ABSTRACT
AIMS: Bendopnea is a clinical symptom of advanced heart failure with uncertain prognostic value. We aimed to evaluate whether bendopnea and the change in oxygen saturation when bending forward (bending oxygen saturation index [BOSI]) are associated with adverse outcomes in ambulatory chronic heart failure (CHF) patients. METHODS AND RESULTS: We prospectively evaluated 440 subjects with symptomatic CHF. BOSI was defined as the difference between sitting and bending oxygen saturation (SpO2 ). The endpoint was the total number of worsening heart failure (WHF) events (heart failure hospitalization or urgent heart failure visit requiring parenteral diuretic therapy). The mean age was 74 ± 10 years, 257 (58.6%) were male, and 226 (51.4%) had a left ventricular ejection fraction <50%. Bendopnea was present in 94 (21.4%) patients, and 120 (27.3%) patients had a BOSI ≥-3%. The agreement between BOSI ≥-3% and bendopnea was moderate (Gwet's AC 0.482, p < 0.001). At a median (p25%-p75%) follow-up of 2.17 years (0.88-3.16), we registered 441 WHF events in 148 patients. After multivariable adjustment, BOSI was independently associated with the risk for total WHF episodes (overall, p < 0.001). Compared to improvement/no change in SpO2 when bending (BOSI 0%), those with BOSI ≥-3% showed an increased risk of WHF events (incidence rate ratio [IRR] 2.16, 95% confidence interval [CI] 1.67-2.79; p < 0.001). In contrast, bendopnea was not associated with the risk of total WHF episodes (IRR 1.04, 95% CI 0.83-1.31; p = 0.705). CONCLUSIONS: In ambulatory and stable CHF patients, BOSI ≥-3% and not bendopnea was independently associated with an increased risk of total (first and recurrent) WHF episodes. Awareness of SpO2 while assessing bendopnea may be a useful tool for predicting heart failure decompensations.
Subject(s)
Heart Failure , Humans , Male , Middle Aged , Aged , Aged, 80 and over , Female , Heart Failure/complications , Heart Failure/epidemiology , Stroke Volume , Ventricular Function, Left , Oxygen SaturationSubject(s)
Cardiovascular Agents/administration & dosage , Coronary Artery Disease/surgery , Drug-Eluting Stents , Non-ST Elevated Myocardial Infarction/surgery , Percutaneous Coronary Intervention/instrumentation , Sirolimus/administration & dosage , Aged , Cardiovascular Agents/adverse effects , Coronary Angiography , Coronary Artery Disease/diagnostic imaging , Female , Humans , Male , Middle Aged , Non-ST Elevated Myocardial Infarction/diagnostic imaging , Percutaneous Coronary Intervention/adverse effects , Prospective Studies , Prosthesis Design , Risk Factors , Sirolimus/adverse effects , Time Factors , Treatment OutcomeABSTRACT
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Subject(s)
Humans , Lipocalins/pharmacokinetics , Gelatinases/pharmacokinetics , Extravasation of Diagnostic and Therapeutic Materials/diagnosis , Kidney Diseases/chemically induced , Coronary Angiography , Contrast Media/adverse effectsSubject(s)
Acute Coronary Syndrome/diagnostic imaging , Acute Kidney Injury/blood , Coronary Angiography , Creatinine/blood , Lipocalin-2/blood , Acute Kidney Injury/chemically induced , Acute Kidney Injury/diagnosis , Aged , Contrast Media/adverse effects , Female , Humans , Linear Models , Logistic Models , Male , Middle Aged , Risk Assessment , Sensitivity and Specificity , Triiodobenzoic Acids/adverse effectsABSTRACT
OBJECTIVE: The aim of this study was to describe our initial experience with the GuideLiner® catheter (Vascular Solutions Inc.) in the transradial treatment of complex lesions. MATERIALS AND METHODS: The clinical, angiographic and procedural data of percutaneous coronary interventions where GuideLiner was used during 2013 were collected. The transradial approach was used in all cases. The indication for its use, efficacy and periprocedural complications were determined. Sixteen consecutive procedures (in 15 patients; 12 males and 3 females) were evaluated. The indication for the use of GuideLiner was a difficulty to advance and properly position a stent through a tortuous and/or calcified artery despite using high-support guide catheters or other useful techniques. RESULTS: Of the 16 angiographic procedures, 14 (87.5%) were successful (stent deployment in 13 cases and a drug-eluting balloon in 1 case). Unsuccessful cases were a chronic total occlusion and a diffusely diseased left anterior descendant artery. A type B dissection of a proximal left circumflex artery was the only periprocedural complication. CONCLUSION: Use of the GuideLiner was an effective and safe technique for the percutaneous treatment of complex coronary lesions in which the adequate progress of angioplasty devices had failed. GuideLiner was particularly helpful when using the transradial approach. Only one minor complication was recorded.
Subject(s)
Coronary Angiography/instrumentation , Coronary Angiography/methods , Percutaneous Coronary Intervention/methods , Aged , Aged, 80 and over , Angina, Stable/surgery , Cardiac Catheters , Coronary Occlusion , Female , Humans , Male , Middle Aged , Myocardial Infarction/surgery , Percutaneous Coronary Intervention/instrumentation , Radial Artery/surgery , Treatment OutcomeABSTRACT
Fetal bovine serum (FBS) is an important factor in the culture of Trypanosoma cruzi, since this parasite obtains and metabolizes fatty acids (FAs) from the culture medium, and changes in FBS concentration reduce the degree of unsaturation of FAs in phosphoinositides. When T. cruzi epimastigotes were cultured with 5% instead of 10% FBS, and stearic acid was used as the substrate, (9) desaturase activity decreased by 50%. Apparent K (m) and V (m) values for stearic acid, determined from Lineaweaver-Burk plots, were 2 microM and 219 pmol/min/mg of protein, respectively. In studies of the requirement for reduced pyridine nucleotide, (9) desaturase activity reached a maximum with 8 microM NADH and then remained constant; the apparent K (m) and V (m) were 4.3 microM and 46.8 pmol/min/mg of protein, respectively. The effect of FBS was observed only for (9) desaturase activity; (12) desaturase activity was not affected. The results suggest that decreased FBS in culture medium is a signal that modulates (9) desaturase activity in T. cruzi epimastigotes.
Subject(s)
Isoenzymes/metabolism , Protozoan Proteins/metabolism , Serum/metabolism , Stearoyl-CoA Desaturase/metabolism , Trypanosoma cruzi/enzymology , Animals , Cattle , Fatty Acids/chemistry , Fatty Acids/metabolism , NAD/metabolismABSTRACT
El río El Tala, utilizado como fuente de abastecimiento de agua y usos recreativos por la población de Catamarca, Argentina, muestra en sus márgenes, un marcado incremento de asentamientos que carecen de red cloacal. El objetivo del trabajo es identificar las actividades humanas y evaluar el impacto sobre la calidad físico-química y bacteriológica del agua utilizando el índice simplificado de calidad del agua e indicadores de contaminación química y biológica
Subject(s)
Environment , Water Microbiology , Water Monitoring , Water Quality , RiversABSTRACT
El río El Tala, utilizado como fuente de abastecimiento de agua y usos recreativos por la población de Catamarca, Argentina, muestra en sus márgenes, un marcado incremento de asentamientos que carecen de red cloacal. El objetivo del trabajo es identificar las actividades humanas y evaluar el impacto sobre la calidad físico-química y bacteriológica del agua utilizando el índice simplificado de calidad del agua e indicadores de contaminación química y biológica
