Prognosis Of Failure Research Articles

Rationale and Design of a Multicenter Trial on Exploratory Analysis of the Effects of Advance Care Planning Guided by the Prediction Program of Heart Failure Prognosis on Quality of Life in Patients With Heart Failure - ACQUAINT-Trial.

Background: Preplanning of care is necessary for patients with endstage heart failure (HF), but advance care planning (ACP) before the loss of a patient's comprehensive capacity is not yet routine for the public or the medical community. The challenge in accurately predicting a patient's prognosis is a strong barrier to implementing ACP. To address this problem, several models for risk stratification have been proposed and are available in clinical settings. Methods and Results: We randomized the procedure to provide estimated patient survival information to attending physicians and then assessed whether there was a change in (1) the frequency of ACP initiation occurred (physician-side evaluation), and/or (2) the patients' quality of life, including mental state (patient-side evaluation). Conclusions: This multicenter, open-label, single-blinded randomized clinical trial aims to assess the hypothesis that providing information on the estimated survival of a patient to the attending physicians will improve the frequency of ACP initiation and quality of life in patients with HF.

Changing clinical practice and prognosis for severe respiratory failure over time: A nationwide inpatient database study

BackgroundSevere respiratory failure requires numerous interventions and its clinical implementation changes over time. We aimed to clarify the clinical practice and prognosis of severe respiratory failure and its changes over time. MethodsIn a nationwide Japanese administrative database from 2016 to 2019, we identified nonoperative patients with severe respiratory failure without congestive heart failure as the main diagnosis who received mechanical ventilation (MV) for more than four days. We examined trends in patient characteristics, adjunctive interventions, and prognosis. ResultsAmong 66,905 patients included in this study, patients received antibiotics (90%), high-dose corticosteroids (14%), low-dose corticosteroids (18%), and 51% were admitted to the critical care unit. Hospital mortality was 35%. Median mechanical ventilation lasted 10 days. Tracheostomy occurred in 23% of cases. Median critical care and hospital stays were 10 and 25 days, respectively. Among survivors, 23% had mechanical ventilation dependency at hospital discharge. Large relative changes in adjunctive therapies included fentanyl (30%–38%), rocuronium (4.4%–6.7%), vasopressin (3.8%–6.0%), early rehabilitation (27%–38%), extracorporeal membrane oxygenation (0.7%–1.2%), dopamine (15%–10%), and sivelestat (8.6%–3.5%). No notable changes were seen in mechanical ventilation duration, tracheostomy, critical care unit stay, hospital stay, or ventilator dependency at discharge, except for a slight reduction in hospital mortality (36%–34%). ConclusionsSeveral adjunctive therapies for severe respiratory failure changed from 2016 to 2019, with an increase in evidence-based practices and a slight decrease in hospital mortality.

Effect of low blood pressure on prognosis of acute heart failure

Low blood pressure (BP) is associated with poor outcomes in patients with heart failure (HF). We investigated the influence of initial BP on the prognosis of HF patients at admission, and prescribing patterns of HF medications, such as angiotensin-converting enzyme inhibitors (ACEi), angiotensin receptor blockers (ARB), and beta-blockers (BB). Data were sourced from a multicentre cohort of patients admitted for acute HF. Patients were grouped into heart failure reduced ejection fraction (HFrEF) and HF mildly reduced/preserved ejection fraction (HFmrEF/HFpEF) groups. Initial systolic and diastolic BPs were categorized into specific ranges. Among 2778 patients, those with HFrEF were prescribed ACEi, ARB, or BB at discharge, regardless of their initial BP. However, medication use in HFmrEF/HFpEF patients tended to decrease as BP decreased. Lower initial BP in HFrEF patients correlated with an increased incidence of all-cause death and composite clinical events, including HF readmission or all-cause death. However, no significant differences in clinical outcomes were observed in HFmrEF/HFpEF patients according to BP. Initial systolic (< 120 mmHg) and diastolic (< 80 mmHg) BPs were independently associated with a 1.81-fold (odds ratio [OR] 1.81, 95% confidence interval [CI] 1.349–2.417, p < 0.001) and 2.24-fold (OR 2.24, 95% CI 1.645–3.053, p < 0.001) increased risk of long-term mortality in HFrEF patients, respectively. In conclusion, low initial BP in HFrEF patients correlated with adverse clinical outcomes, and BP < 120/80 mmHg independently increased mortality. However, this relationship was not observed in HFmrEF/HFpEF patients.

Respiratory virus infections and adenovirus characteristics during acute exacerbation of chronic obstructive pulmonary disease.

