Living with Family and Clinical, Demographic, and Laboratory Characteristics in Patients with Heart Failure
Abstract
Objective: Heart failure (HF) is a progressive clinical syndrome associated with significant morbidity and mortality. It is known that during the course of this syndrome, social factors can impact clinical outcomes alongside medical interventions. Studies have demonstrated that social support provides favorable developments in mortality rates, event-free survival, and readmission rates in HF patients. In our study, we aimed to elucidate the effects of the concept of family, the most significant social support, on clinical characteristics, exercise capacity, echocardiographic, and laboratory features in HF cases. Methods: A multicenter cohort study was conducted, including 303 patients previously diagnosed with HF, following current guidelines and presenting for outpatient follow-up. Patients with a new diagnosis of HF, those with acute decompensated HF, and those with a history of malignancy were excluded from the study. Demographic data (age, gender), comorbidities (hypertension, diabetes mellitus, atrial fibrillation, etc.), HF treatments, laboratory tests, and detailed transthoracic echocardiography results were recorded. Results: Patients were divided into two groups based on whether they lived with a spouse, parent, child, or without any of them, defining the presence or absence of family support. In the study, 303 patients with an average age of 62.1±13.0, of which 94 (31%) were female, were included. The mean left ventricular ejection fraction was 28.7±8.1. When the groups were compared in terms of comorbidities, there was no statistically significant difference in the presence of hypertension, diabetes mellitus, hyperlipidemia, chronic obstructive pulmonary disease, stroke, or atrial fibrillation (all p>0.005). Coronary artery disease was more frequently observed in the group with family support, while chronic kidney disease was more common in the group without family support (p=0.008 and p=0.012, respectively). Smoking prevalence was significantly higher in the group without family support, while alcohol use showed no significant difference (p=0.046 and p=0.602, respectively). Analyzing the results, it was observed that patients with family support were more regularly monitored for HF reasons (71% vs. 59%, p=0.054). Conclusion: It has been observed that the social support provided by family members in individuals with HF can have positive effects on the clinical course of the disease and the patient's lifestyle.
Keywords
References
- Bozkurt B, Coats AJS, Tsutsui H, et al. Universal definition and classification of heart failure: a report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure: Endorsed by the Canadian Heart Failure Society, Heart Failure Association of India, Cardiac Society of Australia and New Zealand, and Chinese Heart Failure Association. Eur J Heart Fail. 2021 Mar;23(3):352-380.
- Savarese G, Becher PM, Lund LH, Seferovic P, Rosano GMC, Coats AJS. Global burden of heart failure: a comprehensive and updated review of epidemiology. Cardiovasc Res. 2023 Jan 18;118(17):3272-3287.
- Celik A, Ural D, Sahin A, et al. Trends in heart failure between 2016 and 2022 in Türkiye (TRends-HF): a nationwide retrospective cohort study of 85 million individuals across entire population of all ages. Lancet Reg Health Eur. 2023 Sep 5;33:100723. doi: 10.1016/j.lanepe.2023.100723.
- Ruppar TM, Cooper PS, Mehr DR, Delgado JM, Dunbar-Jacob JM. Medication Adherence Interventions Improve Heart Failure Mortality and Readmission Rates: Systematic Review and Meta-Analysis of Controlled Trials. J Am Heart Assoc. 2016 Jun 17;5(6):e002606.
- Luttik ML, Jaarsma T, Moser D, Sanderman R, van Veldhuisen DJ. The importance and impact of social support on outcomes in patients with heart failure: an overview of the literature. J Cardiovasc Nurs. 2005 May-Jun;20(3):162-9.
- Senturk B, Kaya H, Celik A, Bekar L, Gungor H, Zoghi M, Ural D, Cavusoglu Y, Temizhan A, Yilmaz MB. Marital status and outcomes in chronic heart failure: Does it make a difference of being married, widow or widower? North Clin Istanb. 2021 Jan 29;8(1):63-70.
- Chin MH, Goldman L. Correlates of early hospital readmission or death in patients with congestive heart failure. Am J Cardiol 1997;79:1640– 4.
- Chung ML, Lennie TA, Riegel B, Wu JR, Dekker RL, Moser DK. Marital status as an independent predictor of event-free survival of patients with heart failure. Am J Crit Care 2009;18:562–70.
- Friedmann E, Thomas SA, Liu F, Morton PG, Chapa D, Gottlieb SS; Sudden Cardiac Death in Heart Failure Trial Investigators. Relationship of depression, anxiety, and social isolation to chronic heart failure outpatient mortality. Am Heart J 2006;152:940.e1–8.
