1.Relevant knowledge status and medication compliance among young and middle-aged patients with ;hypertension
Jing MA ; Qingsheng WANG ; Yu TIAN ; Hong REN ; Yun WANG ; Li LIU ; Xile BI
Chinese Journal of Modern Nursing 2016;22(36):5225-5229
Objective To explore the correlation between relevant knowledge status and drug compliance among young and middle-aged patients with hypertension. Methods We designed questionnaires demonstrated by experts in this field about patients′ general information, status of knowledge related to hypertension and medication compliance. Results Concerning mastery of related knowledge, young and middle-aged patients with hypertension got higher scores in diagnostic criteria, and lower scores in self monitoring and drug treatment;it was statistically significant to compare the relevant knowledge status among young and middle-aged patients with hypertension from different educational backgrounds, occupations and income (P<0.05). Comparison of medication compliance showed statistical significance among patients with different mastery degree of knowledge concerning diagnostic criteria, symptoms, major complications, risk factors, self monitoring and drug therapy (P<0.05); while comparison of medication compliance showed no statistical significance among patients with different mastery degree of knowledge concerning intervention methods and severe hazard ( P>0. 05);it was showed in logistic regression analysis that factors influencing their medication compliance included their mastery degree of risk factors, major complications, drug therapy, self monitoring and diagnosis standard. Conclusions The relevant knowledge status and medication compliance of young and middle-aged patients with hypertension is low. Health education should be emphasized to patients with low level of education or with low income.
2.Right ventricular-arterial uncoupling as an independent prognostic factor in acute heart failure with preserved ejection fraction accompanied with coronary artery disease.
Hongdan JIA ; Li LIU ; Xile BI ; Ximing LI ; Hongliang CONG
Chinese Medical Journal 2023;136(10):1198-1206
BACKGROUND:
Right ventricular (RV)-arterial uncoupling is a powerful independent predictor of prognosis in heart failure with preserved ejection fraction (HFpEF). Coronary artery disease (CAD) can contribute to the pathophysiological characteristics of HFpEF. This study aimed to evaluate the prognostic value of RV-arterial uncoupling in acute HFpEF patients with CAD.
METHODS:
This prospective study included 250 consecutive acute HFpEF patients with CAD. Patients were divided into RV-arterial uncoupling and coupling groups by the optimal cutoff value, based on a receiver operating characteristic curve of tricuspid annular plane systolic excursion to pulmonary artery systolic pressure (TAPSE/PASP). The primary endpoint was a composite of all-cause death, recurrent ischemic events, and HF hospitalizations.
RESULTS:
TAPSE/PASP ≤0.43 provided good accuracy in identifying patients with RV-arterial uncoupling (area under the curve, 0.731; sensitivity, 61.4%; and specificity, 76.6%). Of the 250 patients, 150 and 100 patients could be grouped into the RV-arterial coupling (TAPSE/PASP >0.43) and uncoupling (TAPSE/PASP ≤0.43) groups, respectively. Revascularization strategies were slightly different between groups; the RV-arterial uncoupling group had a lower rate of complete revascularization (37.0% [37/100] vs . 52.7% [79/150], P <0.001) and a higher rate of no revascularization (18.0% [18/100] vs . 4.7% [7/150], P <0.001) compared to the RV-arterial coupling group. The cohort with TAPSE/PASP ≤0.43 had a significantly worse prognosis than the cohort with TAPSE/PASP >0.43. Multivariate Cox analysis showed TAPSE/PASP ≤0.43 as an independent associated factor for the primary endpoint, all-cause death, and recurrent HF hospitalization (hazard ratios [HR]: 2.21, 95% confidence interval [CI]: 1.44-3.39, P <0.001; HR: 3.32, 95% CI: 1.30-8.47, P = 0.012; and HR: 1.93, 95% CI: 1.10-3.37, P = 0.021, respectively), but not for recurrent ischemic events (HR: 1.48, 95% CI: 0.75-2.90, P = 0.257).
CONCLUSION
RV-arterial uncoupling, based on TAPSE/PASP, is independently associated with adverse outcomes in acute HFpEF patients with CAD.
Humans
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Prognosis
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Prospective Studies
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Stroke Volume/physiology*
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Echocardiography, Doppler/adverse effects*
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Coronary Artery Disease/complications*
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Heart Failure
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Pulmonary Artery/diagnostic imaging*
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Ventricular Function, Right/physiology*
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Ventricular Dysfunction, Right