Chronic obstructive pulmonary disease (COPD) is a common respiratory disease globally, characterized by obstructive ventilatory disorder under pulmonary function tests. Recent years have witnessed a yearly increase in the prevalence of COPD. To investigate the impact of respiratory virus infections on patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), and to perform sequencing typing and mutation analysis of viruses with high detection rate. A total of 1523 inpatients with AECOPD admitted to our hospital from April 1,2020 to March 30,2022 were collected and divided into two groups: the infected group (n= 532) and the non-infected group (n= 991). The related indexes between the two groups were collected and compared (including clinical characteristics and laboratory tests that blood cell count, PCT, CRP, adenovirus, respiratory syncytial virus, rhinovirus, influenza A virus, influenza B virus, etc.). In the infected group, the proportion of patients with palpitations (49.44% VS 8.07%, P< 0.001), lipid metabolism abnormalities (18.42% VS 39.96%, P< 0.001), heart failure (39.85% VS 29.87%, P< 0.001), disease duration (17.48 ± 7.47 VS 12.45 ± 11.43 d, P< 0.001), and poor prognosis (69.55% VS 17.15%, P< 0.001) were higher than those in the non-infected group; Adenovirus (ADV) accounted for 75.94% (404/532) of all infected viruses. 31 virus strains could be categorized into 16 ADV-C1, one ADV-C5, two ADV-B3, three ADV-B7, two ADV-D17, two ADV-D19, and five ADV-D27, which were similar to the serotypes reported in severe pneumonia. Furthermore, three strains of C1 adenovirus were found to be highly homologous to the original strain AF534906 by sequencing, and the phylogenetic trees of the three main structural genes were all on the same branch as the original strain. Base mutations and amino acid variants were found in each structural gene segment. In clinical data, it's found that patients with mutations are worse than those without mutations. Respiratory viruses are common in patients with poor prognosis of AECOPD, especially adenovirus, respiratory syncytial virus. Respiratory virus infections will lead to the deterioration of patients with AECOPD, accompanied by longer treatment cycles and poor prognosis.

Effects of baroreflex activation therapy on cardiac function and morphology.

Arterial hypertension (aHTN) plays a fundamental role in the pathogenesis and prognosis of heart failure with preserved ejection fraction (HFpEF). The risk of heart failure increases with therapy-resistant arterial hypertension (trHTN), defined as inadequate blood pressure (BP) control ≥140/90mmHg despite taking ≥3 antihypertensive medications including a diuretic. This study investigates the effects of the BP lowering baroreflex activation therapy (BAT) on cardiac function and morphology in patients with trHTN with and without HFpEF. Sixty-four consecutive patients who had been diagnosed with trHTN and received BAT implantation between 2012 and 2016 were prospectively observed. Office BP, electrocardiographic and echocardiographic data were collected before and after BAT implantation. Mean patients' age was 59.1years, 46.9% were male, and mean body mass index (BMI) was 33.2kg/m2. The prevalence of diabetes mellitus was 38.8%, atrial fibrillation was 12.2%, and chronic kidney disease (CKD) stage ≥3 was 40.8%. Twenty-eight patients had trHTN with HFpEF, and 21 patients had trHTN without HFpEF. Patients with HFpEF were significantly older (64.7 vs. 51.6years, P<0.0001), had a lower BMI (30.0 vs. 37.2kg/m2, P<0.0001), and suffered more often from CKD-stage ≥3 (64 vs. 20%, P=0.0032). After BAT implantation, mean office BP dropped in patients with and without HFpEF (from 169±5/86±4 to 143±4/77±3mmHg [P=0.0019 for systolic BP and 0.0403 for diastolic BP] and from 170±5/95±4 to 149±6/88±5mmHg [P=0.0019 for systolic BP and 0.0763 for diastolic BP]), while a significant reduction of the intake of calcium-antagonists, α2-agonists and direct vasodilators, as well as a decrease in average dosage of ACE-inhibitors and α2-agonists could be seen. Within the study population, a decrease in heart rate from 74 ± 2 to 67 ± 2 min-1 (P=0.0062) and lengthening of QRS-time from 96±3 to 106±4ms (P=0.0027) and QTc-duration from 422±5 to 432±5ms (P=0.0184) were detectable. The PQ duration was virtually unchanged. In patients without HF, no significant changes of echocardiographic parameters could be seen. In patients with HFpEF, posterior wall diameter decreased significantly from 14.0±0.5 to 12.7±0.3mm (P=0.0125), left ventricular mass (LVM) declined from 278.1±15.8 to 243.9±13.4g (P=0.0203), and e' lateral increased from 8.2±0.4 to 9.0±0.4cm/s (P=0.0471). BAT reduced systolic and diastolic BP and was associated with morphological and functional improvement of HFpEF.

