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对HF的液体潴留和内分泌反应的一种方法，这些反应损害心脏性能并导致患者预后不良。虽然自我护理被假设会影响心脏功能，但这一说法的科学依据尚未建立。我们需要进一步的证据表明HF患者的日常自我护理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和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，沿着头向下倾斜的策略程序，被动和非侵入性地挑战心脏的性能，以深入了解这种关系。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HF自我护理与响应15分钟15“头低位倾斜位置挑战的心脏性能的客观测量之间的关系。这项研究的具体目标是：1）描述HF自我护理和基线心脏性能之间的关系，通过测量A）用心力衰竭自我护理指数、医学结局研究特定依从性量表和24小时尿钠水平评估对低钠饮食的依从性的自我护理，和B）用心房利钠肽的血液水平测量心脏性能，作为心房扩张的指标，以及生物阻抗心动图的心脏血流动力学，包括胸液量指数、每搏输出量指数和加速度指数，以及2）描述HF自我护理与响应15分钟、15“头向下倾斜位置挑战的动态心脏性能之间的关系。将HF自我护理指标与心脏性能指标响应体位的相对变化进行比较。这项研究调查了心力衰竭患者的自我护理行为，以及他们在休息和压力下的心脏功能。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。