| Abstract [eng] |
Aim of the work: to evaluate influence of education on quality of life, exercise capacity and clinical status in patients suffering from chronic heart failure. Tasks of the work: to create educational heart failure programme for the patients. To evaluate the influence of education on changes of quality of life in patients suffering from chronic heart failure. To evaluate the influence of education on changes of B-type natriuretic peptide levels (functional status) in patients suffering from chronic heart failure. Study population: Patients suffering from chronic heart failure in stabile condition (functional NYHA class II – III), consulted at Vilnius University Santariškių Clinic Out – patient Department of Cardiology who had been receiving optimal treatment. Methods: The following data were evaluated before tuition and 2 months thereafter: 1. Quality of life (QoL) in accordance with standardized Minnesota questionnaire “Life With Heart Failure” (generali [QoLEI], physical, reflecting emotional QoLEI aspects). 2. Exercise capacity by means of spiroergometry: VO2peak ml/kg/min, VO2peak l/min, AT VO2 ml/kg/min, AT VO2 ml/kg/min, AT VO2 l/min and percentage value of this parameters workload (W), exercise duration in minutes, MET, NYHA, heart rate during anaerobic threshold, peak heart rate, VE/CO2, VE/VO2. Workload intensity was expressed in MET in order to determine NYHA functional class more objectively. 3. Clinical condition in accordance with B-type natriuretic peptide blood level. The date were processed using SPSS 13.0 software version for Windows. The level of significance was fixed and considered to be equal to 0.05; two sided p values were presented in all cases. Results: 1. The mean index of evaluation of quality of life (QoLEI) was 49.39 + 17.86 prior the tuition. Mean QoLEI of physical and emotional aspects were 21.7 + 7.15 and 9.35 + 5.48, respectively. QoLEI decreased up to 37.9 + 18.78 (p < 0.001); QoL corresponding physical and emotional aspects had decreased to17.74 + 7.09 (p < 0.001) and 7.74 + 5.31 (p < 0.001), respectively. 2. Peak VO2 ml/kg/min 2 months after tuition had significantly increased (16.25 + 3.69 vs. 19.26 + 7.22; p = 0.013). The positive changes in AT VO2 ml/kg/min were demonstrated 2 months after the tuition (11.197 + 2.47 vs. 12.694 + 3.28; p = 0.003). The indices reflecting external load had increased significantly: workload (W) 19.26 + 37.10 vs. 104.29 + 40.03; p = 0.001; duration of the exercise 7.28 + 2.59 vs. 8.32 + 2.95; p = 0.007; MET 4.65 + 1.05 vs. 5.20 + 1.27; p = 0.001). The ratio of patients in various NYHA functional classes prior the tuition and 2 months thereafter had also changed: NYHA I – 0/1; NYHA II – 10/19; NYHA III – 21/11. 3. The investigation demonstrated that the blood level of B-type natriuretic peptide (the index of clinical condition) had decreased significantly 2 months after the tuition (348.41 + 471.99 vs. 224 + 340.36; p = 0.023). Conclusions: The quality of life of the patients had improved significantly after the tuition. The tuition has reliable positive influence on exercise capacity. The oxygen volume taken from inspired air during peak exercise had increased significantly as well as oxygen volume taken from inspired air during anaerobic threshold, workload, duration of the exercise, metabolic oxygen consumption units. The heart rate during peak exercise, heart rate during anaerobic threshold and respiratory carbon dioxide coefficient had underwent positive changes. There is a positive relationship between tuition and functional NYHA class. The education had improved clinical condition of the patients suffering from heart failure. The blood levels of natriuretic peptide had decreased significantly after the tuition. |
