Tạp chí Tim mạch học Việt Nam

Highlights from Guidelines and Consensus released at ESC Congress 2024

2024-11-23T19:02:12+07:00

The 2024 ESC guidelines and consensus reveal several significant trends in cardiovascular medicine. They emphasize a more individualized, patient-centered approach while maintaining evidence-based protocols, supported by new biological markers and imaging techniques. Risk factor management and prevention have gained prominence, with comprehensive strategies for managing comorbidities and lifestyle modifications. The guidelines demonstrate greater flexibility in treatment targets and risk stratification, incorporating new markers for more precise patient care. They reinforce the importance of multidisciplinary team approaches and provide detailed frameworks for coordinating care between healthcare providers. Implementation considerations have been expanded, focusing on integrating preventive measures and non-pharmacological interventions throughout the patient journey, with practical recommendations for real-world clinical practice.

Quality of life and its related predictors among acute coronary syndrome patients with coronary stents in Ho Chi Minh City, 2022

2023-05-31T21:51:34+07:00

The health-related quality of life (HRQOL) assessment after coronary stents insertion to issue a very crucial tool for evaluating outcomes. Therefore, we investigated the associations between healthy affect, resilience to improve their health status and the quality of life of patient is improving. A cross-sectional design involving patients with having acute coronary syndrome (ACS) after coronary stents insertion (CSI) and being treated in the hospital in Ho Chi Minh City. The patients (N =210) who came to Tam Duc Heart Hospital for pre- examination during treatment were asked to answer questionnaires which included SF-36 and resilience-25. The t-test and ANOVA was applied to identify the factors related to quality of life and resilience. Result showed the mean score of resilience is 70.2 ± 8.1. The score of physical components summary (PCS) was range from 32.37 to 61.6 and the mean score was 51.0 ± 8.7. For the mental component summary (MCS) was range from 39.6 to 60.0 with the mean score was 51.0±5.7. Factors including age, gender, marital status, working status, education, duration after stent treatment, experience of hospitalization for stent treatment, number of stents in patients and regularly take medication were associated with patients’ quality of life. The mean score of quality of life was significantly different between patients’ resilience level (p < 0.05).

Exploring the impact of lifestyle modification on quality of life of patients with coronary artery disease at one hospital in Ho Chi Minh City, 2022

2023-05-19T19:15:44+07:00

Improving the quality of life (QoL) of patients with Coronary Artery Disease (CAD) is a very important tool for evaluating outcomes. Therefore, we investigated Exploring the Impact of Lifestyle Modification on Quality of Life of Patients with Coronary Artery Disease. A cross-sectional design involving patients with

having Coronary Artery Disease treated in the hospital in Ho Chi Minh City. The patients (N =180) who came to Tam Duc Hospital for pre-examination during CAD treatment were asked to answer questionnaires which included SF-36 and lifestyle. The Pearson correlation was applied to identify the relationship between the lifestyle and quality of life in this study. And Chi-square test, T test, and one-way ANOVA test was also used. The QoL of the male subjects with Coronary Artery Disease were higher than female (60.45 ± 12.71 vs. 34.88 ± 0.00, p < 0.01); living in urban was higher than living in rural (61.42 ± 15.37 vs. 53.59 ± 9.7, p < 0.01); and in working patients was higher than unemployment (62.45 ± 12.68 vs. 55.98 ± 14.27, p < 0.01). And the results showed that approximately 47.8% of the Score of SF-36 could be accounted by the Drinking Score – one of the Lifestyle modification in the CAD patients. The quality of life of male patients were higher than that of women. The QoL of urban residents were higher than that of rural people, and working people were higher than that of retirees.

The value of Hendry’s Score in predicting reduced ejection fraction in chronic heart failure patients with sinus rhythm

2023-11-30T10:10:02+07:00

Objectives: To evaluate the role of Hendry’s score based on the electrocardiogram in predicting heart failure with reduced ejection fraction.

Methods: This is a cross-sectional study, including 91 inpatient heart failure patients at the Vietnam Heart Institute, divided into two groups: heart failure with reduced left ventricular ejection fraction (EF ≤ 40 %) and heart failure with preserved left ventricular ejection fraction (EF ≥ 50%). The collected information included the general characteristics of the disease group (age, gender, etiology, clinical symptoms), blood test NT-proBNP, creatinine, electrolytes, echocardiogram, and electrocardiogram.

