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chronic heart failure:Role of the GP in management

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Family Medicine and Community Health 2018年第1期6卷 3-9页

作者： Leon Piterman Hui Yang Zhaoxia Yin Department of General Practice Monash UniversityMelbourneVictoriaAustralia China GP Program Monash Institute of Health and Clinical EducationMelbourneVictoriaAustralia Shenzhen International Primary Health Care Research Institute ShenzhenGuangdongChina The Third Affiliated Hospital of Shenzhen University Luohu Hospital GroupShenzhenGuangdongChina

The commonest cause of chronic heat failure in China is ischemic heart disease,followed by hypertension and valvular heart *** is essential in establishing a diagnosis as well as helping to identify a cause and to monitor *** includes nonpharmacological as well as pharmacological treatment,and self-care with careful monitoring of salt and fluid intake as well as regular weight *** planning and team-based care are essential in managing patients with chronic heart failure,who often have concurrent multimorbidity and are receiving polypharmacy.

关键词： chronic heart failure general practice team based care

The traditional Chinese medicines treat chronic heart failure and their main bioactive constituents and mechanisms

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Acta Pharmaceutica Sinica B 2023年第5期13卷 1919-1955页

作者： Jie Chen Xiaohong Wei Qian Zhang Yuzhuo Wu Guiyang Xia Huan Xia Lingyan Wang Hongcai Shang Sheng Lin Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing Dongzhimen HospitalBeijing University of Chinese MedicineBeijing 100700China

chronic heart failure(CHF)is a severe public health problem with increasing morbidity and mortality,any treatment targeting a single session is insufficient to tackle *** is characterized by reduced cardiac output resulting from neurohumoral dysregulation and cardiac remodeling,which might be related to oxidative stress,inflammation,endoplasmic reticulum stress,apoptosis,autophagy,mitochondrial function,and *** molecular mechanisms interact with each other through ***,Chinese medicinal herbs have been widely applied in the treatment of CHF,and therapeutic effects of Chinese medicinal herbs and their ingredients have been scientifically confirmed over the past *** Chinese medicine(TCM)with multiple components can confront the different pathogenesis of CHF through multiple *** review analyzes commonly used TCM patent drugs and TCM decoctions that are applicable to different stages of CHF based on clinical *** bioactive ingredients in Chinese medicinal herbs have been found to treat CHF via multiple molecular *** review comprehensively covers the key works on the effects and underlying mechanisms of TCM,herbal ingredients and synergistic effects of constituent compatibility in treating CHF,providing additional ideas to address this threat.

关键词： Natural ingredients chronic heart failure Cardiac remodeling Chinese medicinal herbs Traditional Chinese medicine formula Multiple targets Constituent compatibility Synergistic effects

Effect of Shenmai Injection on Long-Term Prognosis of Patients with chronic heart failure:A Multicenter,Large Sample Capacity,Long-Term Follow-Up Retrospective Cohort Study

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Chinese Journal of Integrative Medicine 2022年第4期28卷 312-318页

作者： GUAN Hui DAI Guo-hua GAO Wu-lin ZHANG Tong SUN Cong REN Li-li HOU Xiao-ming LIU Zhang The First Clinical Medical College Shandong University of Traditional Chinese MedicineJinan250014China Affiliated Hospital of Shandong University of Traditional Chinese Medicine Jinan250011China

