36 research outputs found
Heart Failure with Preserved Ejection Fraction and Pulmonary Hypertension: Focus on Phosphodiesterase Inhibitors
No full textPulmonary hypertension (PH) is common in patients with heart failure with preserved ejection fraction (HFpEF). A chronic increase in mean left atrial pressure leads to passive remodeling in pulmonary veins and capillaries and modest PH (isolated postcapillary PH, Ipc-PH) and is not associated with significant right ventricular dysfunction. In approximately 20% of patients with HFpEF, “precapillary” alterations of pulmonary vasculature occur with the development of the combined pre- and post-capillary PH (Cpc-PH), pertaining to a poor prognosis. Current data indicate that pulmonary vasculopathy may be at least partially reversible and thus serves as a therapeutic target in HFpEF. Pulmonary vascular targeted therapies, including phosphodiesterase (PDE) inhibitors, may have a valuable role in the management of patients with PH-HFpEF. In studies of Cpc-PH and HFpEF, PDE type 5 inhibitors were effective in long-term follow-up, decreasing pulmonary artery pressure and improving RV contractility, whereas studies of Ipc-PH did not show any benefit. Randomized trials are essential to elucidate the actual value of PDE inhibition in selected patients with PH-HFpEF, especially in those with invasively confirmed Cpc-PH who are most likely to benefit from such treatment
Asymptomatic Left Ventricular Hypertrophy Is a Potent Risk Factor for the Development of HFpEF but Not HFrEF: Results of a Retrospective Cohort Study
No full text(1) Background: The structural and functional features of the natural history of asymptomatic hypertensive left ventricular hypertrophy (LVH) are not clearly defined. (2) Objective: To determine structural and functional changes in asymptomatic hypertensive LVH, as well as the incidence and predictors of the transition to different phenotypes of heart failure (HF) after a long-term follow-up. (3) Methods: Based on the assessment of chart reviews, we retrospectively selected 350 asymptomatic patients with hypertensive concentric LVH and LV ejection fraction (EF) ≥ 50%. After a median follow-up of 8.1 years, 223 patients had a re-assessment. The final diagnosis (HF with reduced EF [HFrEF], or HF with preserved EF [HFpEF]) was established according to current recommendations. (4) Results: After a follow-up, only 13% of patients remained asymptomatic, 72% developed HFpEF, and 15% developed HFrEF. The transition to HFpEF was associated with an increase in LV diastolic dysfunction grade in 62% of patients. Multivariable analysis identified age, duration of hypertension, interval changes in LV mass, and a lack of statin treatment as independent predictors of HFpEF. Among 34 patients who developed HFrEF, 16 patients (7% of the whole group) had no interval myocardial infarction, corresponding to an internal mechanism of systolic dysfunction. All these 16 patients had mild systolic dysfunction (LVEF > 40%). Baseline LVEF and LV end-diastolic dimension, and interval atrial fibrillation were identified as predictors of internal HFrEF. (5) Conclusions: The majority of patients with asymptomatic LVH developed HFpEF after long-term follow-up, which was associated with the deterioration of LV diastolic dysfunction and a lack of statin treatment. In contrast, the transition to HFrEF was infrequent and characterized by mild LV systolic dysfunction
Half a Century of Life Don Khutor: the Parish Chronicle of St. Panteleimon• s Church of Khutor Letovskiy, Stanitsa Kremenskaia, Ust`-Medveditskaya District, Troops of the Don Region (1873-1929)
No full textThe article puts forward into scientific circulation a valuable source on the history of the parish life of the late 19th — early 20th century on the Don — the parish chronicle found in one of the investigations of the repressed clergy. This chronicle is unique high temporal coverage, from 1873 to 1929, it includes the years of revolution, Civil war on the Don and the first post-revolutionary decade. The author gives a brief overview of the history of the chronicle, the characteristics of its six authors — rural priests. The first thirty years were marked by the construction and decoration of the church and the absence of conflict. The early twentieth century was marked by the confl icts of the parishioners with the clergy. In the chronicle it was described the hardships of the lives of ordinary Cossacks, the scourge of Civil war, the famine of the early 1920s. In the postwar years there has been growing discontent of the parishioners by the activities of the Soviet government: tax policy, anti-religious propaganda and oppression of the clergy, beginning with collectivization. Narratives are rural priests, and it refl ects their own perception of the key events of the age. The author in the article examines the attitude of the parishioners to the Church, their perception of current events, participation in parish life. He concludes on a high degree of involvement of Cossacks in the Church life, the importance of the Church in their daily lives. The facts given in the article, suggest the sustainability of the parish farm, the community was able to survive in the turmoil of the Civil war. Forced destruction of parish life in the years of collectivization destroyed the community and has led to the degradation and disappearance of rural settlement. The last author of the chronicle was repressed, he and those arrested with him the clergy and parishioners were accused of preparing an armed uprising. The chronicle shows that this accusation was false
Numerical investigation of disc-wing MAV with propeller in a wing slot
No full textConcept of dis?-wing MAV with propeller in a wing slot has a number of advantages and disadvantages. The concept is used by MIPTEAM for solving the problem of fixed wing MAV indoor flight by means of lift maximization for wing with low aspect ratio. There are only few investigations of dis?-wing MAV aerodynamics with propeller in a wing slot. Present work describes numerical investigation technique and aerodynamic characteristics obtained. The main results are: good stall characteristics of this concept, low lift/drag ratio (further improvement is possible) and sophisticated flow pattern. It was obtained that the main part of the lift is created by wing surface in front of the actuator disk. Also, leading edge separation area produces small impact at the lift even at high angles of attack. It was found that increasing of the propeller thrust decreases maximum lift/drag ratio. Flow features in numerical results correspond to the known experimental results and flight tests
Phosphodiesterase 5 inhibitor sildenafil in patients with heart failure with preserved ejection fraction and combined pre- and postcapillary pulmonary hypertension: a randomized open-label pilot study
No full textBackground:
Heart failure with preserved ejection fraction (HFpEF) is frequently complicated by pulmonary hypertension (PH). A pulmonary vascular contribution could be considered as a substantial therapeutic target in HFpEF and PH and combined pre- and postcapillary PH (Cpc-PH).
