***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Abstract Background : Disease management programmes ( DMPs ) improve quality of care for patients with heart failure ( HF ) . However , only a limited number of trials have studied the efficacy of such programmes for patients with heart failure with preserved ejection fraction ( HFPEF ) . Objective : To estimate the impact of a structured , nurse-led patient education programme and care plan in general practice on outcome parameters and events in patients with HFPEF . Methods : Single blinded r and omized clinical trial with an intervention over six months and a follow-up during 12 additional months . In the control group , the patients ( n = 41 ) were managed according to Russian national guidelines . Patients in the intervention group ( n = 44 )  received education on individual lifestyle changes and modifications of cardiovascular disease ( CVD ) risk factors , home-based exercise training and weekly nurse consultations in addition to usual care . Results : Six months after their inclusion , patients in the intervention group significantly improved body mass index , waist circumference , six-min walk test distance , total cholesterol , low-density lipoprotein , left ventricular end-diastolic volume index , quality of life and level of anxiety . After 18 months , there were 11 deaths ( 25 % ) or hospitalizations in the intervention group and 12 ( 29 % ) in the control group ( P = 0.134 ) . Cardiovascular mortality and readmission rate were not reduced significantly after six months of follow-up : the hazard ratio was 0.47 ( 95 % CI : 0.17–1.28 ; P = 0.197 ) . After 18 months , this was 0.85 ( 0.42–1.73 ; P = 0.658 ) . Conclusion : This primary care based DMP for patients with HFPEF improved the patients ’ emotional status and quality of life , positively influenced body weight , functional capacity and lipid profile , and attenuated heart remodelling BACKGROUND Preliminary evidence suggests that meditative exercise may have benefits for patients with chronic systolic heart failure ( HF ) ; this has not been rigorously tested in a large clinical sample . We sought to investigate whether tai chi , as an adjunct to st and ard care , improves functional capacity and quality of life in patients with HF . METHODS A single-blind , multisite , parallel-group , r and omized controlled trial evaluated 100 out patients with systolic HF ( New York Heart Association class I-III , left ventricular ejection fraction ≤40 % ) who were recruited between May 1 , 2005 , and September 30 , 2008 . A group-based 12-week tai chi exercise program ( n = 50 ) or time-matched education ( n = 50 , control group ) was conducted . Outcome measures included exercise capacity ( 6- minute walk test and peak oxygen uptake ) and disease-specific quality of life ( Minnesota Living With Heart Failure Question naire ) . RESULTS Mean ( SD ) age of patients was 67 ( 11 ) years ; baseline values were left ventricular ejection fraction , 29 % ( 8 % ) and peak oxygen uptake , 13.5 mL/kg/min ; the median New York Heart Association class of HF was class II . At completion of the study , there were no significant differences in change in 6-minute walk distance and peak oxygen uptake ( median change [ first quartile , third quartile ] , 35 [ -2 , 51 ] vs 2 [ -7 , 54 ] meters , P = .95 ; and 1.1 [ -1.1 , 1.5 ] vs -0.5 [ -1.2 , 1.8 ] mL/kg/min , P = .81 ) when comparing tai chi and control groups ; however , patients in the tai chi group had greater improvements in quality of life ( Minnesota Living With Heart Failure Question naire , -19 [ -23 , -3 ] vs 1 [ -16 , 3 ] , P = .02 ) . Improvements with tai chi were also seen in exercise self-efficacy ( Cardiac Exercise Self-efficacy Instrument , 0.1 [ 0.1 , 0.6 ] vs -0.3 [ -0.5 , 0.2 ] , P < .001 ) and mood ( Profile of Mood States total mood disturbance , -6 [ -17 , 1 ] vs -1 [ -13 , 10 ] , P = .01 ) . CONCLUSION Tai chi exercise may improve quality of life , mood , and exercise self-efficacy in patients with HF . Trial Registration clinical trials.gov Identifier : NCT00110227 Heart failure ( HF ) is the leading cause of rehospitalization in older adults . The purpose of this pilot study was to examine whether telemonitoring by an advanced practice nurse reduced subsequent hospital readmissions , emergency department visits , costs , and risk of hospital readmission for patients with HF . One hundred two patient/caregiver dyads were r and omized into 2 groups postdischarge ; 84 dyads completed the study . Hospital readmissions , emergency department visits , costs , and days to readmission were abstract