Objective:To explore the effect of Shenmai Injection(SMI)on the long-term prognosis of patients with chronic heart failure(CHF).Methods:The Hospital Information System was used to extract data of CHF patients,and the retrospective cohort study was conducted for *** non-exposed group,standardized Western medicine treatment and Chinese patent medicine or decoction were applied without combination of SMI while in the exposed group,SMI were applied for more than 7 *** indicators are followed with New York heart Association functional classification(NYHA classification),left ventricular ejection fraction(LVEF),N-terminal brain natriuretic peptide precursor(NT-ProBNP),cardiogenic death and heart failure(HF)*** analysis includes Kaplan-Meier analysis and Cox regression which are used to explore the relationship between SMI and outcome ***:A total of 1,211 eligible CHF patients were involved and finally 1,047 patients were followed up *** treatment,the cases of NYHA classification decline in the exposed and non-exposed groups accounted for 64.30%and 43.45%,respectively;the improvement values of LVEF were 8.89%and 7.91%,respectively;the improvement values of NT-ProBNP were 909 pg/mL and 735 pg/mL,*** exposure on SMI,the rates of cardiogenic death and HF readmission reduced from 15.43%to 10.18%and 38.93%to 32.37%.According to Kaplan-Meier analysis,the log-rank P value of SMI and cardiogenic death was 0.014,while the counterpart of SMI and HF readmission was *** regression analysis indicated that for cardiogenic death,age,cardiomyopathy,diabetes,and NYHA classification were risk factors whileβ-blockers,aldosterone receptor antagonists,Chinese patent medicine/decoction and SMI were protective ***,for HF readmission,age,cardiomyopathy,and NYHA classification were risk factors while SMI was a protective ***:Combination with SMI on the standardized Western medicine tre

关键词： Shenmai Injection chronic heart failure cohort study outcome events long-term prognosis

Depression and chronic heart failure in the elderly： an intriguing relationship

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Journal of Geriatric Cardiology 2018年第6期15卷 451-459页

作者： Ilaria Liguori Gennaro Russo Francesco Curcio Giuseppe Sasso David Della-Morte Gaetano Gargiulo Flora Pirozzi Francesco Cacciatore Domenico Bonaduce Pasquale Abete Gianluca Testa Department of Translational Medical Sciences University of Naples 'Federico Ⅱ' Naples Italy Department of Systems Medicine University of Rome Tor Vergata Rome ltaly IRCCS San Raffaele Pisana Rome Italy Division of Internal Medicine A OU San Giovanni di Dio e Ruggi di Aragona Salerno Italy Azienda Ospedaliera dei Colli Monaldi Hospital Heart Transplantation Unit Naples Italy Department of Medicine and Health Sciences University of Molise Campobasso Italy

chronic heart failure and depressive disorders have a high prevalence and incidence in the elderly. Several studies have shown how depression tends to exacerbate coexisting chronic heart failure and its clinical outcomes and vice versa, especially in the elderly. The negative synergism between chronic heart failure and depression in the elderly may be approached only taking into account the multifaceted pathophysiological characteristics underlying both these conditions, such as behavioural factors, neurohormonal activation, inflammatory mediators, hypercoagulability and vascular damage. Nevertheless, the pathophysiological link between these two conditions is not well established yet. Despite the high prevalence of depression in chronic heart failure elderly patients and its negative prognostic value, it is often unrecognized especially because of shared symptoms. So the screening of mood disorders, using reliable questionnaires, is recommended in elderly patients with chronic heart failure, even if cannot substitute a diagnostic interview by mental health professionals. In this setting, treatment of depression requires a multidisciplinary approach including： psychotherapy, antidepressants, exercise training and electroconvulsive therapy. Pharmacological therapy with selective serotonin reuptake inhibitors, despite conflicting results, improves quality of life but does not guarantee better outcomes. Exercise training is effective in improving quality of life and prognosis but at the same time cardiac rehabilitation services are vastly underutilized.

关键词： chronic heart failure Depression The elderly

Qishen Taohong Granule as Adjuvant Therapy for Improving Cardiac Function and Quality of Life in Patients with chronic heart failure:A Randomized Controlled Trial

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Chinese Journal of Integrative Medicine 2022年第1期28卷 12-19页

作者： LI Xing-xing WU Yang FAN Zong-jing CUI Jie LI Dong LIN Quan ZHUANG Rui YAN Rong-kun LIN Qian LI Yan Department of Graduate School Beijing University of Chinese MedicineBeijing(100029)China Department of Cardiology Dongfang HospitalBeijing University of Chinese MedicineBeijing(100078)China Department of Cardiology Xiyuan HospitalChina Academy of Chinese Medical SciencesBeijing(100091)China Department of Cardiology Dongzhimen HospitalBeijing University of Chinese MedicineBeijing(100700)China

