Biomedical subjects

Susan Tiukinhoy

Publications and source records attributed to Susan Tiukinhoy.

3 recordsLinked to original sources

PubMed2003

The role of echocardiography in the diagnosis and management of heart failure.

Heart failure has emerged as one of the most pressing health care issues in the United States. It is estimated that 4.8 million people have chronic heart failure, and approximately 400,000 new cases are diagnosed each year. Since the incidence of heart failure increases significantly with age, its prevalence is likely to increase as the population grows older. The American Heart Association and American College of Cardiology developed clinical practice heart failure guidelines to assist physicians in the diagnosis and management of patients with heart failure, in the hopes of reducing hospitalizations and mortality. These guidelines emphasize the importance of echocardiography in the management of acute and chronic heart failure. However, the guidelines do not elaborate on all the potential applications of echocardiography for this condition. This review was undertaken to examine in detail, the role of echocardiography in the initial management and long-term follow-up of patients with heart failure.

Disease Management↗

PubMedDate not supplied

Improvement in heart rate recovery after cardiac rehabilitation.

PURPOSE: Exercise-based cardiac rehabilitation has been shown to reduce mortality in patients with coronary artery disease. Although the exact mechanisms by which exercise reduces mortality are unclear, one hypothesis invokes the effect of exercise on autonomic tone. Heart rate recovery (HRR) immediately after exercise is a marker of vagal tone that findings have shown to be a powerful predictor of all-cause mortality. This study aimed to evaluate the effect of exercise-based cardiac rehabilitation on HRR. METHODS: A retrospective study was performed. Patients who completed phase 2 cardiac rehabilitation and had entry and exit exercise stress tests (n = 34) were included in the study. A control sample was identified by review of the exercise stress laboratory database (n = 35). Then HRR at baseline and on follow-up were compared. RESULTS: After completion of phase 2 cardiac rehabilitation, the HRR improved from 18 +/- 7 bpm to 22 +/- 8 bpm (P <.001). Among controls, the HRR on serial testing were 21 +/- 10 bpm and 21 +/- 9 bpm (P =.649). The mean difference in HRR on follow-up testing was different between those enrolled in a cardiac rehabilitation program and those who were not (P =.002). CONCLUSION: Exercise training in a cardiac rehabilitation program results in HRR improvement. As a simple parameter for assessing autonomic tone, HRR may be used in a cardiac rehabilitation facility to identify patients with higher risk profiles, and can be useful for evaluating patient outcomes.

Case-Control Studies↗

PubMedDate not supplied

A pilot exercise intervention to improve lower extremity functioning in peripheral arterial disease unaccompanied by intermittent claudication.

PURPOSE: A pilot study was conducted to test the feasibility of supervised treadmill exercise training to improve functioning in study participants with peripheral arterial disease who did not have classical symptoms of intermittent claudication. METHODS: For this study, 32 men and women with peripheral arterial disease but no symptoms of claudication were randomized to exercise training or usual care. The intervention was a 12-week supervised treadmill walking program. Outcomes included 6-minute walk distance, maximum treadmill walking distance, and 4-meter walking velocity. Participant-reported community walking ability was measured with the Walking Impairment Questionnaire (WIQ). Inflammatory blood factor levels also were measured. RESULTS: Altogether, 25 participants who completed follow-up testing were included in intention-to-treat analyses. Of 24 participants (58%) randomized to exercise, 14 completed the entire exercise training program. The participants randomized to the intervention showed greater improvement in their WIQ walking speed score than the control subjects (P =.05). The participants randomized to the intervention showed improvements in their 6-minute walk distance (1134 +/- 347 vs 1266 +/- 295 feet; P =.03), maximal treadmill walking distance (389 +/- 248 vs 585 +/- 293 feet; P <.001), WIQ distance score (52.3 +/- 29.1 vs 63.1 +/- 25.1; P =.002), and WIQ speed score (48.7 +/- 26.8 vs 59.7 +/- 22.7; P =.008). The participants randomized to the control condition showed improvements in maximal treadmill walking distance (362 +/- 180 vs 513 +/- 237 feet; P =.014). There were no significant changes in the inflammatory blood factors after exercise. CONCLUSIONS: This pilot study demonstrated that a supervised treadmill walking program may be feasible and may improve functioning for individuals with peripheral arterial disease who do not have classical symptoms of intermittent claudication. Further study is needed with a larger sample to identify optimal exercise methods that improve lower extremity functioning in men and women with peripheral arterial disease who do not have intermittent claudication.

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