- Krumholz HM, Butler J, Miller J, Vaccarino V, Williams CS, Mendes de Leon CF, et al. Prognostic importance of emotional support for elderly patients hospitalized with heart failure. Circulation 1998;97:958–64.
- Vinson JM, Rich MW, Sperry JC, Shah AS, McNamara T. Early readmission of elderly patients with congestive heart failure. J Am Geriatr Soc 1990;38:1290–5.
- Luttik ML, Jaarsma T, Veeger N, van Veldhuisen DJ. Marital status, quality of life, and clinical outcome in patients with heart failure. Heart Lung 2006;35:3–8.
- Lu MLR, Davila CD, Shah M, Wheeler DS, Ziccardi MR, Banerji S, et al. Marital status and living condition as predictors of mortality and readmissions among African Americans with heart failure. Int J Cardiol 2016;222:313–8.
- Galderisi M, Cosyns B, Edvardsen T et al. 2016–2018 EACVI Scientific Documents Committee; 2016–2018 EACVI Scientific Documents Committee. Standardization of adult transthoracic echocardiography reporting in agreement with recent chamber quantification, diastolic function, and heart valve disease recommendations: an expert consensus document of the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2017 Dec 1;18(12):1301-1310.
- Tel Aydın H, Günay D. The determination of the supportive care needs of patients diagnosed with cancer. Cumhuriyet Medical Journal. 2020;42(2), 152-162.
- Caraballo C, Desai NR, Mulder H et al. Clinical Implications of the New York Heart Association Classification. J Am Heart Assoc. 2019 Dec 3;8(23):e014240.
- Crespo-Leiro MG, Anker SD, Maggioni AP, et al. Heart Failure Association (HFA) of the European Society of Cardiology (ESC). European Society of Cardiology Heart Failure Long-Term Registry (ESC-HF-LT): 1-year follow-up outcomes and differences across regions. Eur J Heart Fail. 2016 Jun;18(6):613-25.
- Joseph P, Roy A, Lonn E, et al. Global Variations in Heart Failure Etiology, Management, and Outcomes. JAMA. 2023 May 16;329(19):1650-1661.
- Tsutsui H, Albert NM, Coats AJS et al.Natriuretic peptides: role in the diagnosis and management of heart failure: a scientific statement from the Heart Failure Association of the European Society of Cardiology, Heart Failure Society of America and Japanese Heart Failure Society. Eur J Heart Fail. 2023 May;25(5):616-631.
- Schefold JC, Filippatos G, Hasenfuss G, Anker SD, von Haehling S. Heart failure and kidney dysfunction: epidemiology, mechanisms and management. Nat Rev Nephrol. 2016 Oct;12(10):610-23.
- Wang K, Ni G, Wu Q, Zhou Y, Yao W, Zhang H, Li X. Prognostic Value of N-Terminal Pro-B-Type Natriuretic Peptide and Glomerular Filtration Rate in Patients with Acute Heart Failure. Front Cardiovasc Med. 2020 Jul 21;7:123.
- Kondo T, Nakano Y, Adachi S, Murohara T. Effects of Tobacco Smoking on Cardiovascular Disease. Circ J. 2019 Sep 25;83(10):1980-1985.
- Watkins T, Mansi M, Thompson J, Mansi I, Parish R. Effect of marital status on clinical outcome of heart failure. J Investig Med. 2013 Jun;61(5):835-41.
- Enard KR, Coleman AM, Yakubu RA, Butcher BC, Tao D, Hauptman PJ. Influence of Social Determinants of Health on Heart Failure Outcomes: A Systematic Review. J Am Heart Assoc. 2023 Feb 7;12(3):e026590.
- Kewcharoen J, Thangjui S, Kanitsoraphan C, Techorueangwiwat C, Mekraksakit P, Vutthikraivit W. The effects of marital status on outcome of heart failure population: a systematic review and metaanalysis. Acta Cardiol. 2021 Feb;76(1):11-19.
