According to the American Heart Association, there are currently 5 million Americans diagnosed with congestive heart failure and that number is steadily increasing (AHA, 2003). The alarming problem of congestive heart failure and other related medical complications has created a need for devices that not only assist the heart but also help the heart to grow and remodel back to its normal configuration. Currently, there are several direct cardiac compression devices (DCCDs) that do assist the heart, however, they do not help the heart to grow and remodel correctly. Dr. John C. Criscione of Texas A&M University has proposed a novel DCCD, in which the compression of the device reinforces the natural curvature of the heart, helping it to grow and remodel correctly. It is hypothesized that with the support of the device, the cells of the heart will be stimulated to grow and remodel back to their normal size and return to their proper function. Two key components necessary to the novel DCCD were designed and constructed for this study. The first component was an adjustable outer shell which enabled the device to become smaller as the failing heart returned to normal size. The second component was an inflatable inner membrane that applies direct pressure to the outer wall of the heart in a way that promotes physiological stress and strain patterns.

Cardiovascular disease (CVD) is the leading cause of death in the United States. Oxidative stress plays an important role in the pathogenesis of CVD. Heart failure is the end point of many forms of CVD. The purpose of this study is to identify novel cardiac specific indicators of oxidative injury useful for early and convenient diagnosis of heart failure.To determine the most suitable method for identification of non-invasive oxidative injury indicators in general, human diploid fibroblasts (HDFs) were treated with H2O2 for collection of mRNA, cell lysates and conditioned media to perform cDNA microarray and LC-MS/MS based Multidimensional Protein Identification Technology (MudPIT) analyses. Electron Spray Ionization (ESI)-LC-MS/MS analysis of the conditioned media led to the finding of IGFBP-6 as a non-invasive biomarker of cell oxidative injuy in vitro and in vivo. The data obtained from this study indicate that proteomic analysis of conditioned media is useful to identify non-invasive biomarkers valuable for diagnosis or management of diseases.Cardiomyocyts (CMCs) and Cardiac fibroblasts (CFs) in culture were used to identify cardiac specific indicators of oxidative stress. Increased level of Cystatin C was detected in the conditioned medium of CMCs due to H2O2 treatment. In vivo models of oxidative stress were used to validate the increase of Cystatin C. Cystatin C levels increased in the plasma of mice with doxorubicin induced cardiomyopathy and coronary artery occlusion induced myocardial infarction (MI). These data indicate that Cystatin C can be a potential indicator of CMC oxidative injury in vitro and in vivo.Cystatin C is a cysteine protease inhibitor. The finding that oxidative stress induces Cystatin C led us to investigate a novel pathway regulating cardiac extracellular matrix (ECM) with CFs in culture, increased levels of ECM protein and decreased levels of Cathepsin B (CTB) protein and activity were detected upon Cystatin C treatment. With coronary artery occlusion induced MI mouse model, increased levels of Cystatin C and ECM protein and decreased levels of CTB protein and activity were detected in the infarcted area of the myocardium. These data indicate that Cystatin C serves as a potential fibrotic factor during myocardial remodeling.

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Syfte:            Syftet med denna litteraturstudie var att studera hur personer med hjärtsvikt kan få en förbättrad nutrition genom egenvård. Metod:          Studien genomfördes som en litteraturöversikt. Artiklarna söktes via databaserna CINAHL och PubMed. Resultat:       Studiens resultat innehöll 10 artiklar med kvantitativ ansats. En förutsättning för att personer med hjärtsvikt ska klara sin egenvård och ges möjlighet att förbättra sin nutrition är utbildning. Utbildningsmetoder som i föreliggande litteraturstudie har visat sig fungera är att kombinera skriftlig och muntlig utbildning. Undervisningen bör innehålla information om vilken typ av mat personer med hjärtsvikt behöver äta samt varför. En god följsamhet till givna riktlinjer nås genom att ge personer med hjärtsvikt individuellt anpassad information samt att uppföljning sker och information ges kontinuerligt. Slutsats:        Det är mycket viktigt att hälso- och sjukvårdspersonal kombinerar muntlig och skriftlig information vid utbildning inom nutrition riktad till personer med hjärtsvikt för att stärka deras egenvård. Hälso- och sjukvårdspersonal bör se till att kontinuerlig uppföljning sker för att optimera följsamheten.

Thesis (M Nursing)--Montana State University--Bozeman, 2009. / Typescript. Chairperson, Graduate Committee: Susan Luparell. Includes bibliographical references (leaves 49-53).

Thesis (M.S.)--University of Michigan, 1998. / Includes bibliographical references.

Thesis (M.S.)--University of Michigan, 1998. / Includes bibliographical references.

Thesis (M.S.)--Ball State University, 2008. / Title from PDF t.p. (viewed on Aug. 21, 2009). Research paper (M.S.), 3 hrs. Includes bibliographical references (p. 53-56).

Thesis (M. S.)--Florida State University, 2005. / Advisor: Jeanne Flannery, Florida State University, School of Nursing. Title and description from dissertation home page (viewed Feb. 7, 2006). Document formatted into pages; contains vii, 90 pages. Includes bibliographical references.

Thesis (M.S.)--Ball State University, 2009. / Title from PDF t.p. (viewed on July 12, 2010). Research paper (M.S.), 3 hrs. Includes bibliographical references (p. 48-50).