Search results for "HEART"

High- versus low-dose ACE inhibition in chronic heart failure

1998

Abstract Objectives. To determine dose-related clinical and neurohumoral effects of angiotensin-converting enzyme (ACE) inhibitors in patients with chronic heart failure (CHF), we conducted a double-blind, placebo-controlled, randomized study of three doses (2.5 mg, 5 mg and 10 mg) of the long-acting ACE inhibitor imidapril. Background. The ACE inhibitors have become a cornerstone in the treatment of CHF, but whether high doses are more effective than low doses has not been fully elucidated, nor have the mechanisms involved in such a dose-related effect. Methods. In a parallel group comparison, the effects of three doses of imidapril were examined. We studied 244 patients with mild to moder…

Colesterol-no HDL como objetivo terapéutico

2019

Although cholesterol linked to low-density lipoproteins (c-LDL) is well established as a risk factor for cardiovascular disease, there is often a more complex dyslipidaemia pattern that contributes to the formation of atherosclerotic plaque. Non-HDL cholesterol (c-NO-HDL) is used to estimate the total amount of atherogenic lipoproteins in plasma, some of which are not usually determined in daily clinical practice. c-NO-HDL is easily calculated from the subtraction of total plasma cholesterol from the cholesterol content carried by high density lipoproteins. The c-NO-HDL has a predictive value superior to that of C-LDL to estimate the risk of major cardiovascular events in epidemiological st…

Subclinical atrial fibrillation: how hard should we look?

2012

More than three decades ago, an analysis from the Framingham Heart Study revealed that atrial fibrillation (AF) increases the risk of stroke by a factor of five in non-rheumatic AF and by a factor of 17 in rheumatic AF.1 Since then, it has convincingly been shown that anticoagulation is one of the most effective secondary stroke prophylactic treatment options, which reduces the risk of stroke by 2/3,2 even in an older population.3 AF may occur in different types and in an individual patient often starts with paroxysmal AF, but later becomes persistent or permanent AF.4 Interestingly, the risk of stroke or systemic embolism is influenced by cardiovascular risk factors such as hypertension, d…

Avoidant coping, verbal-autonomic response dissociation and pain tolerance

2006

Higher autonomic reactivity relative to self-reported discomfort, often found in repressors and avoidant copers might be associated with a diminished perception of bodily symptoms. This study aimed at relating such so-called verbal-autonomic response dissociation to pain tolerance. Eighty-five volunteers underwent a public speaking task and a cold pressor test. Heart rate and negative affect in response to the speech, and pain ratings and facial muscle responses for the cold pressor were obtained. A dissociation score was calculated for each individual in response to speech, thereby subtracting standardized changes in negative affect from standardized changes in heart rate. Response dissoci…

P1462 Additive value of global longitudinal strain measurement in patients with known or suspected ischaemic heart disease undergoing stress echo

2020

Abstract BACKGROUND Speckle-tracking echocardiography (STE) can be applied in a large variety of clinical conditions. Global longitudinal strain (GLS) shows high diagnostic accuracy for the detection of myocardial ischemia as it reflects changes in subendocardial fibers deformation that are more exposed to ischemic damage, even before alterations in segmental kinetics are revealed. PURPOSE Aim of our study was to assess whether the measurement of global longitudinal strain during stress-echo can provide additional information compared to the assessment of conventional parameters such as left ventricular ejection fraction (LVEF) and wall motion abnormalities. We also evaluated the added valu…

Predictors of diuresis response to levosimendan administration in patients with acute heart failure

2021

Abstract Funding Acknowledgements Type of funding sources: None. Levosimendan, a calcium sensitizer and potassium channel-opener, is appreciated  for its effects on systemic and pulmonary hemodynamic and for the relief of symptoms in acute heart failure (AHF). Positive effects of levosimendan on renal function have been also described. The aim of the present analysis was to assess the predictors of the diuresis response to levosimendan administration in high risk acute heart failure patients. Methods We analysed 34 consecutive patients admitted with high risk AHF to one centre and treated in intensive cardiac care unit. Levosimendan was administered on top of other treatment as a 24-hour in…

Prognostic Value and Kinetics of Soluble Neprilysin in Acute Heart Failure

2015

Abstract Objectives This study sought to examine the prognostic value of the soluble form of neprilysin (sNEP) in acute heart failure (AHF) and sNEP kinetics during hospital admission. Background sNEP was recently identified in chronic heart failure (HF) and was associated with cardiovascular outcomes. Methods A total of 350 patients (53% women, mean 72.6 ± 10.7 years of age) were included in the study. Primary endpoints were composites of cardiovascular death or HF hospitalizations at short-term (2 months) and long-term (mean: 1.8 ± 1.2 years) follow-up. sNEP was measured using an ad hoc–modified enzyme-linked immunosorbent assay, and its prognostic value was assessed using Cox regression …

Heart failure with mid-range ejection fraction: a transition phenotype?

2017

Heart failure with preserved ejection fraction infrequently evolves toward a reduced phenotype in long-term survivors: a long-term prospective longit…

2019

Background: Long-term trajectories of left ventricular ejection fraction (LVEF) in heart failure (HF) patients with preserved EF (HFpEF) remain unclear. Our objective was to assess long-term longitudinal trajectories in consecutive HFpEF patients and the prognostic impact of LVEF dynamic changes over time. Methods and Results: Consecutive ambulatory HFpEF patients admitted to a multidisciplinary HF Unit were prospectively evaluated by 2-dimensional echocardiography at baseline and at 1, 3, 5, 7, 9, and 11 years of follow-up. Exclusion criteria were patients having a previous known LVEF <50%, patients undergoing only 1 echocardiogram study, and those with a diagnosis of dilated, noncompa…

Symmetric dimethylarginine serum level as a new marker of left ventricular ejection fraction in patients with acute myocardial infarction

2013

Purpose: Asymmetric dimethylarginine (ADMA) is a by-product of protein methylation that has been implicated in the prognosis after acute myocardial infarction (MI) and heart failure through Nitric Oxide Synthase (NOS) inhibition. We aimed to investigate whether SDMA – the endogenous symmetrical stereoisomer of ADMA- that has insignificant inhibitory effects on NOS- might be a marker of left ventricular function in acute MI. Methods: Blood samples from 635 consecutive patients hospitalized 1 (23%). Mean LVEF was 55±13%. Mean ADMA, SDMA and L-arg levels were at 0.72±0.42, 0.51±0.44 and 91±54 μmol/L, respectively. Spearman analysis showed that LVEF was correlated negatively with SDMA (r=-0.151…