Tinnitus in Elderly Patients as an
Indicator of Prognosis of Mild-To-Moderate Congestive Heart Failure –Study
Author: Dr. Reeja Tharu
Date: July 06, 2011 - General Health News
Claudio Borghi et al carried out a study
to assess the prevalence of tinnitus in a large group of elderly patients with
chronic heart failure (CHF) and to define the relationship between the
occurrence of tinnitus and the severity and prognosis of CHF.
Tinnitus
Tinnitus is a head noise, which does not
have an external source. It is usually perceived by the patient alone and
cannot be heard by anyone outside. The noise may lasts for five or more minutes
and may occur at least once a week.
Tinnitus is largely considered a
nonspecific symptom of an unknown dysfunction of the hearing system and is
associated with hearing loss of various degrees.
Various factors are associated with
tinnitus ranging from genetic to iatrogenic, neurological to vascular. However
a proper explanation is still not available.
Any clinical condition that causes a
reduction in blood flow to the ear level can cause tinnitus or trigger a flare
in those patients already affected by this disorder.
Various clinical conditions are
associated with tinnitus and they include middle ear diseases, vascular
diseases, hypertension, diabetes, autoimmune disorders, and degenerative neural
disorders.
Chronic heart failure (CHF)
CHF could be considered as an ideal
biological model to test the vascular disregulatory hypothesis of tinnitus
since it is linked to reduced cardiac output.
Like tinnitus, CHF too is more prevalent
in the elderly population.
Method Of Study
A cross–sectional study was carried out
on 958 consecutive elderly patients (age >65 years) with a diagnosis of CHF
to correlate the relationship between tinnitus and the clinical prognosis of
mild-to-moderate chronic heart failure (CHF) in a large group of elderly patients.
Blood pressure, echocardiographic
parameters, brain natriuretic peptide (BNP), hospitalization, and mortality for
CHF were some of the parameters that were measured.
Multivariate logistic regression was used
for analysis.
Patients who were excluded from the study
include those with –
• Stage 3 to stage 5 chronic renal
failure
• Hypoproteinemia
• Recent increase in diuretic dosage (less
than 30 days)
• Diuretic dosage change during follow-up
• Use of other ototoxic drugs such as
aminoglycosidics
• Continuous use of fully dosed non-steroidal
anti-inflammatory drugs (NSAIDs).
Each patient was actively followed-up for
a cumulative period of 12 months after enrolment in the study.
Conclusion
To date, this is the first large, cross-sectional,
clinical study that has been carried out to link tinnitus and CHF in elderly
patients.
The study suggests that in the elderly, presence
of tinnitus is linked to a decline in LV function and that this could be the
result of insufficient auto regulatory mechanism related to circulation of the
inner ear.
The one-year hospitalization and
mortality from CHF was significantly increased in patients with tinnitus.
This may be considered as an indirect symptom
of poor hemodynamic stability in elderly CHF patients and allows for the early
identification of patients with CHF who need more aggressive management to
improve their quality of life.
The data from this study indirectly
supports the hypothesis that tinnitus is linked to poor CHF control in elderly
patients and can have some important clinical implications in the early
identification of CHF patients who need aggressive management.
Source: Tinnitus in elderly patients and
prognosis of mild-to-moderate congestive heart failure: a cross-sectional study
with a long-term extension of the clinical follow-up; Claudio Borghi et al; BMC
Medicine 2011.
Fuente-Medindia
Articulo Original: Tinnitus in Elderly
Patients as an Indicator of Prognosis of Mild-To-Moderate Congestive Heart
Failure -Study - |
MedIndia http://www.medindia.net/news/Tinnitus-in-Elderly-Patients-as-an-Indicator-of-Prognosis-of-Mild-To-Moderate-Congestive-Heart-Failure-Study-87371-2.htm#ixzz1tfYYOX7y
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