Results: Forty-seven people were diagnosed with HFpEF, and 44 suffered from HFrEF. Multiple logistic regression analysis revealed certain ECG variables that were independent predictors of HFrEF, i.e., left atrial hypertrophy (LAH), QRS duration > 100 ms, right bundle branch block (RBBB), ST-T segment changes, and prolongation of the QT interval. Based on Hendry’s Score, we obtained a score for HFpEF of -1 to +3. At the same time, HFrEF had a score of +4 to +6 with 81.3% sensitivity, 84% specificity, a 70.5% positive predictive value, an 87.2% negative predictive value, and an accuracy of 86%.

Conclusions: The scoring system derived from this study, including the presence or absence of LAH, QRS duration > 100 ms, RBBB, ST-T segment changes, and prolongation of the QT interval can be used to predict the type of HF with satisfactory sensitivity and specificity.

Coronary Artery Disease Management in Ho Chi Minh City: The Role of Self-Care and Disease Knowledge in Reducing Health Risks

2024-08-06T13:55:25+07:00

In order to avoid cardiac complications, patients with coronary artery disease (CAD) should the effect of self-care agency on health risk behaviors. Coronary artery engage in heart-healthy behaviors. Therefore, it is presumed that individuals have acquired self-care agency and a thorough understanding of their disease. Therefore, we investigated the associations between healthy affect, Self-Care, Disease Knowledge to improve their Health Risks status of patient.

A descriptive-correlational design involving patients with having coronary artery disease (CAD) and being treated in Ho Chi Minh City. The participants (N =191) who living in Binh Chanh, Nha Be, Can Gio and answer questionnaires which included Exercise in Self-care Agency scale (ECSA), Health Behavior Scale (HBS) and the Baecke questionnaire. The Linear regression correlation coefficient analysis, and computed r was applied this study. Result showed significant predictive relationships between self-care agency, disease-related knowledge, and health risk behaviors. Higher levels of self-care agency and disease-related knowledge were associated with lower health risk behaviors. Gender, marital status, and specific health conditions like hypertension and stroke also played significant roles in influencing health risk behaviors. Mediation analysis further revealed that disease-related knowledge partially mediates disease, self-care, health knowledge, health behavior.

The correlation between disease awareness, disposition, and caregiving competency among parents of children with congenital heart disease in selected communities in Vietnam

2024-09-09T08:54:50+07:00

Objectives: To investigate the relationship between disease awareness, caregiving disposition, and competency among parents of children with congenital heart disease.

Methodology: A correlational descriptive study was conducted involving 275 parents of children with congenital heart disease across three regions: the Mekong Delta, Central Highlands, and Central Coastal areas.

Results: Parents of children with congenital heart diseases demonstrated a high level of disease awareness, with a mean score of 3.82. Their atttitude towards the condition was notably positive, scoring an average of 4.65, and their caregiving competency was similarly strong, with a mean score of 4.36. While no significant correlation was found between disease awareness and both disposition or caregiving competency, a significant positive correlation was identified between attitude and caregiving competency, reflected by a high correlation coefficient and a p-value of less than 0.001. Furthermore, the study revealed that the linear regression model had an r² value of 0.386, indicating that 38.6% of the variability in caregiving ability could be explained by factors, such as acceptance of the condition, recognition of parental role, and support and collaboration with other parents of children with congenital heart disease.

Conclusions: Disposition and caregiving competency play a critical role in determining the health outcomes and quality of care for children with congenital heart disease. As such, it is essential to design and implement specialized training programs tailored for parents, aimed at strengthening their caregiving skills and improving the overall well-being of their children.

Improve knowledge about nutrition and nourishment in patients with acute heart failure in 2023

2024-11-18T14:47:34+07:00

Abstract: To improve the quality of treatment and care for heart failure patients, there is an importance of educating patients about self-care and coordinating among cardiologists, cardiological nurses and nutritionists. A prospective and interventional study was conducted in 86 patients who admitted due to acute heart failure at the department of cardiological emergency and intensive care in Vietnam National Heart Institute, Bach Mai Hospital, from July 1^st, 2022 to October 31^th, 2023.