Physiological network approach to prognosis in cirrhosis: A shifting paradigm.

Decompensated liver disease is complicated by multi-organ failure and poor prognosis. The prognosis of patients with liver failure often dictates clinical management. Current prognostic models have focused on biomarkers considered as individual isolated units. Network physiology assesses the interactions among multiple physiological systems in health and disease irrespective of anatomical connectivity and defines the influence or dependence of one organ system on another. Indeed, recent applications of network mapping methods to patient data have shown improved prediction of response to therapy or prognosis in cirrhosis. Initially, different physical markers have been used to assess physiological coupling in cirrhosis including heart rate variability, heart rate turbulence, and skin temperature variability measures. Further, the parenclitic network analysis was recently applied showing that organ systems connectivity is impaired in patients with decompensated cirrhosis and can predict mortality in cirrhosis independent of current prognostic models while also providing valuable insights into the associated pathological pathways. Moreover, network mapping also predicts response to intravenous albumin in patients hospitalized with decompensated cirrhosis. Thus, this review highlights the importance of evaluating decompensated cirrhosis through the network physiologic prism. It emphasizes the limitations of current prognostic models and the values of network physiologic techniques in cirrhosis.

The role of miR-128 and MDFI in cardiac hypertrophy and heart failure: Mechanistic.

Heart failure (HF) prognosis depends on various regulatory factors; microRNA-128 (miR-128) is identified as a regulator of cardiac fibrosis, contributing to HF. MyoD family inhibitor (MDFI), which is reported to be related with Wnt/β-catenin pathway, is supposed to be regulated by miR-128. This study investigates the interaction between miR-128 and MDFI in cardiomyocyte development and elucidates its role in heart injury. Gene expression profiling assessed miR-128's effect on MDFI expression in HF using qPCR and Western blot analysis. Luciferase assays studied the direct interaction between miR-128 and MDFI. MTT, transwell, and immunohistochemistry evaluated the effects of miR-128 and MDFI on myocardial cells in mice HF. Genescan and luciferase assays validated the interaction between miR-128 and MDFI sequences. miR-128 mimics significantly reduced MDFI expression at mRNA and protein levels with decrease rate of 55%. Overexpression of miR-128 promoted apoptosis with the increase rate 65% and attenuated cardiomyocyte proliferation, while MDFI upregulation significantly enhanced proliferation. Elevated miR-128 levels upregulated Wnt1 and β-catenin expression, whereas increased MDFI levels inhibited these expressions. Histological analysis with haematoxylin and eosin staining revealed that miR-128 absorption reduced MDFI expression, hindering cell proliferation and cardiac repair, with echocardiography showing corresponding improvements in cardiac function. Our findings suggest miR-128 interacts with MDFI, playing a crucial role in HF management by modulating the Wnt1/β-catenin pathway. Suppression of miR-128 could promote cardiomyocyte proliferation, highlighting the potential value of the miR-128/MDFI interplay in HF treatment.

Assessment of Electrical Impedance of the Liver and Spleen under Occlusion of Hepatic Blood Flow

