RESUMO
BACKGROUND: Nocturnal hypertension is reported as a risk factor for cardiovascular disease. This study aimed to explore the potential association between nocturnal hypertension and heart failure (HF) rehospitalization in patients with HF with preserved ejection fraction (HFpEF). METHODS: A total of 538 patients with HFpEF from May 2018 to December 2021 were consequently recruited in this study and followed up until they were readmitted for HF or the end of this study. Cox regression analysis was used to reveal the potential association between nighttime blood pressure (BP) levels, nocturnal hypertension and nocturnal BP patterns and HF rehospitalization. Kaplan-Meier curve was used to assess the cumulative event-free survival rate between groups. RESULTS: There were 537 patients with HFpEF were included in the final analysis. The mean age of the study population was 77.14 ± 8.68 years, and 41.2% of patients were men. After a median follow-up duration of 10.93 (4.19-21.13) months, 176 patients (32.7%) with HFpEF were readmitted for HF. Cox regression analysis had revealed that nighttime systolic BP level [hazards ratio (HR) = 1.018, 95% CI: 1.008-1.028, P = 0.001], nighttime diastolic BP level (HR = 1.024, 95% CI: 1.007-1.042, P = 0.007), nocturnal hypertension (HR = 1.688, 95% CI: 1.229-2.317, P = 0.001) were associated with HF rehospitalization. Kaplan-Meier analysis had demonstrated that patients with nocturnal hypertension had significantly lower event-free survival rate (log-rank P < 0.001). Furthermore, patients with a riser pattern had a higher risk of HF rehospitalization (HR = 1.828, 95% CI: 1.055-3.166, P = 0.031) and lower event-free survival rate (log-rank P = 0.003) than those with a dipper pattern. These findings were also confirmed in patients with HFpEF and hyperuricemia. CONCLUSIONS: Nighttime BP levels, nocturnal hypertension and a riser pattern are independently associated with HF rehospitalization in patients with HFpEF, and prominently in patients with HFpEF and hyperuricemia. Well controlled nighttime BP levels should be emphasized and considered in patients with HFpEF.
RESUMO
Aqueous zinc-ion batteries (AZBs) with high energy density, low cost and environmental characteristics, have become the promising device for energy storage. However, uncontrolled zinc dendrite growth remains an impediment to the popularization of AZBs. The unrestricted two-dimensional (2D) ions diffusion is the main cause of the above defect. In this work, mixed cellulose ester (MCE) membrane is proposed as the separator. A dense homogeneous pore structure can achieve a physical shunting effect on ion diffusion, which can control and homogenize the ion motion. Further, the mechanism of this physical pore effect is confirmed by comparing the behavior of Zn deposition in MCE systems with different pore sizes but the same composition. As conjectured, a membrane with a smaller pore size is more favorable. In addition, the MCE contains many polar oxygen-containing functional groups that can facilitate and modulate ion diffusion through coordination. This chemical ion guiding effect, together with the above physical pore effect, gives the separator the ability to suppress dendrite formation. Zn/Zn symmetric cells with this membrane exhibit ultralong cycle life exceeding 1250 h at 0.5 mA cm-2 and 1000 h at 5 mA cm-2. And the Zn//MnO2 battery presents excellent cycle stability for more than 500 cycles with a capacity retention of 90.67%. This work proposes MCE separators and reveals their coordinated regulation of physical and chemical effects on metal-based anodes. This will shed light on the development of high-performance separators and AZBs.