Objective:To confirm the improvement of cardiac function and quality of life(QoL)in patients with chronic heart failure(CHF)via Chinese medicine(CM)Qishen Taohong Granule(QTG).Methods:This study was a single-center,prospective,randomized,controlled clinical ***-six patients from 27 to 84 years old diagnosed with CHF New York heart Association(NYHA)classⅡorⅢin stage C were enrolled and randomly assigned at a 1:1 ratio to receive QTG or trimetazidine(TMZ),in addition to their standard medications for the treatment of *** study period was 4 *** primary outcomes included cardiac function evaluated by NYHA classification and left ventricular ejection fraction(LVEF),as well as QoL evaluated by CHF Integrated Chinese and Western Medicine Survival Scale(CHFQLS).The secondary outcomes included 6-min walking test(6 MWT),CM syndrome score,symptom and sign scores and N-terminal pro-B-type natriuretic peptide level(NT-proBNP).All indices were measured at baseline and the end of the ***:At the 4-week follow-up period,the effective rate according to NYHA classification in the QTG group was better than that in the TMZ group(74.29%vs.54.29%,P0.05).The CHFQLS scores improved by 13.82±6.04 vs.7.49±2.28 in the QTG and TMZ groups,respectively(P<0.05).Subgroup analysis of the CHFQLS results showed that physiological function,role limitation and vitality were significantly higher in the QTG group than in the TMZ group(15.76±7.85 vs.7.40±3.36,P<0.05;16.00±8.35 vs.10.53±4.64,P<0.05;15.31±8.09 vs.7.89±4.60,P<0.05).Compared with TMZ group,treatment with QTG also demonstrated superior performance with respect to 6 MWT,CM syndrome,shortness of breath,fatigue,gasping,general edema and NT-proBNP *** significant adverse reactions or adverse cardiac events occurred during treatment in either ***:In addition to conventional treatments,the use of QTG a

关键词： chronic heart failure Chinese medicine Qishen Taohong Granule cardiac function quality of life

Is heart rate reduction more important than target dose in chronic heart failure therapy with a beta-blocker?

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Journal of Geriatric Cardiology 2011年第4期8卷 260-262页

作者： Yong-Fang Guo Yi An Department of Cardiology The Affiliated Hospital of Medical College of Qingdao UniversityQingdao 266000Shandong ProvinceChina

1 Introduction Beta-adrenoceptor blocking agents(beta-blockers)are now well established as cornerstone therapy in patients with systolic chronic heart failure(CHF).[1]Clinical data have overwhelmingly proven the beneficial effects of beta-blocker therapy in terms of improving patient prognosis,decreasing requirements for hospitalization,and postponing disease progression.[2-4]However,it remains unclear what the optimal efficacious and safe dose for an individual patient with CHF is,and whether this can simply be inferred from the target dose for each beta-blocking agent as used in the major clinical trials.

关键词： heart rate beta-blockers chronic heart failure

Long-term Administration of Angiotension-Converting Enzyme Inhibitor Improves the Outcome of chronic heart failure in Senile Patients

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2002年第3期22卷 257-259页

作者：陈学林张劲农柯琴梅张银环刘承云 Geridtric Department Xiehe Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan

One hundred and sixteen senile patients (older than 65 years) with chronic heart failure (CHF) were analyzed retrospectively in order to verify if old patients with CHF would benefit from long term (one year) angiotension converting enzym e inhibitor (ACEI) treatment. The frequency of drugs (including ACEI, digitalis and diuretic) used was stratified into four degrees accordingly. Develop ment of the CHF was scored with regard to relapse rate and severity of this dise ase. Stepwise regression analysis was applied to explore the relationship betwee n the scored outcome of CHF and the frequency of individual drug administration. A significant relationship of the scored outcome of CHF to the frequency of ACE I usage but not to digitalis nor to diuretics was found (partial coefficient of the correlation r =0.42, P =0.002). It was concluded that the long term a dministration of ACEI improves the outcome of CHF in senile patients.