Kalp Yetersizliği Hastalarında Aileyle Birlikte Yaşamanın Hastalığın Klinik, Demografik ve Laboratuvar Özellikleriyle İlişkisi
Abstract
Amaç: Kalp yetersizliği (KY) ciddi morbidite ve mortalite ile seyredebilen ilerleyici klinik bir sendromdur. KY seyri sırasında tıbbi müdahalelerin yanı sıra, sosyal faktörlerin de klinik sonuçları etkileyebileceği bilinmektedir. Sosyal desteğin KY hastalarında mortalite, olaysız sağ kalım ve yeniden yatış oranlarında tatmin edici gelişmeler sağladığı gösterilmiştir Biz de çalışmamızda en büyük sosyal destekleyici olan aile kavramının KY olgularında klinik özellikler, egzersiz kapasitesi, ekokardiyografik ve laboratuar özellikleri üzerine olan etkilerini ortaya koymayı amaçladık. Yöntem: Çok merkezli, kesitsel olarak yapılan çalışmaya güncel kılavuzlara uygun olarak daha önce KY tanısı koyulan ve ayaktan takip amacıyla poliklinik başvurusu olan 303 hasta dahil edildi. Yeni tanı KY, akut dekompanse KY olan hastalar ile malignite öyküsü olanlar çalışmadan dışlandı. Hastaların demografik verileri (yaş, cinsiyet), komorbiditeler (hipertansiyon, diabetes mellitus, atriyal fibrilasyon vb.), kullandıkları KY tedavileri, laboratuvar testleri ve ayrıntılı transtorasik ekokardiyografi sonuçları dahil olmak üzere ayrıntılı klinik verileri kaydedildi. Hastalar eş, anne, baba veya çocuklarıyla aynı evde yaşıyorsa aile desteği olanlar, bunlardan herhangi biri yoksa aile desteği olmayanlar şeklinde 2 gruba ayrılarak karşılaştırıldı. Bulgular: Çalışmaya 94’ü (%31) kadın ve yaş ortalaması 62,1±13,0 olan 303 KY tanılı hasta dahil edildi. Hastaların ortalama sol ventrikül ejeksiyon fraksiyonu 28,7±8,1 idi. Gruplar komorbiditeler açısından karşılaştırıldığında hipertansiyon, diyabetes mellitus, hiperlipidemi, kronik obstruktif akciğer hastalığı, inme, atrial fibrilasyon varlığı açısından istatistiksel anlamlı fark yoktu (hepsi için, p>0.005). Koroner arter hastalığı aile desteği olan grupta anlamlı şekilde daha sık görülmekteyken kronik böbrek hastalığı ise aile desteği olmayan grupta daha sık izlenmekteydi. (sırasıyla p=0,008 ve p=0,012). Sigara kullanımı aile desteği olmayan grupta anlamlı şekilde daha yüksek iken alkol kullanım oranları arasında fark izlenmedi (sırasıyla p=0,046 ve p=0,602). Yapılan analizler sonunda aile desteği olan gruptaki hastaların KY nedeniyle daha yüksek oranda düzenli takipte olduğu görüldü (%71 vs. %59, p=0,054). Sonuç: KY sahip kişilerde aile bireyleri tarafından oluşturulan sosyal desteğin hastalığın klinik seyri ve hastanın yaşam alışkanlıkları üzerine olumlu etkileri olabileceği görülmüştür.
Keywords
References
- Bozkurt B, Coats AJS, Tsutsui H, et al. Universal definition and classification of heart failure: a report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure: Endorsed by the Canadian Heart Failure Society, Heart Failure Association of India, Cardiac Society of Australia and New Zealand, and Chinese Heart Failure Association. Eur J Heart Fail. 2021 Mar;23(3):352-380.
- Savarese G, Becher PM, Lund LH, Seferovic P, Rosano GMC, Coats AJS. Global burden of heart failure: a comprehensive and updated review of epidemiology. Cardiovasc Res. 2023 Jan 18;118(17):3272-3287.
- Celik A, Ural D, Sahin A, et al. Trends in heart failure between 2016 and 2022 in Türkiye (TRends-HF): a nationwide retrospective cohort study of 85 million individuals across entire population of all ages. Lancet Reg Health Eur. 2023 Sep 5;33:100723. doi: 10.1016/j.lanepe.2023.100723.
- Ruppar TM, Cooper PS, Mehr DR, Delgado JM, Dunbar-Jacob JM. Medication Adherence Interventions Improve Heart Failure Mortality and Readmission Rates: Systematic Review and Meta-Analysis of Controlled Trials. J Am Heart Assoc. 2016 Jun 17;5(6):e002606.
- Luttik ML, Jaarsma T, Moser D, Sanderman R, van Veldhuisen DJ. The importance and impact of social support on outcomes in patients with heart failure: an overview of the literature. J Cardiovasc Nurs. 2005 May-Jun;20(3):162-9.
- Senturk B, Kaya H, Celik A, Bekar L, Gungor H, Zoghi M, Ural D, Cavusoglu Y, Temizhan A, Yilmaz MB. Marital status and outcomes in chronic heart failure: Does it make a difference of being married, widow or widower? North Clin Istanb. 2021 Jan 29;8(1):63-70.
- Chin MH, Goldman L. Correlates of early hospital readmission or death in patients with congestive heart failure. Am J Cardiol 1997;79:1640– 4.
- Chung ML, Lennie TA, Riegel B, Wu JR, Dekker RL, Moser DK. Marital status as an independent predictor of event-free survival of patients with heart failure. Am J Crit Care 2009;18:562–70.
