چكيده لاتين :
Introduction- The clinical syndrome of heart failure (HF) remains a leading cause of cardiac morbidity
and mortality. The coming years will see a continuous growth in the epidemic of HF and
increasingly complex pharmacological, interventional, and device-based therapies, effective in
reducing HF morbidity and mortality. Highly trained clinician-specialists are needed to assist in
optimally evaluating and managing patients with HF.
Objective- The aim of the present study was to determine the best management protocol for HF by
surveying different therapeutic protocols (medical, cardiac resynchronization therapy [CRT]
program, and enhanced external counterpulsation [EECP]).
Methods- Initial assessment was performed for a total of 280 HF patients evaluated in the Heart Failure
Clinic. Eighty patients were included in the study; the selection being done in accordance with the
inclusion criteria of ejection fraction (EF) :יS:35%. By surveying different therapeutic protocols,
disease management programs (DPMs), namely medical, CRT, and EECP, were performed in
three study groups: group A; medical therapy (n=37), group B; EECP (n=16), and group C; CRT
(n=27). Changes in New York Heart Association (NYHA) functional class and echocardiographic
indexes were evaluated in the three groups.
Results- There was no significant change in EF, left ventricular end-systolic volume (LVESV), left
ventricular end-diastolic volume (LVEDV), and E/Eי ratio after medical therapy. There was,
however, a significant improvement in NYHA function class (P (LESS THAN)0.00 I). EECP significantly
improved EF (P(LESS THAN)0.05) and E/Eי ratio (P(LESS THAN)O.OO I). There was also a significant reduction in LVESV
(P(LESS THAN)0.05) with improvement in NYHA func(LESS THAN)0.05), E/Eי ratio (P(LESS THAN)O.OOI), and EF (P(LESS THAN)O.OO I).There
was improvement in NYHA functional class and rehospitalization as well (P(LESS THAN)O.OO I).
Conclusion- Our findings suggest that disease management programs or guideline-based treatments
reduce first hospitalization and rehospitalization rates in patients with heart failure and improve
NYHA functional class and the echocardiographic findings of LVESV, LVEDV, LVEF, and E/Eי
ratio. In the hope of improving HF outcomes, disease management programs (medical care, EFCP,
CRT-D implantation, etc.) have been developed to standardize and optimize HF treatment,
focusing on disease education for the patient and continuing support after hospital discharge
