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Obesity Paradox: Comparison of Heart Failure Patients With and Without Comorbid Diabetes
Lee, Kyoung Suk,Moser, Debra K.,Lennie, Terry A.,Pelter, Michele M.,Nesbitt, Thomas,Southard, Jeffrey A.,Dracup, Kathleen AMERICAN ASSOCIATION OF CRITICAL CARE NURSES 2017 American journal of critical care Vol.26 No.2
Song, Eun Kyeung,Moser, Debra K,Dunbar, Sandra B,Pressler, Susan J,Lennie, Terry A SAGE Publications 2014 European journal of cardiovascular nursing Vol.13 No.6
<P><B>Background:</B></P><P>Despite a growing recognition that a strict low sodium diet may not be warranted in compensated heart failure (HF) patients, the link between sodium restriction below 2 g/day and health outcomes is unknown in patients at different levels of HF severity.</P><P><B>Purpose:</B></P><P>The purpose of this study was to compare differences in event-free survival among patients with <2 g/day, 2–3 g/day, or >3 g/day sodium intake stratified by New York Heart Association (NYHA) class.</P><P><B>Method:</B></P><P>A total of 244 patients with HF completed a four-day food diary to measure daily sodium intake. All-cause hospitalization or death for a median of 365 follow-up days and covariates on age, gender, etiology, body mass index, NYHA class, ejection fraction, total comorbidity score, the presence of ankle edema, and prescribed medications were determined by patient interview and medical record review. Hierarchical Cox hazard regression was used to address the purpose.</P><P><B>Results:</B></P><P>In NYHA class I/II (<I>n</I>=134), patients with <2 g/day sodium intake had a 3.7-times higher risk (<I>p</I>=0.025), while patients with >3 g/day sodium intake had a 0.4-times lower risk (<I>p</I>=0.047) for hospitalization or death than those with 2–3 g/day sodium intake after controlling for covariates. In NYHA class III/IV (<I>n</I>=110), >3 g/day sodium intake predicted shorter event-free survival (<I>p</I>=0.044), whereas there was no difference in survival curves between patients with <2 g/day and those with 2–3 g/day sodium intake.</P><P><B>Conclusion:</B></P><P>Sodium restriction below 2 g/day is not warranted in mild HF patients, whereas excessive sodium intake above 3 g/day may be harmful in moderate to severe HF patients.</P>
Self-reported Adherence to a Low-Sodium Diet and Health Outcomes in Patients With Heart Failure :
Song, Eun Kyeung,Moser, Debra K.,Kang, Seok-Min,Lennie, Terry A. ASPEN PUBLISHERS INC 2016 JOURNAL OF CARDIOVASCULAR NURSING Vol.31 No.6
<P>Background: Most clinicians rely on patients' self-report of following a low-sodium diet to determine adherence of patients with heart failure (HF). Whether self-reported adherence to a low-sodium diet is associated with cardiac eventYfree survival is unclear. Purposes: To determine (1) whether self-reported is concordant with adherence to a low-sodium diet measured by food diaries and 24-hour urinary sodium excretion and (2) whether self-reported adherence to a low-sodium diet predicts cardiac eventYfree survival. Methods: Adherence to a low-sodium diet was measured using 3 measures in 119 HF patients: (1) self-reported adherence, 1 item from the Self-care of Heart Failure Index scale; (2) a 3-day food diary; (3) 24-hour urinary sodium excretion. Patients were followed up for a median of 297 days to determine cardiac hospitalization or emergency department visit. One-way analysis of variance and Cox regression were used to address our purposes. Results: Self-reported adherence was concordant with adherence to a low-sodium diet measured by food diaries and 24-hour urinary sodium excretion. Thirty-one patients who reported they always follow a low-sodium diet had an average sodium intake less than 3 g/d (F = 5.07, P =.002) and 3.3 g of a mean 24-hour urinary sodium excretion (F = 3.393, P =.020). Patients who reported they never or rarely follow a low-sodium diet had 4.7 times greater risk of having cardiac events than did those who always followed a low-sodium diet (P =.017). Conclusion: Self-reported adherence to a low-sodium diet predicted cardiac eventYfree survival demonstrating clinicians can use this as an indicator of adherence.</P>
The link of unintentional weight loss to cardiac event-free survival in patients with heart failure.
Song, Eun Kyeung,Lee, Yongjik,Moser, Debra K,Dekker, Rebecca L,Kang, Seok-Min,Lennie, Terry A ASPEN PUBLISHERS INC 2014 JOURNAL OF CARDIOVASCULAR NURSING Vol.29 No.5
<P>Patients with heart failure (HF) commonly have unintentional weight loss, depressive symptoms, and elevated levels of high-sensitivity C-reactive protein (hsCRP). Each of these variables has been independently associated with shorter cardiac event-free survival. However, little data exist on the relationships of unintentional weight loss, hsCRP level, and depressive symptoms to cardiac event-free survival.</P>