pi* in origin (tau approximately 0.8 micros). Emission spectra have been recorded in a low concentration frozen DME {1 : 5 : 5 (v/v) DMF-MeOH-EtOH} glass. For the R = o-CH(3)C(6)H(4), o-ClC(6)H(4) and o-CF(3)C(6)H(4) cations the envelope of vibronic structure and energies of the vibrational components are essentially the same as that recorded in dichloromethane. However, for the [Pt{4'-(Ph)trpy}(CN)](+) cation, there is a blue-shift in the energies of the vibrational components as compared to that recorded in dichloromethane, as well as a change in the envelope of vibronic structure to a more "domed" pattern; this has been interpreted in terms of a higher percentage of intraligand (3)pi-pi* character in the emitting state for the glass. Increasing the concentration of the glass invariably leads to aggregation of the cations and the consequent development of new low energy bands, such that at 0.200 mM broad peaks centred at ca. 650 and 700 nm dominate the spectrum; these bands are assigned to excimeric (3)pi-pi* and (3)MMLCT emission, respectively.