- Friedmann E, Thomas SA, Liu F, Morton PG, Chapa D, Gottlieb SS; Sudden Cardiac Death in Heart Failure Trial Investigators. Relationship of depression, anxiety, and social isolation to chronic heart failure outpatient mortality. Am Heart J 2006;152:940.e1–8.
- Krumholz HM, Butler J, Miller J, Vaccarino V, Williams CS, Mendes de Leon CF, et al. Prognostic importance of emotional support for elderly patients hospitalized with heart failure. Circulation 1998;97:958–64.
- Vinson JM, Rich MW, Sperry JC, Shah AS, McNamara T. Early readmission of elderly patients with congestive heart failure. J Am Geriatr Soc 1990;38:1290–5.
- Luttik ML, Jaarsma T, Veeger N, van Veldhuisen DJ. Marital status, quality of life, and clinical outcome in patients with heart failure. Heart Lung 2006;35:3–8.
- Lu MLR, Davila CD, Shah M, Wheeler DS, Ziccardi MR, Banerji S, et al. Marital status and living condition as predictors of mortality and readmissions among African Americans with heart failure. Int J Cardiol 2016;222:313–8.
- Galderisi M, Cosyns B, Edvardsen T et al. 2016–2018 EACVI Scientific Documents Committee; 2016–2018 EACVI Scientific Documents Committee. Standardization of adult transthoracic echocardiography reporting in agreement with recent chamber quantification, diastolic function, and heart valve disease recommendations: an expert consensus document of the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2017 Dec 1;18(12):1301-1310.
- Tel Aydın H, Günay D. The determination of the supportive care needs of patients diagnosed with cancer. Cumhuriyet Medical Journal. 2020;42(2), 152-162.
- Caraballo C, Desai NR, Mulder H et al. Clinical Implications of the New York Heart Association Classification. J Am Heart Assoc. 2019 Dec 3;8(23):e014240.
- Crespo-Leiro MG, Anker SD, Maggioni AP, et al. Heart Failure Association (HFA) of the European Society of Cardiology (ESC). European Society of Cardiology Heart Failure Long-Term Registry (ESC-HF-LT): 1-year follow-up outcomes and differences across regions. Eur J Heart Fail. 2016 Jun;18(6):613-25.
- Joseph P, Roy A, Lonn E, et al. Global Variations in Heart Failure Etiology, Management, and Outcomes. JAMA. 2023 May 16;329(19):1650-1661.
- Tsutsui H, Albert NM, Coats AJS et al.Natriuretic peptides: role in the diagnosis and management of heart failure: a scientific statement from the Heart Failure Association of the European Society of Cardiology, Heart Failure Society of America and Japanese Heart Failure Society. Eur J Heart Fail. 2023 May;25(5):616-631.
- Schefold JC, Filippatos G, Hasenfuss G, Anker SD, von Haehling S. Heart failure and kidney dysfunction: epidemiology, mechanisms and management. Nat Rev Nephrol. 2016 Oct;12(10):610-23.
- Wang K, Ni G, Wu Q, Zhou Y, Yao W, Zhang H, Li X. Prognostic Value of N-Terminal Pro-B-Type Natriuretic Peptide and Glomerular Filtration Rate in Patients with Acute Heart Failure. Front Cardiovasc Med. 2020 Jul 21;7:123.
- Kondo T, Nakano Y, Adachi S, Murohara T. Effects of Tobacco Smoking on Cardiovascular Disease. Circ J. 2019 Sep 25;83(10):1980-1985.
- Watkins T, Mansi M, Thompson J, Mansi I, Parish R. Effect of marital status on clinical outcome of heart failure. J Investig Med. 2013 Jun;61(5):835-41.
- Enard KR, Coleman AM, Yakubu RA, Butcher BC, Tao D, Hauptman PJ. Influence of Social Determinants of Health on Heart Failure Outcomes: A Systematic Review. J Am Heart Assoc. 2023 Feb 7;12(3):e026590.
- Kewcharoen J, Thangjui S, Kanitsoraphan C, Techorueangwiwat C, Mekraksakit P, Vutthikraivit W. The effects of marital status on outcome of heart failure population: a systematic review and metaanalysis. Acta Cardiol. 2021 Feb;76(1):11-19.
Details
| Primary Language | English |
|---|---|
| Subjects | Family Medicine |
| Journal Section | Research Article |
| Authors | |
| Publication Date | March 29, 2024 |
| Submission Date | January 5, 2024 |
| Acceptance Date | March 4, 2024 |
| Published in Issue | Year 2024Volume: 46 Issue: 1 |