关键词： geratology chronic heart failure angiotensio n converting enzyme inhibitor

Lyophilized recombinant human brain natriuretic peptide for chronic heart failure:Effects on cardiac function and inflammation

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世界临床病例杂志 2023年第26期11卷 6066-6072页

作者： Feng Li Hao Li Rong Luo Jia-Bao Pei Xue-Ying Yu Department of Cardiovascular Internal Medicine People's Hospital of JieshouJieshou 236500Anhui ProvinceChina

BACKGROUND chronic heart failure(CHF)is a serious and prevalent condition characterized by impaired cardiac function and *** therapy for CHF has limitations,prompting the exploration of alternative *** human brain natriuretic peptide(BNP)has emerged as a potential therapy,with evidence suggesting that it can improve cardiac function and reduce inflammation in patients with ***,further research is required to determine the efficacy and safety of lyophilized recombinant human BNP in CHF patients and its impact on microinflammatory *** study aimed to investigate the effects of lyophilized recombinant human BNP therapy on CHF patients’cardiac function and microinflammatory *** To investigate the effects of freeze-dried recombinant human BNP therapy on cardiac function and microinflammatory status in patients with *** In total,102 CHF patients admitted to our hospital from January 2021 to January 2022 were randomly assigned to control and observation groups(n=51 patients/group).The control patients were treated with standard HF therapy for 3 d,whereas the observational patients were injected with the recombinant human BNP for 3 *** efficacy,inflammatory factor levels,myocardial damage,cardiac function before and after the treatment,and adverse reactions during treatment were compared between the two *** The overall clinical efficacy was higher in the observation group than in the control *** with baseline,serum hypersensitive C-reactive protein,N-terminal proBNP,and troponin I level,and physical,emotional,social,and economic scores were lower in both groups after treatment,with greater reductions in levels and scores noted in the observation group than in the control *** overall incidence of adverse reactions in the observation group was not significantly different compared with that in the control group(P>0.05).CONCLUSION Freeze-dried recombinant human BNP therapy can

关键词： chronic heart failure Lyophilized recombinant human brain natriuretic peptide Cardiac function Microinflammatory state

Electrophysiological changes of autonomic cells in left ventricular outflow tract in guinea pigs with iron deficiency anemia complicated with chronic heart failure

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Asian Pacific Journal of Tropical Medicine 2017年第12期10卷 1197-1200页

作者： Ling Fan Li-Feng Chen Jing Fan Department of Hematology The First Affiliated Hospital of Hebei North University Department of Physiology Basic Medical College Hebei North University Department of Obstetrics and Gynecology The Sixth Hospital of Zhangjiakou

Objective: To investigate the electrophysiological changes of autonomic cells in left ventricular outflow tract in guinea pigs with iron deficiency anemia complicated with chronic heart ***: Guinea pigs model of iron deficiency anemia complicated with chronic heart failure in 10 guinea pigs of the experimental group was made by feeding a low iron diet,pure water and subcutaneous injection of isoproterenol. The control group consisting of 11 guinea pigs was given normal food, normal water and injected with normal saline. The left ventricular outflow tract model specimen was also prepared. The standard microelectrode technique was used to observe electrophysiological changes of autonomic cells in the outflow tract of left ventricular heart failure complicated with iron deficiency anemia in guinea pig model. The indicators of observation were maximal diastolic potential, action potential amplitude, 0 phase maximal depolarization velocity, 4 phase automatic depolarization velocity, repolarization 50% and 90%, and spontaneous discharge ***: Compared with the control group, 4 phase automatic depolarization velocity,spontaneous discharge frequency and 0 phase maximal depolarization velocity decreased significantly(P heart failure.

关键词： Iron deficiency anemia chronic heart failure Guinea pig model Autonomic cells Left ventricular outflow tract Electrophysiology