Chronic heart failure diagnostics and application of neuropeptides. in residential elderly
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1 Chronic heart failure diagnostics and application of neuropeptides in residential elderly Maaike Barents geboren 27 december 1950 te Utrecht
2 Paranimfen: Els Barents Christien Enzing Barents, Maaike Chronic heart failure diagnostics and application of neuropeptides in residential elderly Dissertation University of Groningen, The Netherlands with references with summary in English and Dutch. book: ISBN: Ebook : ISBN: PDF without DRM All rights reserved. No part of this publication may be reproduced, stored in retrieval system, or transmitted, in any form or by any means, electronically, mechanically, by photocopying, or otherwise, without the prior written permission of the author. Cover design: Simone Koster, simone@anderkaliber.nl Druk & lay-out: Gildeprint Drukkerijen B.V., Enschede 2
3 Chronic heart failure diagnostics and application of neuropeptides in residential elderly Proefschrift ter verkrijging van de graad van doctor aan de Rijksuniversiteit Groningen op gezag van de rector magnificus prof. dr. E. Sterken en volgens besluit van het College voor Promoties. De openbare verdediging zal plaatsvinden op woensdag 23 december 2015 om 16:15 uur door Maaike Barents geboren op 27 december 1950 te Utrecht 3
4 Promotores Prof. F.A.J. Muskiet Prof. J.L. Hillege Copromotor Dr. M.J.L. de Jongste Beoordelingscommissie Prof. A.W. Hoes Prof. W.P.A. Achterberg Prof. A.A. Voors Financial support by the Dutch Heart Foundation for the publication of this study was gratefully acknowledged. 4
5 We recognize thankfully the support for this thesis given by Corparis Welzijn met Zorg, 5
6 6
7 CONTENTS List of abbreviations 10 Chapter 1 15 General introduction to heart failure 1.2 Rationale Mortality Morbidity Defining heart failure and its causes Prevalence of heart failure (HF) HF disease burden (DALY) Quality of life Diagnostics and algorithm Natriuretic peptides Therapies for heart failure Residential elderly Heart failure in residential elderly Aim and outline of the thesis 29 Chapter 2 Diagnostics and prevalence of heart failure in residential elderly. Chapter Prevalence and misdiagnosis of chronic heart failure in nursing home residents: the role of B-type natriuretic peptides. Barents M, van der Horst IC, Voors AA, Hillege JL, Muskiet FA, de Jongste MJ. Neth Heart J 2008;16(4):
8 Chapter Underestimated prevalence of chronic heart failure among the nursing home residents in Aruba. Stoutjesdijk E, Brouns RM, Barents M, de Jongste MJ, Besselink HJ, Cheng JD, Wever R, Muskiet FA. West Indian Med J 2014;63(6): Chapter Validation of neuropeptides in stable heart failure patients. Patients with stable chronic heart failure exhibit also high intraindividual Biological variation of amino-terminal pro-brain natriuretic peptide (NT-proBNP) in urine when compared to the variation in plasma. Schimmel AM, Barents M, de Jongste MJ, Römer JW, Steward HN, Muskiet FA. Accepted for publication in part in Clinical Chemistry. Chapter BNP and NT-proBNP, predictors of 1-year mortality in nursing home residents. Barents M, Hillege HH, van der Horst IC, de Boer RA, Koster J, Muskiet FA, de Jongste MJ. J Am Med Dir Assoc 2008;9(8): Chapter Chronic heart failure, related to help with activities of daily living in nursing home residents. Barents M, Hillege HH, Muskiet FA, de Jongste MJ. Act Adapt Aging 2011;35(2):
9 Chapter Physical exercise performed by residential elderly of high age is safe and does not affect chronic heart failure symptoms, NT-proBNP and cardiovascular-metabolic indices: a pilot, single-blinded RCT. Barents M, Weening E, Muskiet FA, Hillege HH, de Jongste MJ. Submitted. Chapter Chapter 6.1 Summary 174 Chapter 6.2 Discussion 185 Chapter 6.3 Recommendations and future perspectives 191 Chapter Chapter 7.1 Samenvatting 200 Chapter 7.2 Discussie 211 Chapter 7.3 Aanbevelingen en toekomst perspectieven 217 Dankwoord en CV 221 9