Methods:
We enrolled 50 patients with HFpEF and Cpc-PH who were determined by echocardiography to have pulmonary artery systolic pressure (PASP) > 40 mmHg, pulmonary vascular resistance > 3 Wood units, and/or transpulmonary gradient > 15 mmHg.
Results:
The patients were assigned to the phosphodiesterase 5 (PDE5) inhibitor sildenafil group (25 mg TID for 3 months followed by 50 mg TID for 3 months; n = 30) or the control group (n = 20). In the sildenafil group after 6 months, the 6-min walk distance increased by 50 m (95% CI, 36 to 64 m); substantial improvement in NYHA functional class and exercise capacity during diastolic stress test were revealed; decreases in early mitral inflow to mitral annulus relaxation velocities ratio by 2.4 (95% CI, − 3.3 to − 1.4) and PASP by 17.0 mmHg (95% CI, 20.4 to 13.5) were observed; right ventricular systolic function (M-mode tricuspid annular plane systolic excursion) increased by 0.42 cm (95% CI, 0.32 to 0.52 cm; P < 0.01 for all). No changes occurred in the control group.
Conclusions:
In a subset of patients with HFpEF and Cpc-PH assessed by echocardiography, PDE5 inhibition was associated with an improvement in exercise capacity, pulmonary haemodynamic parameters, and right ventricular function. The role of sildenafil needs to be considered in randomized trials in selected patients with HFpEF with invasively confirmed Cpc-PH.
Trial registration:
Russian National Information System of Research, Development and Technology Data of Civilian Usage (NIS, https://rosrid.ru), registration number 01201257849. Registered 20 April 2012.
This manuscript adheres to the CONSORT guidelines
Optimization of ownership for the innovation economy of Russia.
No full textIn article the original author's concept on improvement of qualifiers of forms of the account of the property which the author uses as the precondition to re-structuring of toolkit of the sociologist for deep studying, improvement of a condition and development of economy of Russia at a new historical stage of development is stated. The rich actual material which has made base for theoretical constructions stated in article, the author has saved up, studying the big file of the scientific literature. Thanks to the popular statement which has been not overloaded with special terms, article can be useful not only to professional sociologists, philosophers and economists, but in general to all who is interested in those actual problems which are considered within the limits of corresponding sciences. The author will be deeply grateful to readers for responses and critical remarks for its work.Optimization of ownership, innovation economy
ON THE ISSUE OF FOUNDATIONS, TARGETS AND LIMITS OF CONSTITUTIONAL LIMITATION OF THE BASIC HUMAN AND CIVIL RIGHTS AND FREEDOMS
No full textThe article presents the confirmation of the research results obtained by the author in the course of dissertation research. It contains the characteristics of foundations, targets and limits of the constitutional limitation of the basic human and civil rights and freedoms, as well as the analysis of various points of view on this issue
Погребения Гераев в архитектурном комплексе Мурад Рейса / The Gerays burial in the architectural complex of Murad Reis
No full textВ настоящей работе рассматриваются захоронения Гераев на острове Родос в контексте архитектурного комплекса Мурад Рейса. В ней дается описание этого комплекса с выборочной библиографией и краткой историей изучения. В рамках публикации приводятся все выявленные на данный момент погребальные памятники Гераев в составе комплекса, показывается возможность и перспективность их дальнейшего изучения. / The paper deals with Gerays graveside on the island of Rhodes in the context of Murat Reis architectural complex. It describes the complex and provides selective bibliography and concise history of studying it. The author lists all Gerays burial monuments of the complex discovered to date, shows the possibilities and prospects of their further examination
Design of Ducted Fans of Small Height for Hexacopter with Long Hover Ability
No full textInvestigated is the ability of the usage of small height ducted fans in multicopters for increase in the hover time and protecting the propellers and surrounding. A set of numerical and experimental investigations concerning duct aerodynamics and efficiency of electrical part (drive, speed controller, accumulator) was conducted. The effects of interference between two ducted fans situated close to each other are also investigated
The determination of the «administrative responsibility» in doctrine of the administrative law
No full textThe article deals with such a category as «administrative responsibility», the study of which provides a number of existing in the doctrine of administrative law point of view, approaches to the consideration of these concepts with the aim of isolating the essential features of such a category, allowing further pay tribute to her determination. It is alleged that the administrative responsibility vested with specific features that distinguish this type of legal liability from criminal, civil, disciplinary and financial liability. One of such feature is the system of administrative penalties. A comprehensive analysis of the doctrinal approaches to the concept of administrative responsibility of the author points out that each of the proposed concepts offers its own set of constitutive features of these categories. In addition, the author notes that the legal definition of the concept being studied is also missing. The article stated that the institution of administrative liability is represented not only a set of substantive and procedural rules governing initiation of administrative offenses and impose an administrative penalty, but as a basis of doctrinal information about the study in this study category, thus presenting a comprehensive legal Institute
