Search

Unlabelled: The aim of this study was to evaluate the gender-oriented differences in the outcomes of a lifestyle intervention trial (diet, smoking cessation, and exercise) among patients who had open heart surgery. A randomized, nonblind intervention study was performed on 500 patients who had open heart surgery. Immediately after hospital discharge, 250 patients were randomly allocated lifestyle intervention by receiving oral and written information in the form of a booklet with specific educational information for postoperative rehabilitation. The remaining 250 patients received the regular oral instructions. The applied lifestyle intervention proved to be beneficial only in men as far as quitting smoking (relative risk [RR]: 0.36, confidence interval [CI]: 0.16-0.80; P = .01) and returning to work (RR: 0.35, CI: 0.13-0.92; P = .03) are concerned. For both genders, no significant associations between dietary and physical activity recommendations were observed., Conclusion: Lifestyle nursing intervention immediately after open heart surgery had a beneficial effect on men 1 year after the surgery but not on women. Thus, there is a need for gender-specific studies among women., (© The Author(s) 2015.)

Introduction: The aim of this study was to record the results from a modern diagnostic and therapeutic approach to patients with pulmonary arterial hypertension., Methods: We studied the clinical characteristics and the treatment of 69 patients (50 women, 72.5%), aged 44 +/- 17 years, who were diagnosed with pulmonary hypertension (World Health Organisation categories I, IV and V). The patients' outcomes were recorded over 14 years' operation of our Pulmonary Hypertension Unit., Results: Twenty-seven patients (39.1%) suffered from idiopathic pulmonary hypertension, 12 (17.4%) from thromboembolic obstructive disease, 14 (20.3%) from congenital heart diseases, 11 (15.9%) from connective tissue diseases, 3 (4.3%) from portal hypertension, 2 (2.9%) from sarcoidosis, and 1 (1.4%) from pulmonary veno-occlusive disease. Six patients (8.7%) were in New York Heart Association (NYHA) functional class I, 28 (40.6%) were in class II, 30 (43.5%) were in class III, and 5 (7.2%) were in class IV. Thirty-four patients completed a 6-minute walk test and covered a mean distance of 352 +/- 137 m. N-terminal pro-brain natriuretic peptide (NT-proBNP) levels were measured in 18 patients, with a mean value of 1665 +/- 1935 pg/ml. A vasoreactivity test in 41 patients had a positive response in 10 (24.4%). Twenty-six patients (37.7%) were treated with combination therapy, whereas 16 (23.2%) either did not comply with or were not given specific medication. The mortality over a mean follow-up period of 5 +/- 4 years was 26%, significantly lower than that reported before the introduction of new drugs. An advanced NYHA class was an independent predictor of mortality (p=0.004), while elevated NT-proBNP levels were also associated with poor survival (p=0.013)., Conclusions: Pulmonary arterial hypertension is a severe disease that leads to right heart failure and death. Despite the latest advances, vigilance and continuous investigation are needed in order to achieve a prompt diagnosis and the most suitable treatment.