10 ABBREVIATIONS AND DEFINITIONS ACE-i ADL angiotensin-converting enzyme inhibitor activities of daily living Advance care planning aims to help patients, establish decisions about future care that take effect when they lose capacity AF ARB AWBZ atrial fibrillation angiotensin-2 receptor blocker Algemene Wet Bijzondere Ziektekosten, funding source of elderly care medicine except geriatric rehabilitation (Ziektekosten Wet) BNP CHF B-type natriuretic peptide or brain natriuretic peptide chronic heart failure. Actually, non-acute heart failure is a better term because a physician does not wait to diagnose heart failure till it has become chronic (three months). But, we have used chronic heart failure in all publications and decided therefore not to replace the term comorbidity diseases of which a person suffers, near the disease which is focussed at. Comorbidity is standardised by the Charlson comorbidity index. This combined age and comorbidity is developed to estimate the relative risk of death from prognostic clinical variables. In many studies, the index is applied to correct for existing comorbidity (1) COPD CRT-P/CRT-D CVD CVA CV i chronic obstructive pulmonary diseases chronic resynchronization therapy-pacemaker/defibrillator cardiovascular diseases cerebrovascular accident intraindividual biological variation CVRM guideline cardiovascular risk management guideline (2) 10
11 DALY disability adjusted life years is a measure of overall disease burden, expressed as the number of years lost due to ill-health, disability or early death ECG echo egfr elderly electrocardiogram echocardiogram estimated glomerular filtration rate persons of 65 years and older; also older persons elderly care physi- cian the elderly care physician is a physician who specializes in long- term care for frail elderly people and chronic patients with complex health problems (3) ESC GP HbA1c HDL-C European Society of Cardiology general practitioner HbA1c 8,5% = GTA (Gron. Transmurale Afspraak ) T2DM high-density lipoprotein cholesterol; HDL-C 1 mmol/l (39 mg/dl) males, HDL-C 1,2 mmol/l (46 mg/dl) females HF HFpEF HFrEF Hg ICD IR Lab Noord LDL-C LTCFs heart failure heart failure with preserved ejection fraction heart failure with reduced ejection fraction mercury implantable cardioverter defibrillator insulin resistance Laboratorium Noord (Laboratory North) in The Netherlands low-density lipoprotein cholesterol; LDL-C < 2,5mmol/L (100 mg/dl) long-term care facilities comprising nursing homes and care homes for the elderly LVEF left ventricular ejection fraction 11
12 MDS minimum data set, items of the Resident Assistant Instrument (RAI). MDS-items consist of systematic observations of dependency and de livered aid through which dependence and aid can be quantified. These observations focus on self-reliance of the individual residential elderly during predefined activities of daily living. MET Metabolic Equivalent Task (MET), an unit for metabolism in rest METS MeSH MI MMSE metabolic syndrome medical subject headings; controlled key words of MEDLINE database myocardial infarction minimum mental state estimation multi medication use a daily intake of at least five different drugs (4) multimorbidity multiple co-occurring, chronic or long-term diseases or conditions, none considered as index disease (5) MSD NICE guideline NH NLM database NND musculoskeletal disorders National Institute for Health and Care Excellence nursing home National Library of Medicine database (Maryland, USA) neurodegenerative disorders norm physical activity a minimum of physical activity at 4 METs for individuals of years during 30 min at 5 days a week and 3 METs for 55+ years (6) NP NT-proBNP NYHA class oldest old persons PMC database polypharmacy natriuretic peptide amino-terminal prob-type natriuretic peptide New York Heart Association classification of heart failure persons aged > 85 years (medicaldictionary.thefreedictionary.com) Pub Med Central database polypharmacy is defined as the use of five or more drugs, including prescribed, over-the-counter, and complementary medicines (4) 12
13 primary care physicians physicians, general practitioners and elderly care physicians Quol RAAS RAI quality of life renin-angiotensin-aldosterone system Resident s Assessment Instruments, software program for providing problem lists as base for the individual care-treatment plan made by the direct care-giver and for the State Governors (7) RCT RIVM RD residential elderly randomized controlled trial Rijks Instituut voor Volksgezondheid en Milieu renal dysfunction elderly residing in nursing homes or care homes; also institutionalised frail elderly TIA TMWD TUG TG T2DM Verenso transient ischemic attack ten meter walk distance timed up and go test triglycerides; fasting TG 8mmol/L type 2 diabetes mellitus vereniging van specialisten ouderengeneeskunde en sociaal geriaters (Society of elderly care physicians and social geriatricians) VZH verzorgingshuis, care home for the elderly. One of the institutes of LTCFs 13
14 14
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