Introduction. Liver resection remains the main trend in the treatment for primary and metastatic liver tumors and provides better overall and disease-free 5-year survival compared with conservative treatment options. Extensive liver resection is accompanied by the risk of post-resection liver failure. There is currently no absolute algorithm for determining the prognosis of post-resection liver failure. One of the ways to find new approaches to assessing the prognosis and diagnosing post-resection liver failure is bioimpedance analysis of the liver.The aim of the study was to assess the effect of hepatic blood flow occlusion on changes in the electrical impedance of the liver and spleen.Materials and methods. The study involved 20 male Wistar rats weighed 180-270 g. In the first series, experimental animals underwent occlusion of the hepatic blood flow for 15 minutes, and then underwent reperfusion (n=10). In the second series, occlusion of the hepatic blood flow was carried out for 90 minutes (n=10). Under general anesthesia, a median laparotomy was performed, followed by the application of a vascular clip to an analogue of the hepatoduodenal ligament, followed by clamping of the bile duct, hepatic artery and portal vein for 15 minutes in the first series and 90 minutes in the second series of the experiment. Invasive bioimpedansometry of the liver was performed using an original device for measuring the impedance of biological tissues BIM-II (RF patent No. 2366360). The data obtained were analysed at a frequency of 2 kHz, the hepatosplenic index (HSI) was calculated as the ratio of the average electrical impedance of the liver to the average electrical impedance of the spleen.Results. The 1st series of experiments. After applying the clips to the hepatoduodenal ligament analogue, the value of the electrical impedance of the liver parenchyma at a frequency of 2 kHz did not change and amounted to 2.3 (2.11; 3.1) kΩ versus 2.34 (2.05; 2.81) kΩ registered before manipulation. The median spleen impedance decreased statistically significantly from 2.7 (2.07; 3.5) kΩ to 1.63 (1.47; 2.04) kΩ (p 0.05). After 15-minute occlusion of the hepatic blood flow, the electrical impedance of the liver parenchyma statistically significantly increased by 1.47 times and amounted to 3.98 (2.64; 4.59) kΩ. The median value of spleen impedance was 1.86 (1.52; 2.23) kΩ, and was statistically significantly lower (p0.05) than before the clip application. After reperfusion, the liver impedance decreased to 3.11 (2.06; 5.11) kΩ, and the spleen impedance was 2.08 (1.53; 2.55) kΩ, while both parameters were statistically significantly different from the initial values. The dispersion coefficient D2kHz/20kHz of the liver statistically significantly increased to 2.10 (1.67; 2.58) 15 minutes after the clip application relative to the parameters before vascular exclusion – 1.71 (1.44; 2.08) and immediately after clamping analogue of the hepatoduodenal ligament – 1.60 (1.46; 2.11). After reperfusion, the dispersion coefficient D2kHz/20kHz of the liver parenchyma did not differ from the initial values and amounted to 1.79 (1.52; 2.29). The dispersion coefficient D2kHz/20kHz of the spleen decreased significantly immediately after occlusion of the hepatic blood flow from 1.54 (1.28; 1.71) to 1.36 (1.20; 1.62) and was at the corresponding level, including that after reperfusion. Fifteen minutes after the clip application, the dispersion coefficient D2kHz/20kHz of the spleen was statistically significantly lower than the values of D2kHz/20kHz of the liver (p0.05) – 1.42 (1.19; 1.6) versus 2.1 (1.67; 2.58). Before vascular exclusion of the liver, the median HSI was 0.89 (0.72, 1.11). After the clip application, the HSI parameter statistically significantly increased to 1.43 (1.28; 1.95) due to a decreased electrical impedance in the spleen parenchyma. After 15-minute ischemia, HSI statistically significantly increased to 2.01 (1.26; 2.68), and after reperfusion it remained at a level higher than the initial level.The 2nd series of experiments. Before vascular exclusion, the electrical impedance of the liver parenchyma of experimental rats was 2.39 (1.8, 2.57) kΩ. After 15 minutes, the electrical impedance increased significantly to 3.2 (3.08; 3.32) kΩ, which was consistent with the results of the previous experiment. After 30, 45, 60 and 90 minutes, the impedance values of the liver parenchyma did not change and were increased if compared with the initial level. The coefficient of the electrical impedance dispersion of the liver increased statistically significantly after 15-minute ischemia and remained at a high level until the end of the experiment. After the clip application, the HSI parameter statistically significantly increased after 15 minutes and remained at a level higher than the initial level in 30 minutes, 45 minutes, 60 minutes, 90 minutes of ischemia.Conclusions. After vascular exclusion of the liver, interrelated changes in the electrical impedance of the liver and spleen occurred within 15 minutes. These processes are mainly associated with changes in blood supply to the studied organs and ischemia effects.

Outcomes and Prognosis of Acute Liver Failure: Insights from a Busy Liver Centre at Max Healthcare

Outcomes and Prognosis of Acute Liver Failure: Insights from a Busy Liver Centre at Max Healthcare

Evaluating Biomarkers as Tools for Early Detection and Prognosis of Heart Failure: A Comprehensive Review.

There is a high prevalence of heart failure (HF) worldwide, which has significant consequences for healthcare costs, patient death and quality of life. Therefore, there has been much focus on finding and using biomarkers for early diagnosis, prognostication and therapy of HF. This overview of the research presents a thorough examination of the current state of HF biomarkers and their many uses. Their function in diagnosing HF, gauging its severity and monitoring its response to therapy are all discussed. Particularly promising in HF diagnosis and risk stratification are the cardiac-specific biomarkers, B-type natriuretic peptide and N-terminal pro-B-type natriuretic peptide. Markers of oxidative stress, extracellular matrix, renal function, inflammation and cardiac peptides have shown promise in evaluating HF severity and prognosis. MicroRNAs and insulin-like growth factor are two emerging biomarkers that have shown potential in helping with HF diagnosis and prognosis.

