The Influence of Heart Failure Self-Care Behavior on Cardiac Performance

心力衰竭自我护理行为对心脏功能的影响

• 批准号: 7274456
• 负责人: Christopher Sean Lee
• 金额: $ 2.96万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-01 至 2010-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7274456
• 关键词: Abdomen; Acceleration; Adherence; Affect; American; Atrial Natriuretic Factor; Behavior; Blood; Blood Plasma Volume; Blood Volume; Cardiac; Chest; Clinical; Complex; Cross-Sectional Studies; Decision Making; Development; Endocrine; Force of Gravity; Fostering; Functional disorder; Future; Head-Down Tilt; Health; Heart; Heart Atrium; Heart failure; Hormonal; Hormones; Hour; Intervention; Invasive; Knowledge; Lead; Left; Leg; Liquid substance; Measurable; Measurement; Measures; Medical; Monitor; Morbidity - disease rate; Outcome; Outcome Study; Patients; Performance; Persons; Physiological; Play; Positioning Attribute; Procedures; Process; Purpose; Quality of life; Rate; Relative (related person); Research Personnel; Rest; Role playing therapy; Score; Self Care; Sodium; Sodium-Restricted Diet; Stress; Stretching; Stroke Volume; Symptoms; Syndrome; Techniques; Technology; Time; Translations; Urine; Work; base; cardiography; day; design; disability; experience; heart function; hemodynamics; hospital readmission; improved; indexing; innovation; insight; research study; response; theories

DESCRIPTION (provided by applicant): Heart failure (HF), a syndrome that affects more than five million Americans, is associated with disability, increased morbidity, and decreased quality-of-life. Self-care may be one way of controlling fluid retention and endocrine responses to HF that impair cardiac performance and lead to poor patient outcomes. Although self-care is hypothesized to influence cardiac performance, the scientific basis of this claim has not yet been established. We need further evidence that HF patient's day-to-day self-care practices can influence cardiac performance in order to impress on patients the important role that they play in maintaining optimal cardiac performance and in increasing the quality and years of their health. We intend to use bioimpedance cardiography technology and hormone measurement, along with a strategic procedure of head-down tilt to passively and non-invasively challenge the heart's performance to gain insight into this relationship. A cross-sectional study is proposed to examine the relationship between HF self-care measured using subjective and objective measures and the objective measurement of cardiac performance in response to fifteen minutes of a 15¿ head-down tilt positional challenge. The specific aims of this study are to: 1) describe the relationship between HF self-care and baseline cardiac performance, by measuring A) self-care with the Self-Care of Heart Failure Index, the Medical Outcomes Study Specific Adherence Scale, and 24-hour urine sodium levels to assess adherence to a low sodium diet, and B) cardiac performance with blood levels of atrial natriuretic peptide, as an index of atrial distension, and cardiac hemodynamics with bioimpedence cardiography, including thoracic fluid volume index, stroke volume index, and acceleration index, and 2) describe the relationship between HF self-care and dynamic cardiac performance in response to a fifteen minute, 15¿ head-down tilt positional challenge. Measures of HF self-care will be compared to the relative change in measures of cardiac performance in response to body positioning. This research study examines the self-care behaviors of persons with heart failure and how their heart functions at rest and when stressed. This study will help determine if the day-to-day self-care behaviors of heart failure patients can influence how the heart functions.

描述（由申请人提供）：心力衰竭 (HF) 是一种影响超过 500 万美国人的综合征，与残疾、发病率增加和生活质量下降有关，自我护理可能是控制液体潴留的一种方法。心力衰竭的内分泌反应会损害心脏功能并导致患者预后不良，尽管自我护理被认为会影响心脏功能，但这一说法的科学依据尚未确定。今天自我保健实践可以影响心脏功能，以便让患者认识到他们在维持最佳心脏功能以及提高健康质量和寿命方面所发挥的重要作用。我们打算使用生物阻抗心动图技术和激素测量以及低头倾斜过程被动地和非侵入性地挑战心脏的性能，以战略性地洞察这种关系。提出了一项横断面研究，以检查使用主观和客观测量方法测量的心力衰竭自我护理与客观测量之间的关系。十五分钟的心脏功能反应15¿本研究的具体目的是：1) 通过测量 A) 心力衰竭自我护理指数（医学指标）来描述心力衰竭自我护理与基线心脏功能之间的关系。结果研究特定依从性量表和 24 小时尿钠水平，以评估对低钠饮食的依从性，以及 B) 以心房钠尿肽血液水平作为心房扩张指标的心脏性能，以及以心房扩张指标衡量的心脏血流动力学生物阻抗心动图，包括胸液容量指数、每搏输出量指数和加速指数，2) 描述心力衰竭自我护理与响应 15 分钟、15° 的动态心脏表现之间的关系低头倾斜姿势挑战将心力衰竭自我护理的测量与身体姿势反应的心脏功能测量的相对变化进行比较。这项研究检查了心力衰竭患者的自我护理行为及其心脏功能。这项研究将有助于确定心力衰竭患者的日常自我护理行为是否会影响心脏功能。