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排序方式: 共有245条查询结果,搜索用时 15 毫秒
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Krista Siiril?-Waris Johan Lassus John Melin Keijo Peuhkurinen Markku S Nieminen Veli-Pekka Harjola 《European heart journal》2006,27(24):3011-3017
AIMS: Acute heart failure (AHF) is associated with poor prognosis and requires recurrent hospitalizations. However, studies on AHF characteristics, treatment, and prognostic factors are few. Our aim was to investigate the characteristics, treatment, and 1-year prognosis of AHF and identify prognostic factors in different clinical groups. METHODS AND RESULTS: We conducted a prospective multicentre study with 620 patients hospitalized due to AHF; mean age 75.1 (10.4) years, 50% male. Half of the patients had new-onset heart failure. Acute congestion (63.5%) and pulmonary oedema (26.3%) were the most common clinical presentations. Left ventricular ejection fraction (LVEF) was reported in two-thirds of patients. Half of these had preserved systolic function (LVEF> or =45%). At discharge, 86% of patients had beta-blockers and 76% either ACE-inhibitors or angiotensin receptor blockers in use. The 12-month all-cause mortality was 27.4%. We identified several clinical and biochemical prognostic risk factors in univariate analysis. Independent predictors of 1-year mortality were older age, male gender, lower systolic blood pressure (SBP) on admission, C-reactive protein, and serum creatinine >120 micromol/L. CONCLUSION: We present the characteristics and prognosis of an unselected population of AHF patients. One-year mortality is high, and independent clinical risk factors include age, male gender, lower SBP on admission, C-reactive protein, and renal dysfunction. 相似文献
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Ovidiu Chioncel John Parissis Alexandre Mebazaa Holger Thiele Steffen Desch Johann Bauersachs Veli‐Pekka Harjola Elena‐Laura Antohi Mattia Arrigo Tuvia B. Gal Jelena Celutkiene Sean P. Collins Daniel DeBacker Vlad A. Iliescu Ewa Jankowska Tiny Jaarsma Kalliopi Keramida Mitja Lainscak Lars H Lund Alexander R. Lyon Josep Masip Marco Metra Oscar Miro Andrea Mortara Christian Mueller Wilfried Mullens Maria Nikolaou Massimo Piepoli Susana Price Giuseppe Rosano Antoine Vieillard‐Baron Jean M. Weinstein Stefan D. Anker Gerasimos Filippatos Frank Ruschitzka Andrew J.S. Coats Petar Seferovic 《European journal of heart failure》2020,22(8):1315-1341
Cardiogenic shock (CS) is a complex multifactorial clinical syndrome with extremely high mortality, developing as a continuum, and progressing from the initial insult (underlying cause) to the subsequent occurrence of organ failure and death. There is a large spectrum of CS presentations resulting from the interaction between an acute cardiac insult and a patient's underlying cardiac and overall medical condition. Phenotyping patients with CS may have clinical impact on management because classification would support initiation of appropriate therapies. CS management should consider appropriate organization of the health care services, and therapies must be given to the appropriately selected patients, in a timely manner, whilst avoiding iatrogenic harm. Although several consensus‐driven algorithms have been proposed, CS management remains challenging and substantial investments in research and development have not yielded proof of efficacy and safety for most of the therapies tested, and outcome in this condition remains poor. Future studies should consider the identification of the new pathophysiological targets, and high‐quality translational research should facilitate incorporation of more targeted interventions in clinical research protocols, aimed to improve individual patient outcomes. Designing outcome clinical trials in CS remains particularly challenging in this critical and very costly scenario in cardiology, but information from these trials is imperiously needed to better inform the guidelines and clinical practice. The goal of this review is to summarize the current knowledge concerning the definition, epidemiology, underlying causes, pathophysiology and management of CS based on important lessons from clinical trials and registries, with a focus on improving in‐hospital management. 相似文献
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Anne‐Maree Kelly Oene Van Meer Gerben Keijzers Justina Motiejunaite Peter Jones Richard Body Simon Craig Mehmet Karamercan Sharon Klim Veli‐Pekka Harjola Franck Verschuren Anna Holdgate Michael Christ Adela Golea Colin A. Graham Jean Capsec Cinzia Barletta Luis Garcia‐Castrillo Win S. Kuan Said Laribi 《Internal medicine journal》2020,50(2):200-208
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The cardiorenal syndrome is a clinical manifestation of the bidirectional interaction between the heart and kidneys. Evaluating
renal function is an essential part of the assessment of every cardiac patient. It has become clear that serum creatinine
is not an accurate enough marker of glomerular filtration rate (GFR) and should not be used to evaluate kidney dysfunction.