ed from medical records . Participants were interviewed soon after discharge and 3 months later about effects of telemonitoring on depressive symptoms , quality of life , and caregiver mastery . There were no significant differences due to telemonitoring for any outcomes . Caregiver mastery , informal social support , and electronic home monitoring were not significant predictors for risk of hospital readmission . Further studies should address the interaction between the advanced practice nurse and follow-up intervention with telemonitoring of patients with HF to better target those who are most likely to benefit AIMS Supervised exercise can benefit selected patients with heart failure , however the effectiveness of home-based exercise remains uncertain . We aim ed to assess the effectiveness of a home-based exercise programme in addition to specialist heart failure nurse care . METHODS AND RESULTS This was a r and omized controlled trial of a home-based walking and resistance exercise programme plus specialist nurse care ( n=84 ) compared with  specialist nurse care alone ( n=85 ) in a heart failure population in the West Midl and s , UK . PRIMARY OUTCOME Minnesota Living with Heart Failure Question naire ( MLwHFQ ) at 6 and 12 months . SECONDARY OUTCOMES composite of death , hospital admission with heart failure or myocardial infa rct ion ; psychological well-being ; generic quality of life ( EQ-5D ) ; exercise capacity . There was no statistically significant difference between groups in the MLwHFQ at 6 month ( mean , 95 % CI ) ( -2.53 , -7.87 to 2.80 ) and 12 month ( -0.55 , -5.87 to 4.76 ) follow-up or secondary outcomes with the exception of a higher EQ-5D score ( 0.11 , 0.04 to 0.18 ) at 6 months and lower Hospital Anxiety and Depression Scale score ( -1.07 , -2.00 to -0.14 ) at 12 months , in favour of the exercise group . At 6 months , the control group showed deterioration in physical activity , exercise capacity , and generic quality of life . CONCLUSION Home-based exercise training programmes may not be appropriate for community-based heart failure patients AIM One of the major treatment goals in congestive heart failure ( CHF ) is to preserve the functional level of the patient and to improve psychosocial factors . For these purpose s , exercise training is recommended for the management of CHF . With this background , the aim of this study is to investigate the effects of aerobic exercise on quality of life , depression and anxiety levels in a Turkish patient population with CHF . METHODS Sixty patients with CHF in stage II-III according to NYHA were included . Patients were r and omly assigned either to a cardiac rehabilitation group or to a control group .  Twenty-seven patients were allocated to a weekly aerobic walking program on treadmill , thrice a week for 8 weeks , and 26 patients  did not receive any exercise training . Both groups were assessed by an ergospirometric exercise test , Hacettepe Quality of Life Question naire ( HQoL ) , Beck Depression Inventory ( BDI ) , Spielberger Trait Anxiety Inventory ( STAI ) at baseline and at the end . RESULTS Forty-four patients ( treatment group : 23 ) completed the study . In the treatment group , significant increases in peak oxygen consumption , exercise time and metabolic equivalents ( MET ) levels were attained ( P=0.001 , P=0.001 , P=0.003 , respectively ) . Significant decreases in BDI ( P=0.004 ) and STAI subgroups ( P=0.049 , P=0.023 , respectively ) were observed , whereas there was no change in HQoL scores . In the control group , there was no difference between baseline and 8th week evaluation in all parameters . CONCLUSIONS Patients with CHF tolerated aerobic exercise programs well . This result ed with improvement in both physical and psychologic wellbeing , but not in quality of life in the short term The purpose of this study was to evaluate the effect of stress management training on quality of life , functional capacity , and heart rate variability in elderly patients with New York Heart Association class I-III congestive heart failure ( CHF ) . While substantial research exists on stress management training for patients with coronary heart disease , there are few data on the value of psychosocial training on patients with CHF . Thirty-three multiethnic patients ( mean age , 66+/-9 years ) were assigned through incomplete r and omization to one of two treatment groups or a wait-listed control group . The 14 participants who completed the treatment attended eight training sessions during a 10-week period . The training consisted of 75-minute sessions adapted from the