Results: Of the 86 participants, the highest age group was over 75 years old, accounting for 45.5%, males were 55.8%, higher than females being 44.2%. The general nutritional knowledge score was 11.4%, with 72.5% of participants having cognition at a medium level. The knowledge of them about weight was about half (53.8%), about sodium restriction was 51.2% and they were in medium level. After 1-month of discharging, there was improvement in practice (10.78%), compared to 7.8% in admission. There was a significant difference about nutritional self-care between before and after discharged 1 month (t=10.88, p<0.001). There was no statistical significance between the percentage of malnutrition at admission (23.3%) and at discharge (29.1%). 46.5% of patients were interrupted in nourishment while practicing procedures, accounting for 23.3%. After intervention, three-fourths achieved more energy and the most in the sixth day.

Survey on blood glucose and electrolyte levels in patients with acute myocarditis treated at Bach Mai Hospital

2024-11-18T15:26:38+07:00

Background and Objectives:
Myocarditis is a condition characterized by inflammation of the heart muscle tissue due to various causes, with viruses being a common cause. During the progression of the disease, damage to the heart muscle can lead to acute heart failure, dangerous arrhythmias, cardiogenic shock, or even cardiac arrest, which can result in rapid death. Clinical markers such as chest pain, shortness of breath, and arrhythmias, along with diagnostic tools like electrocardiograms and cardiac ultrasounds, play a crucial role in diagnosing and predicting the disease. In addition to monitoring vital signs, tracking blood glucose and electrolyte levels is an important criterion for nurses in managing patients with acute myocarditis. This aids in making appropriate care and treatment decisions for each specific patient. The study aims to investigate blood glucose and electrolyte levels and their relationship with the severity of heart failure and ventricular arrhythmias in patients with acute myocarditis.

Methods:
A retrospective review was conducted on the records of 119 patients with acute myocarditis treated at Bach Mai Hospital from 2017 to 2021. Biochemical results were included in a regression model to assess their correlation with the occurrence of adverse clinical outcomes during hospitalization.

Results:
Among the 119 patients (66.4% male; average age 33.93 ± 15.87 years), significant electrolyte disturbances included severe hyponatremia (6.7%), severe hypokalemia (5.8%), hyperkalemia (8.1%), and blood glucose disorders (31.1%). Severe hyponatremia was found to be predictive of ventricular arrhythmias and in-hospital mortality. Severe hypokalemia was also predictive of ventricular arrhythmias and in-hospital mortality. Hyperkalemia was associated with a higher risk of ventricular arrhythmias. Patients with severe conditions requiring intensive care, such as intravenous feeding or intravenous insulin administration, demonstrated a higher risk of in-hospital mortality.

Conclusion:
Severe electrolyte disturbances, such as severe hyponatremia, severe hypokalemia, and hyperkalemia, have prognostic significance in patients with acute myocarditis.

The Influence of Teamwork Skills and Challenges on Team - Based Learning of Nursing Students in a Selected University in Vietnam

2024-09-24T14:43:59+07:00

Objectives: To explore the influence of teamwork skills and challenges on the team-based learning, in order to optimize the experiences and outcomes of team-based learning for nursing students.

Methodology: A descriptive correlational study was conducted with the participation of 280 second, third, and fourth-year students studying in the Bachelor of Nursing program at a selected university in Da Nang city.

Results: The findings of the study provide valuable insights into the factors influencing teamwork skills and the challenges faced by nursing students when team-based learning. The overall assessment of teamwork skills was answered by students with an average score of 4.03, indicating that students generally had "Agree" teamwork skills, with "communication skills" rated as "Strong Agree". The average score for the challenges encountered was 3.92, which is interpreted as "Usually". This suggests that students generally encountered these challenges frequently, but not always. Specific challenges identified included engagement, time management, motivation, personality conflicts, and social context, all rated as "Often" occurring. Student ratings of team-based learning were rated as "very good" with a mean of 3.91. The relationship between teamwork skills and team-based learning was found to be highly correlated, with Pearson's r = 0.51. The challenges and team-based learning were also highly correlated, with Pearson's r = 0.61. All the correlations were statistically significant, with a p-value of less than 0.001.

Conclusions: These correlations were supported by high Pearson r coefficients and low p-values, indicating a very strong and significant positive relationship. Nursing students demonstrated strong teamwork skills, particularly in adaptability, coordination, decision-making, and communication. The results of this study also suggest that although team-based learning is generally effective, nursing students still face significant challenges, particularly in areas such as time management, motivation, and resolving personality conflicts.

