RESUMEN
Diagnosis of heart failure with preserved ejection fraction (HFpEF) is associated with certain difficulties since many patients with HFpEF have a slight left ventricular diastolic dysfunction and normal filling pressure at rest. Diagnosis of HFpEF is improved by using diastolic transthoracic stress-echocardiography with dosed exercise (or diastolic stress test), which allows detection of increased filling pressure during the exercise. The present expert consensus explains the requirement for using the diastolic stress test in diagnosing HFpEF from clinical and pathophysiological standpoints; defines indications for the test with a description of its methodological aspects; and addresses issues of using the test in special patient groups.
Asunto(s)
Investigación Biomédica , Cardiología , Insuficiencia Cardíaca , Consenso , Ecocardiografía , Ecocardiografía de Estrés , Prueba de Esfuerzo , Insuficiencia Cardíaca/diagnóstico por imagen , Humanos , Federación de Rusia , Volumen Sistólico , Función Ventricular Izquierda , Carga de TrabajoRESUMEN
At an international online expert meeting held on September 16, 2021, the results of the empagliflozin research program EMPA-REG Outcome, EMPEROR-Reduced and EMPEROR-Preserved were reviewed. We analyzed cardiovascular and renal outcomes during the treatment with empagliflozin in patients with chronic heart failure, regardless of the presence of type 2 diabetes mellitus. The positive results of the EMPEROR-Preserved study are updated and their significance for clinical practice is discussed. Several proposals have been adopted that will accelerate the introduction of empagliflozin therapy into practice in patients with heart failure and overcome clinical inertia.
Asunto(s)
Enfermedades Cardiovasculares , Diabetes Mellitus Tipo 2 , Insuficiencia Cardíaca , Inhibidores del Cotransportador de Sodio-Glucosa 2 , Humanos , Inhibidores del Cotransportador de Sodio-Glucosa 2/efectos adversos , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Glucósidos/efectos adversos , Insuficiencia Cardíaca/tratamiento farmacológico , Enfermedades Cardiovasculares/tratamiento farmacológicoRESUMEN
Modern strategy of antihypertensive therapy base on the results of recently published randomized clinical trials discusses in this article. Data about optimal components of triple combined antihypertensive pill and a history of design and implementation of combined antihypertensive drugs are reviewed. Role of combined antihypertensive pills in reduction of nonadherence antihypertensive therapy also discussed.
Asunto(s)
Antihipertensivos/uso terapéutico , Quimioterapia Combinada , Hipertensión/tratamiento farmacológico , Amlodipino/uso terapéutico , Humanos , Hipertensión/fisiopatología , Indapamida/uso terapéutico , Perindopril/uso terapéuticoRESUMEN
The article discusses the issue of searching for optimum oral anticoagulants to prevent thrombosis and embolism induced by heart disease both in patients with atrial fibrillation and sinus rhythm. A complex bidirectional relationship between atrial fibrillation and coronary atherosclerosis is considered along with possible mechanisms for development of myocardial infarction in patients with atrial fibrillation. The authors provided evidence-based data which can be used in selecting an anticoagulant for prevention of heart disease induced thrombosis and embolism taking into account both the efficacy and safety established in randomized clinical studies.