Clinic and ambulatory heart rates in patients with ischaemic heart disease and/or chronic heart failure taking rate-limiting medications: are they interchangeable?
نویسندگان
چکیده
BACKGROUND The prognostic benefit from heart rate (HR) reduction in patients with ischaemic heart disease (IHD) and/or chronic heart failure (CHF) is now firmly established. Most decisions regarding initiation and/or dose adjustment of HR-limiting medications in such patients are based on clinic HR. Yet, this is a highly variable parameter that may not necessarily reflect HR control over the 24 h period. OBJECTIVE To examine the level of agreement between mean clinic and mean ambulatory HRs in patients with IHD and/or CHF taking rate-limiting medications. METHODS Prospective, observational study. Fifty patients with IHD and/or CHF who attended cardiology outpatient clinics at the Manchester Heart Centre and underwent same-day 24 h continuous ECG recording between March and October 2013 were included in the study. Mean clinic HR was compared with mean 24 h, daytime and night-time HRs. Limits-of-agreement plots were constructed to examine the relationship between the two HR measures in more detail. RESULTS The mean clinic HR was numerically similar to the mean HRs of all ambulatory time periods examined. However, on Bland-Altman plots, the limits of agreement between clinic and ambulatory HR means were quite wide, with the mean clinic HR ranging between 10.93 and 13.58 bpm below and 8.4 and 18.15 bpm above the mean ambulatory HR. CONCLUSIONS Although numerically similar, the means of clinic and ambulatory HRs in patients with IHD and/or CHF display wide limits of agreement. As such, the two measures cannot be regarded as interchangeable.
منابع مشابه
تاثیر بازدید منزلبر پذیرشمجدد بیمارانمبتلا بهنارساییقلبی
Background : Heart failure is a chronic disease with relapsing nature. As a result the recurrent hospitalization of patient with heart failure has become a major topic of discussion in the field of health care. Various studies has shown that home visit exert a positive influence on readmission and mortality rate in these patients. Objective : To determine the effect of home visit on readmis...
متن کاملSelf-care behaviors in patients with systolic heart failure
Background and Purpose: To improve life quality, and lower mortality and rehospitalization for heart failure patients, awareness and adherence to self-care behaviors are essential. This study aims to determine the adherence level to self-care behaviors in the patients with systolic heart failure hospitalized in Alborz hospital in Karaj andShahriar hospital, and it was conducted in 2013. Methods...
متن کاملHypotension in patients with coronary disease: can profound hypotensive events cause myocardial ischaemic events?
OBJECTIVE To determine whether anginal episodes might be related to extremes of hypotension in patients with ischaemic heart disease taking drugs to treat angina and heart failure. DESIGN AND SETTING Observational study of patients with ischaemic heart disease attending an urban tertiary referral cardiology centre. INTERVENTIONS AND OUTCOME MEASURES A selected patient population was enrolle...
متن کاملمقایسه تأثیر آموزش به بیمار با یا بدون مشارکت خانواده بر پیروی از رژیم درمانی در مبتلایان به نارسایی مزمن قلبی
Introduction: Adherence to treatment programs is a major challenge in patients with chronic heart failure. In the event of non-compliance, these patients will be associated with adverse health outcomes. Since the interventions such as training to improve adherence to health regimens have a special place, this study aimed to compare the effect of the patients’ education with or without their fam...
متن کاملGuideline Compliance in Chronic Heart Failure Patients with Multiple Comorbid Diseases: Evaluation of an Individualised Multidisciplinary Model of Care
OBJECTIVE To assess the impact of individualised, reconciled evidence-based recommendations (IRERs) and multidisciplinary care in patients with chronic heart failure (CHF) on clinical guideline compliance for CHF and common comorbid conditions. DESIGN AND SETTING A retrospective hospital clinical audit conducted between 1st July 2006 and February 2011. PARTICIPANTS A total of 255 patients w...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Postgraduate medical journal
دوره 91 1071 شماره
صفحات -
تاریخ انتشار 2015