The impact of compassionate care on patient satisfaction with the care provided

2024-10-06T14:46:02+07:00

Objectives: This study investigated the relationship between quality of nursing care, compassionate care, and patient satisfaction. It identifies key factors that contribute to patient satisfaction, allowing nursing managers to develop a targeted model that enhances the quality of care and improves the patient experience. Research Subjects: The study involved 266 patients hospitalized for a minimum of 72 hours at hospital in Vietnam, selected from the General Internal Medicine and General Surgery departments. Research Results: Overall patient satisfaction ratings for nursing care, quality of nursing care, and compassionate care were positive, with mean scores of 3.54 ± 0.69, 3.46 ± 0.86, and 3.54 ± 0.67, respectively. Results showed that 71.1% of patients received compassionate care at the level of "Sometimes", with 22.9% at the level of "Always". The relationship between the level of compassionate care and patient satisfaction was statistically significant (p < 0.001), with patient expectations being the main predictor of satisfaction (β = 0.661, p = 0.003).

Conclusion: Research highlights the importance of maintaining quality of nursing care and incorporating compassionate care attributes to enhance patient satisfaction. Healthcare organizations should focus on improvement quality of nursing care and foster a culture of compassionate care to optimize patient experiences and outcomes.

SCAI cardiogenic shock classification for predicting short-term mortality in acute myocardial infarction

2024-11-23T18:32:00+07:00

Background: Cardiogenic shock (CS) remains a critical complication of acute myocardial infarction (AMI) with severe outcomes. The Society for Cardiovascular Angiography and Interventions (SCAI) classification is a valuable tool for assessing the severity and progression of CS.

Objectives: Our study aimed to evaluate the association between initial SCAI classification and 30-day mortality in AMI patients and assess the prognostic value of SCAI changes within 24 hours post-admission.

Methods: All patients with AMI were classified according to the SCAI stages at admission and re-evaluated after 24 hours. 30-day mortality rates were compared across SCAI stages, and Cox regression analysis was used to assess the risk of death based on 24-hour transition SCAI classification.

Results: At admission, among 232 AMI patients, 50.8% were classified as SCAI A, 21.6% as SCAI B, 23.3% as SCAI C, and 4.3% as SCAI D/E. The 30-day mortality rates for each classification were 1.7% for SCAI A, 30.0% for SCAI B, 68.5% for SCAI C, and 90% for SCAI D/E. Within 24 hours of admission, 14.5% of patients experienced a worsening SCAI stage, 73.4% remained unchanged SCAI, and 12.1% showed improved SCAI. Patients with a worsening SCAI classification had a significantly higher risk of 30-day mortality, with an adjusted hazard ratio (HR) of 50.4 compared to those with stable SCAI status (p log-rank = 0.00001). Conversely, patients with stable or improved SCAI stages had notably lower mortality rates.

Conclusion: The initial SCAI stage at admission and its changes within 24 hours are crucial predictors of 30-day mortality in AMI patients with CS.

Wellens syndrome: A warning sign of an impending "catastrophe"

2023-04-24T15:29:23+07:00

The term acute coronary syndrome includes a set of symptoms and signs attributable to acute myocardial ischemia that is generally due to the rupture or erosion of an atherosclerotic plaque with the consequent formation of a thrombus that totally or partially obstructs the involved coronary artery. It has a wide range of clinical presentations. The electrocardiogram plays an important role in the diagnosis and treatment of acute coronary syndrome, the spectrum includes a normal electrocardiogram, T-wave abnormalities, ST-segment depression, or ST-segment elevation. It is also useful for acute coronary syndrome presentations that are not so typical and can sometimes go unnoticed, such as right or left bundle branch block, posterior wall myocardial infarction, de Winter T wave pattern, and Wellens syndrome. A case of Wellens syndrome was identified in an outpatient cardiology consultation, the patient was immediately referred for urgent invasive coronary angiography, and as a result, a stent was successfully implanted from the ostium of the anterior descending coronary artery. The early identification of these variants is valuable so that the patient receives optimal drug treatment and is referred on time to invasive coronary angiography. The role of the echocardiogram with strain imaging and its contribution to the diagnosis is highlighted.