1,721,310 research outputs found
Facts and numbers on epidemiology and pharmacological treatment of heart failure with preserved ejection fraction
No full textHeart failure with preserved ejection fraction (HFpEF) is a major and growing public health problem. Epidemiologic studies demonstrated that heart failure (HF) can be clinically diagnosed in patients with normal or preserved left ventricular ejection fraction. These patients are therefore termed as having HFpEF. In the past, this was often called diastolic HF. Because of the permanent increase of the prevalence of HFpEF during the past decades, HFpEF now accounts for more than 50% of the total HF population. There are uncertainties and debates regarding the definition, diagnosis, and pathophysiology with the consequence that all outcome trials performed so far used criteria for inclusion and exclusion that were not consistent. These trials also failed to document improved prognosis. Recent smaller proof-of-concept or Phase II clinical trials investigating different pathophysiological approaches with substances such as the neprilysin inhibitor–angiotensin receptor blocker− combination (LCZ 696), ranolazine, or ivabradine were successful to improve biomarkers, haemodynamics, or functional capacity. Future trials will need to document whether also prognosis can be improved
Cyclooctatetraenyl complexes of the early transition metals and lanthanides. 13. The first organolanthanide complex of the tripod ligand [(C5H5)Co{P(O)(OEt)(2)}(3)](-)
No full textThe reaction of [(eta(8)-C8H8)Sm(mu-Cl)(THF)](2) (1) with Na[(C5H5)Co{P(O)(OEt)(2)}(3)] (2) in a molar ratio of 1:2 in THF solution affords orange, crystalline (eta(8)-C8H8)Sm[(C5H5)Co-{P(O)(OEt)(2)}(3)] (3) as the first organolanthanide complex containing Klaui's tripod ligand. The compound has been fully characterized by elemental analysis and spectroscopic methods
Comorbidities in heart failure with preserved ejection fraction
No full textChronic heart failure is one of the most common causes of hospitalization and death in industrialized countries. Demographic changes with an aging population are expected to further increase the prevalence of chronic heart failure. The associated increase in comorbidities in patients with chronic heart failure leads to a less favorable prognosis for survival. A selection of the major comorbidities discussed in this review—along with prevalence, impact on prognosis, treatment approaches, and current study status—include atrial fibrillation, arterial hypertension, coronary artery disease, coronary microvascular dysfunction, renal dysfunction, type 2 diabetes, sleep apnea, reduced lymphatic reserve, and the effects on oxygen utilization and physical activity. The complex clinical picture of heart failure with preserved ejection fraction (HFpEF) remains challenging in the nearly absence of evidence-based therapy. Except for comorbidity-specific guidelines, no HFpEF-specific treatment of comorbidities can be recommended at this time. Optimized care is becoming increasingly relevant to reducing hospitalizations through a seamless inpatient and outpatient care structure. Current treatment is focused on symptom relief and management of associated comorbidities. Therefore, prevention through early minimization of risk factors currently remains the best approach
Recommendations for the treatment of heart failure. What's new?
No full textTreatment escalation of chronic systolic heart failure depends on left ventricular function and symptoms of the patients. In symptomatic patients with severely reduced left ventricular function (ejection fraction a parts per thousand currency signaEuro parts per thousand 30 %), the following therapeutic approaches are recommended: (1) angiotensin-converting enzyme (ACE) inhibitors (angiotensin receptor blocker in case of ACE inhibitor intolerance); (2) beta-blockers; (3) mineralocorticoid receptor antagonists; (4) diuretics in case of signs and symptoms of congestion; (5) digitalis, in particular in patients with atrial fibrillation; (6) ivabradine in patients with sinus rhythm and a heart rate a parts per thousand yenaEuro parts per thousand 75/min; (7) an implantable cardioverter defibrillator (ICD); (8) in case of left bundle branch block or wide QRS complex, cardiac resynchronization therapy (CRT; in most cases in combination with an implantable cardioverter defibrillator); (9) intravenous administration of iron in case of iron deficiency; (10) exercise training should be strongly recommended in patients with stable heart failure
Diagnosis of Heart Failure with Preserved Ejection Fraction
No full textHeart failure with preserved ejection fraction (HFpEF) constitutes a growing health care burden worldwide. Although definitions vary somewhat among guidelines, in general the presence of typical heart failure symptoms and signs in combination with a preserved left ventricular ejection fraction (>= 50%) and functional and/or structural left ventricular changes makes the diagnosis likely. This review focuses on the current understanding of diagnostic criteria, as presented in current guidelines and consensus recommendations, and on new insights from recent papers. The role of comorbidities that often contribute to symptoms and hamper the HFpEF diagnostics is also reviewed
ansa-Metallocene von Calcium und Strontium: Eintopfsynthese von Organometallkomplexen der schwereren Erdalkalimetalle
No full textDichloro(dimethylsulfoximino)phosphane
No full textThe title compound, C2H6Cl2NOPS, crystallizes as dimers via C - H center dot center dot center dot O hydrogen bonds. S - N [ 1.5446 ( 16) angstrom] is shorter than P - N [ 1.618 ( 2) angstrom], although the latter is a short phosphorus - nitrogen single bond
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