Creatinine-based estimates of GFR are preferred, but require renal function to be stable and are not suitable when changes
in kidney function occur. Cystatin C (CysC) has been the target of much interest in the search for an alternative measure
of GFR. As an endogenous biomarker, CysC possesses many of the properties required of a good marker of renal function. Compared
with that of creatinine, plasma concentrations of CysC are less influenced by factors other than GFR. Consequently, CysC correlates
with true GFR more accurately than creatinine. Equations for estimating GFR from CysC values have also been developed, which
makes values easier to interpret and facilitates the clinical use of this new marker. The use of CysC in acute kidney injury
has also shown promising results. CysC has been studied as a risk marker for prognosis in cardiovascular disease. This effect
is attributed to the strong impact of renal dysfunction on progressive cardiovascular disease and impaired survival. Higher
levels of CysC have consistently been predictive of incident or recurrent cardiovascular events and adverse outcomes. CysC
is a predictor of the development of heart failure and increased levels of CysC have an independent association with higher
mortality in both chronic and acute heart failure. In conclusion, CysC appears to be an interesting marker of renal function
and is useful for risk stratification in heart failure. 相似文献
7.
In vivo release and turnover of secreted platelet antiheparin proteins in rhesus monkey (Macaca mulatta) 总被引:1,自引:0,他引:1
Musial J; Niewiarowski S; Edmunds LH Jr; Addonizio VP Jr; Nicolaou KC; Colman RW 《Blood》1980,56(4):596-607
Human and rhesus monkey platelets secrete at least two antiheparin proteins: platelet factor 4 (PF4) and low affinity platelet factor 4 (LA-PF4). Neither of these proteins showed species-related antigenic differences. As determined by radioimmunoassay, the levels of PF4 and LA-PF4 antigen per 10(9) monkey platelets amounted to 10.7 and 20.3 microgram, respectively. One milliliter of monkey plasma prepared from blood collected into an anticoagulant composed of EDTA, prostaglandin E1, and theophylline solution contained 22.4 ng LA-PF4 and 8.0 ng PF4. Concentrations of these two platelet-specific proteins in monkeys closely resembled levels found in human platelets and plasma. Infusion of prostacyclin (PGI2) (100 or 300 ng/kg/min) into monkeys for 15 min resulted in a significant decrease of plasma levels of LA-PF4 antigen and of PF4 by 40%--60% (p < 0.0001). This decrease was related to the inhibitory effect of PGI2 on the secretion of platelets stimulated by a catheter or by venipuncture. Longer infusion of PGI2 did not produce further significant change. The supernate obtained after aggregation of human platelets stimulated by thrombin was injected into monkeys receiving PGI2 infusion. The disappearance of LA-PF4 antigen in monkey plasma followed a biphasic exponential curve with half-lives for the fast and slow components of 8.4 and 63 min. PF4 disappeared faster but followed the same pattern (half-lives for the fast and slow component of 2.1 and 70 min). Analysis of the experimental data suggests that the low levels of secreted platelet proteins in monkey plasma are related to their minimal in vivo release and to their rapid clearance. 相似文献
8.
The BRONCH‐AHF study: effects on short‐term outcome of nebulized bronchodilators in emergency department patients diagnosed with acute heart failure
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