Hospitalization is an opportunity to optimize heart failure (HF) therapy. As optimal treatment for hospitalized HF patients in sinus rhythm with heart rate≥70bpm is unclear, we investigated the ...impact of combined beta-blocker (BB) and ivabradine versus BBs alone on short and longer term mortality and rehospitalization.
A retrospective analysis was performed on 370 hospitalized HF patients with heart rate≥70bpm (150 BB+ivabradine, 220 BB alone) in the Optimize Heart Failure Care Program in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Russia, Ukraine, and Uzbekistan, from October 2015 to April 2016.
At 1month, 3months, 6months and 12months, there were fewer deaths, HF hospitalizations and overall hospitalizations in patients on BB+ivabradine vs BBs alone. At 12months, all-cause mortality or HF hospitalization was significantly lower with BB+ivabradine than BBs (adjusted hazard ratio HR 0.45 (95% confidence interval CI 0.32–0.64, P<0.0001). Significantly greater improvement was seen in quality of life (QOL) from admission to 12months with BB+ivabradine vs BBs alone (P=0.0001). With BB+ivabradine, significantly more patients achieved ≥50% target doses of BBs at 12months than on admission (82.0% vs 66.6%, P=0.0001), but the effect was non-significant with BBs alone.
Heart rate lowering therapy with BB+ivabradine started in hospitalized HF patients (heart rate≥70bpm) is associated with reduced overall mortality and re-hospitalization over the subsequent 12months. A prospective randomized trial is needed to confirm the advantages of this strategy.
•Hospitalized heart failure patients with heart rate≥70 bpm have a higher mortality risk.•In those patients beta blockers (BB) + ivabradine reduced 12-month mortality/rehospitalization vs BB alone.•A large clinical trial is needed to confirm the advantages of this strategy
This review paper explores the impact of fluctuations in environmental factors on human chrono-periodic systems. A multitude of external and internal environmental factors influence the organism ...throughout its lifespan, and many have the potential to disrupt human homeostasis. It would be inaccurate to assume that specific responses to each stimulus were developed and solidified during the evolutionary process. With the exception of genetic defects, there could not have been evolutionarily fixed pathological reactions in the body, as this would contradict the laws of selection. Therefore, all typical responses of the body to the stimulus should be considered primarily adaptive, i.e., physiological.
A new family of Cu(II) and Ni(II) salen complexes was synthesized and fully characterized through various physicochemical methods. Their catalytic activity was evaluated in the phase transfer C
...-alkylation reaction of the Schiff bases of D,L-alanine ester and benzaldehyde derivatives. It was found that the introduction of a chlorine atom into the
- and
-positions of the phenyl ring of the substrate resulted in an increase in both the chemical yield and the asymmetric induction (
66-98%). The highest enantiomeric excess was achieved in the case of a Cu(II) salen complex based on (
,
)-cyclohexanediamine and salicylaldehyde at -20 °C. The occurrence of a bulky substituent in the ligand present in the complexes led to a drastic decrease in
and chemical yield. For instance, the introduction of bulky substituents at positions 3 and 5 of the phenyl ring of the catalyst resulted in a complete loss of the stereoselectivity control in the alkylation reaction.
This study aimed to examine the alteration of circadian structures of electrolytes, trace elements, and white blood cell homeostasis under the action of stressors factors. Male rabbits were used in ...experimental work. Four-hour urine and blood specimens were collected over a span of 48–72 hours. Total Na (sodium), K (potassium), Ca (calcium), Mg (magnesium), Cu (copper), and Zn (zinc) were analyzed on atomic absorption spectrophotometer. Rhythm’s parameters have been estimated by the nonlinear least square method for sinusoidal rhythms and by dispersion analysis for nonsinusoidal rhythms. Intact rabbits’ chronoperiodical systems of water-mineral and white blood cell homeostasis were characterized by circadian structures. Acrophases of indices of water-mineral and white blood cell homeostasis in intact rabbits mostly had individual nature. Temporal structure of water-mineral and white blood cell homeostasis in rabbits under the action of stress were characterized by infradian rhythms or nonperiodical oscillations.
Objective: The aim of this study was to examine the peculiarities of various components of water-mineral chronoperiodical system under the action of seasonal factors in practically healthy ...individuals and in patients with the syndrome of vegetative dystonia (SVD). Methods: Forty practically healthy individuals and 38 ambulatory patients with SVD were investigated. Practically healthy subjects and patients with SVD were on identical regimen (sleep, wake, and diet). Four-hour urine specimens were collected over a period of 72–120 hours, with duration of 4–5 days. Each sample of urine was analyzed for electrolytes and some microelements. Temporal organization (biological and weather factors) parameters have been measured by nonlinear least squares method for the rhythms with sinusoidal structure and dispersion analysis for the rhythms with non-sinusoidal organization. Parameters of weather factors were received from the hydrometeorological service of Yerevan, Armenia.Results: Healthy subjects were characterized with the circadian structure of macro and microelements chronoperiodical system. Acrophases of the biorhythms were individual, and were outstripping the acrophases of the weather indices’ oscillations.Conclusion: Chronostructure of macro- and microelement homeostasis in patients with SVD were characterized with infradian oscillations. For patients with SVD, significant correlation between rhythms of electrolytes and trace elements and oscillations of weather factors was different in comparison with the data for healthy subjects. In patients with SVD, acrophases of chronoperiodical system of electrolytes and microelements frequently were concurrent relative to the acrophases of fluctuations of the weather factors.
A new family of Cu(II) and Ni(II) salen complexes was synthesized and fully characterized through various physicochemical methods. Their catalytic activity was evaluated in the phase transfer Csub.α ...-alkylation reaction of the Schiff bases of D,L-alanine ester and benzaldehyde derivatives. It was found that the introduction of a chlorine atom into the ortho- and para-positions of the phenyl ring of the substrate resulted in an increase in both the chemical yield and the asymmetric induction (ee 66–98%). The highest enantiomeric excess was achieved in the case of a Cu(II) salen complex based on (S,S)-cyclohexanediamine and salicylaldehyde at −20 °C. The occurrence of a bulky substituent in the ligand present in the complexes led to a drastic decrease in ee and chemical yield. For instance, the introduction of bulky substituents at positions 3 and 5 of the phenyl ring of the catalyst resulted in a complete loss of the stereoselectivity control in the alkylation reaction.
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