Freeze-Frame stress management program developed by the Institute of HeartMath . Subjects were assessed at baseline and again at the completion of the training . Depression , stress management , optimism , anxiety , emotional distress , and functional capacity were evaluated , as well as heart rate variability . Significant improvements ( p<0.05 ) were noted in perceived stress , emotional distress , 6-minute walk , and depression , and positive trends were noted in each of the other psychosocial measures . The 24-hour heart rate variability showed no significant changes in autonomic tone . The authors noted that CHF patients were willing study participants and their emotional coping and functional capacity were enhanced . This program offers a simple and cost-effective way to augment medical management of CHF . Given the incompleteness of CHF medical management and the exploding interest in complementary medical intervention , it seems imperative that further work in psychosocial treatment be undertaken Objectives : To evaluate the feasibility of screening and recruiting patients with major depression and congestive heart failure ( CHF ) in a tertiary care cardiology hospital and to obtain preliminary efficacy , tolerability , and safety data for nefazodone treatment of a major depressive episode in CHF patients . Method : We conducted a 12-week , open-label trial of nefazodone given in dosages up to 600 mg daily . We assessed patients at baseline , 1 , 2 , 4 , 8 , and 12 weeks . Measures used were the 17-item Hamilton Depression Rating Scale ( HDRS ) , the Clinical Global Impression Scale , the Beck Depression Inventory , Spielberger 's State-Trait Anxiety Inventory , and the Minnesota Living with Heart Failure Question naire . We also obtained pre- and post study ECGs , 24-hour Holter monitor recordings , and plasma levels of norepinephrine .  Results : After screening 443 CHF patients , 28 patients with major depression met study eligibility criteria . The 23 patients who completed 4 or more weeks of medication showed significant improvement on all depression scales and in quality of life . Of 19 subjects who completed the full 12-week trial , 74 % experienced a decline of 50 % or more on HDRS scores . The completers also showed a significant reduction in heart rate , an increase in QT intervals ( but not in the QTc ) , and a marginally significant decrease in plasma norepinephrine . There were no changes in heart rate variability . Conclusions : It is feasible to screen and recruit CHF patients with major depression for an antidepressant trial . Nefazodone seems sufficiently safe , tolerable , and efficacious to justify a larger , placebo-controlled trial Purpose To compare the effects of home-based and hospital-based exercise programs on exercise capacity , quality of life , psychological symptoms , and hemodynamic parameters in heart failure ( HF ) patients . Methods Seventy-four patients were r and omized into either a hospital-based exercise  ( Group 1 ) or a  home-based exercise ( Group 2 ) group . Prior to and after the 8-week rehabilitation program , the two groups were compared with respect to their functional capacity [ maximal oxygen uptake ( pVO2 ) and 6-min walk test ( 6MWT ) ] , quality of life ( Medical Outcomes Study and the 36-item Short Form Survey , SF-36 ) , psychological symptoms [ Beck Depression Inventory ( BDI ) and State-Trait Anxiety Inventory ] , and hemodynamic parameters [ ( left ventricular diastolic diameter in diastole , left ventricular diameter in systole , Mitral Early diastolic peak flow velocity (E)/late diastolic peak flow velocity ( A ) , Mitral E/Mitral early peak velocity ( Em ) , Tei index , right ventricular systolic peak velocity ( Sm ) , tricuspid annular plane systolic excursion , systolic pulmonary arterial pressure ( SPAP ) , and left and right ventricular ejection fraction ( LVEF and RVEF ) ] . Results After the exercise programs , significant improvement was observed in pVO2 , 6MWT and subscales of physical function , general health , and vitality of SF 36 , as well as BDI and LVEF in both groups ( P < 0.05 ) . A comparison of the two exercise groups revealed no significant differences between them regarding the analyzed variables ( P > 0.05 ) . Conclusion Both the hospital-based and home- 
    Output:
    
Studies with SSRIs examined effects of sertraline , paroxetine , and citalopram .
CONCLUSIONS Evidence is strong that pharmacology and CAM may improve depression .
Moderate evidence supports the use of exercise .
A strong body of evidence indicates that disease management programs do not improve depression .