Nonpharmacologic therapy improves functional and emotional status in congestive heart failure

J B KostisA C Wilson


To compare the effects of a multimodal nonpharmacologic intervention to digoxin and to placebo in patients with congestive heart failure receiving background therapy with angiotensin-converting enzyme inhibitors. Randomized, parallel assignment to three treatment groups of 20 patients with congestive heart failure (New York Heart Association Class II and III). Nonpharmacologic treatment program included the following: (1) graduated exercise training, three to five times per week; (2) structured cognitive therapy and stress management; and (3) dietary intervention aimed at salt reduction and weight reduction in the overweight. Digoxin was titrated to achieve a blood level between 0.8 and 2.0 ng/ml. Placebo and digoxin were administered in a randomized, double-blind fashion. Echocardiographic ejection fraction improved (p < 0.05) in the digitalis group (change = +4.4 +/- 6.5) compared with both placebo (change = -3.2 +/- 3.9) and nonpharmacologic therapy (change = -3.2 +/- 3.9). The nonpharmacologic treatment program was well tolerated by all patients and resulted in significant improvement (p < 0.05) in exercise tolerance (digoxin = +51 +/- 50 s, placebo = +91 +/- 76, nonpharmacologic therapy = +182 +/- 139), as well as Beck Dep...Continue Reading

Associated Clinical Trials


Jan 1, 1992·Cardiology·T P Archer, C V Leier
Jun 1, 1992·Archives of Internal Medicine·W B ApplegateM J Graney
Jun 1, 1992·British Heart Journal·N G Uren, D P Lipkin
Jan 1, 1991·Journal of Cardiovascular Pharmacology·G JenningsE Dewar
Jan 1, 1991·International Journal of Psychiatry in Medicine·R A MaricleJ D Hosenpud
Sep 1, 1990·The Journal of Clinical Investigation·J R MinottiM V Icenogle
Jan 1, 1989·Cardiology·P Dubach, V F Froelicher
Aug 1, 1987·Journal of Clinical Psychopharmacology·S P RooseJ T Bigger
Mar 1, 1983·Annals of Internal Medicine·E ReisinH M Batson
Oct 21, 1983·JAMA : the Journal of the American Medical Association·A H GlassmanJ T Bigger
Feb 25, 1993·The New England Journal of Medicine·L SandvikK Rodahl
Apr 1, 1993·Journal of the American College of Cardiology·S AdamopoulosG K Radda
Jun 1, 1961·Archives of General Psychiatry·A T BECKJ ERBAUGH
Feb 1, 1960·Journal of Neurology, Neurosurgery, and Psychiatry·M HAMILTON

❮ Previous
Next ❯


Feb 7, 2001·Rehabilitation Nursing : the Official Journal of the Association of Rehabilitation Nurses·B A Goodwin
Oct 13, 2007·Heart Failure Reviews·Carlos Eduardo Negrao, Holly R Middlekauff
Oct 19, 2012·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·Misook L ChungSusan K Frazier
Jun 1, 1997·International Journal of Nursing Studies·T JaarsmaK Dracup
Jan 1, 1999·Progress in Cardiovascular Diseases·A AfzalS J Keteyian
Sep 15, 1998·Lancet·L R Erhardt, C M Cline
Apr 5, 2000·International Journal of Cardiology·M F Piepoli, A Capucci
Aug 30, 2000·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·A Giordano
Jan 2, 2004·The American Journal of Nursing·Nancy T Artinian
Jul 21, 2000·The Journal of Cardiovascular Nursing·D K Moser, P L Worster
Nov 6, 2004·The Journal of Cardiovascular Nursing·Nancy T ArtinianMitzi M Saunders
Jan 6, 2005·The Journal of Cardiovascular Nursing·Mary KodiathMartha Shively
Jan 1, 1997·Journal of Cardiopulmonary Rehabilitation·S J KeteyianJ R Schairer
Aug 31, 2001·The American Journal of Geriatric Cardiology·W S Aronow
Feb 12, 2004·Nursing in Critical Care·Catherine T Mondoa
Dec 19, 2002·The Online Journal of Knowledge Synthesis for Nursing·Cynthia D. Adams, Susan Bennett
Jun 29, 2002·The Online Journal of Knowledge Synthesis for Nursing·Maryanne CrowtherRichard Hader
Feb 6, 2002·Congestive Heart Failure·R B Berlin, B R Schatz
Nov 21, 2001·Current Controlled Trials in Cardiovascular Medicine·Andrew JS Coats
Aug 9, 2012·Journal of Geriatric Physical Therapy·Joseph F Norman
Dec 2, 2004·Sports Medicine·Tim MeyerWilfried Kindermann
Nov 25, 2003·Southern Medical Journal·Marshall H ChinPaul J Rathouz
Apr 27, 2011·Nature Reviews. Cardiology·Andrew J Stewart Coats
May 17, 2002·Current Opinion in Cardiology·D PsirropoulosG Tsapas
Oct 3, 1999·Journal of the American Academy of Nurse Practitioners·M Simón-Weinstein
Jun 2, 2005·Expert Opinion on Investigational Drugs·John T ParissisDimitrios Kremastinos
Jan 12, 2013·Heart & Lung : the Journal of Critical Care·Misook L ChungDebra K Moser
Jul 14, 2010·Journal of Psychosomatic Research·Rebecca A GaryAndrew L Smith
Jun 9, 2009·International Journal of Cardiology·Dimitris TousoulisChristodoulos Stefanadis
Feb 6, 2008·The Nursing Clinics of North America·Rebecca L Dekker
Jul 31, 2007·International Journal of Cardiology·Christine NorraPatrick Schauerte
Jan 20, 2007·Heart & Lung : the Journal of Critical Care·Seongkum HeoMisook L Chung
Jul 17, 2003·Journal of the American Academy of Nurse Practitioners·Maryanne Crowther
Dec 31, 2008·Pharmacotherapy·Kristin Watson, Kelly M Summers

❮ Previous
Next ❯

Related Concepts

Trending Feeds


Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.


Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.


Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.