RESUMEN
The chalcogen-bonding interactions formed at both sides of the thiocarbonyl group in thiourea were investigated. In particular, the role of these chalcogen-bonding interactions in the trans-trans conformation of thiourea was evaluated via single-crystal X-ray diffraction analysis and DFT calculations. The obtained results indicate that the Seâ¯Sâ¯Se dual chalcogen-bonding interactions play a stronger role in controlling the planar structure than the Sâ¯Sâ¯S interactions.
RESUMEN
AIMS: Vericiguat has been used to treat patients with heart failure with reduced ejection fraction (HFrEF) who demonstrated worsening heart failure despite treatment with other guideline-directed medical therapies. The haemodynamic effects of vericiguat remain unclear. METHODS AND RESULTS: This study enrolled 12 patients (median age, 63 [quartiles 53.5, 70] years; 16.7%(N=2) women) with symptomatic HFrEF (New York Heart Association functional class II-IV) who demonstrated worsening heart failure despite treatment with the four foundational guideline-recommended therapies between March and December 2022, with follow-ups completed in June 2023. A balloon-tipped pulmonary artery thermodilution catheter was placed in the right internal jugular vein to perform right heart catheterisation (RHC) on day 1. Haemodynamic data were acquired before and after vericiguat intake (2.5 mg) on days 2 and 3. The data on days 2 and 3 were averaged. RHC was repeated on day 105 (37, 168). Oral intake of vericiguat 2.5 mg decreased mean pulmonary artery pressure (19.3 [14.3, 26.8] mmHg) and pulmonary artery wedge pressure (PAWP) (11 [7.5, 15] mmHg) before the intake to mean pulmonary artery pressure (17.5 [12.5, 24] mmHg) and PAWP (9.3 [6.8, 14] mmHg) at 30 min after (both P < 0.05). Reduction in PAWP was also found from 14.5 [9.5, 19.5] mmHg on day 1 to 9.5 [6.5, 12.5] mmHg on day 105 (37, 168) (P < 0.05), when vericiguat was titrated to 2.5 mg 25% (N = 3), 5 mg 50% (N = 6), and 10 mg 25% (N = 3). CONCLUSIONS: The consistent reduction in PAWP underscores the well-tolerated nature of vericiguat and its potential to enhance cardiac performance in patients with HFrEF.
Asunto(s)
Insuficiencia Cardíaca , Hemodinámica , Pirimidinas , Volumen Sistólico , Humanos , Femenino , Insuficiencia Cardíaca/fisiopatología , Insuficiencia Cardíaca/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Volumen Sistólico/fisiología , Anciano , Pirimidinas/administración & dosificación , Hemodinámica/efectos de los fármacos , Hemodinámica/fisiología , Estudios de Seguimiento , Cateterismo Cardíaco/métodos , Resultado del Tratamiento , Presión Esfenoidal Pulmonar/fisiología , Presión Esfenoidal Pulmonar/efectos de los fármacos , Compuestos Heterocíclicos con 2 AnillosRESUMEN
In humans, ventricular folds are located superiorly to the vocal folds. Under special circumstances such as voice pathology or singing, they vibrate together with the vocal folds to contribute to the production of voice. In the present study, experimental data measured from physical models of the vocal and ventricular folds were analyzed in the light of nonlinear dynamics. The physical models provide a useful experimental framework to study the biomechanics of human vocalizations. Of particular interest in this experiment are co-oscillations of the vocal and ventricular folds, occasionally accompanied by irregular dynamics. We show that such a system can be regarded as two coupled oscillators, which give rise to various cooperative behaviors such as synchronized oscillations with a 1:1 or 1:2 frequency ratio and desynchronized oscillations with torus or chaos. The insight gained from the view of nonlinear dynamics should be of significant use for the diagnosis of voice pathologies, such as ventricular fold dysphonia.