Heart failure and health related quality of life.

Quality of life is a major goal in the context of preventive and therapeutic cardiology. It is important, both as an outcome measure in clinical trials of congestive heart failure (CHF) and as a consideration in individual physicians' therapeutic decisions. In this article, quality of life concepts are reviewed, methods of measurement are explored and clinically significant changes on prognosis are discussed.

The effect of dietary sodium restriction on neurohumoral activity and renal dopaminergic response in patients with heart failure.

Background: This work evaluates the effect of a low-sodium diet on clinical and neurohumoral parameters and on renal dopaminergic system activity in heart failure (HF) patients.

Methods: We included 24 patients with mild-to-moderate stable HF with left ventricle ejection fraction <40%. Twelve patients were studied before and after a 15-day low-sodium diet; 12 maintained their usual diet.

[Physiopathology of heart failure].

In this paper we review pathophysiologic aspects of heart failure (HF). Mechanisms that normally act to prevent decrease in stroke volume and peripheral pressure are activated in HF and become maladaptive. These mechanisms lead to cardiac stimulation (inotropism, chronopism and lusotropism), peripheral vasoconstriction and sodium and water retention.

C-reactive protein: a new golden marker of cardiovascular risk.

The need for new cardiovascular risk factors, due to the limitations of traditional factors, is pointed out. Recent views regarding the role of inflammation in the evolution of the atherosclerotic process, namely in the formation of the atheroma plaque, its progression and rupture, and initiation of acute coronary events, are briefly summarized. These events point to the possibility that inflammatory markers could constitute new markers of cardiovascular risk.

Effect of a heart failure clinic on survival and hospital readmission in patients discharged from acute hospital care.

Ambulatory care by physicians especially devoted to the management of heart failure (HF) has been reported to have beneficial effects. The aim of this work was to assess the effect of outpatient management at a HF clinic, as compared with care by the usual assistant physician, on prognosis of HF patients. In this non-randomised study, we prospectively followed 339 patients after a hospitalisation index for HF, in order to compare prognosis between two groups of HF patients according to the ambulatory assistance setting: either a specific outpatient clinic (n=157) or the usual assistant physician (n=182).

The renal dopaminergic system, neurohumoral activation, and sodium handling in heart failure.

Background: Dopamine of renal origin exerts natriuretic and diuretic actions by activating specific receptors located in the renal proximal tubular epithelial cells. Heart failure (HF) is accompanied by activation of several neurohumoral systems. The interaction of these systems with the renal dopaminergic system and its effect on sodium handling in HF are not clarified.