Boosting field data using synthetic SCADA datasets for wind turbine condition monitoring

State-of-the-art Deep Learning (DL) methods based on Supervisory Control and Data Acquisition (SCADA) system data for the detection and prognosis of wind turbine faults require large amounts of failure data for successful training and generalisation, which are generally not available. This limitation prevents benefiting from the superior performance of these methods, especially in SCADA-based failure prognosis. Data augmentation approaches have been proposed in the literature for generating failure data instances within a SCADA sequence to reduce the imbalance between healthy and faulty state data points, which is relevant to fault detection tasks. However, the successful implementation of DL-based failure prognosis methods requires the availability of multiple run-to-failure SCADA sequences. This paper proposes a data-driven method for generating synthetic run-to-failure SCADA sequences with custom operational and environmental conditions and progression of degradation. An Artificial Neural Network (ANN) is trained with signals that represent these factors to reconstruct the SCADA signals. Then, it is used to generate synthetic SCADA datasets based on data available from a wind turbine that experienced a gearbox failure. Synthetic data sets generated are evaluated on the basis of the similarity of their signal distributions, the temporal dynamics within each signal, and the temporal dynamics among different SCADA signals with those in similar field datasets. The results show that the generated synthetic datasets are consistent with their field counterparts, with a comparatively lower diversity in their dynamic behaviour in time.

Cardiomyopathy in First-Degree Relatives of Patients Presenting With Acute Myocarditis: Prevalence and Prognostic Significance.

Acute myocarditis has been genetically linked to dilated cardiomyopathy (DCM), but the clinical significance remains uncertain. We investigated the prevalence and long-term prognosis of DCM and heart failure (HF) among unselected patients hospitalized with acute myocarditis and their first-degree relatives compared with an age- and sex-matched cohort. This was an observational study utilizing the Danish nationwide registries, where all patients with a first-time myocarditis diagnosis from 1995 to 2018 were identified and matched (on birth year and sex) with 10 controls from the general population. Totally 3176 patients with acute myocarditis and 31 760 controls were included (median age, 49.8 [Q1-Q3, 32.5-70.2] years; 35.6% female). At baseline, patients with myocarditis had a higher prevalence of DCM (7 [0.2%] versus 8 [0.0%]) and HF (336 [10.6%] versus 695 [2.2%]) than controls; P<0.0001 for both. Patients with myocarditis more often had siblings with DCM (12 [0.4%] versus 17 [0.05%]) or HF (36 [1.1%] versus 89 [0.3%]); P<0.0001, odds ratios 7.09 (3.38-14.85) and 2.92 (1.25-6.80), respectively, whereas parental DCM and HF did not differ among patients with myocarditis and controls. Patients with myocarditis had greater 20-year incidence of DCM, HF, and all-cause mortality (0.5% [0.3%-0.9%], 15% [13%-17%], and 47% [44%-50%]) compared with controls (0.06% [0.03%-0.11%], 6.8% [6.4%-7.3%], and 34% [33%-35%]; P<0.0001). Having a first-degree relative with DCM or HF was associated with increased long-term mortality among the patients with myocarditis (hazard ratio, 1.40 [1.11-1.77]) but not among the controls (hazard ratio, 0.90 [0.81-1.01]; Pdifference=0.0008). Acute myocarditis aggregates with DCM within families, where it carries a worsened prognosis. A differential association between parents and siblings (with sibling preponderance) could suggest that additional environmental factors are important for myocarditis development even in predisposed individuals.

Exploring tumor organoids for cancer treatment

As a life-threatening chronic disease, cancer is characterized by tumor heterogeneity. This heterogeneity is associated with factors that lead to treatment failure and poor prognosis, including drug resistance, relapse, and metastasis. Therefore, precision medicine urgently needs personalized tumor models that accurately reflect the tumor heterogeneity. Currently, tumor organoid technologies are used to generate in vitro 3D tissues, which have been shown to precisely recapitulate structure, tumor microenvironment, expression profiles, functions, molecular signatures, and genomic alterations in primary tumors. Tumor organoid models are important for identifying potential therapeutic targets, characterizing the effects of anticancer drugs, and exploring novel diagnostic and therapeutic options. In this review, we describe how tumor organoids can be cultured and summarize how researchers can use them as an excellent tool for exploring cancer therapies. In addition, we discuss tumor organoids that have been applied in cancer therapy research and highlight the potential of tumor organoids to guide preclinical research.

Machine learning in heart failure diagnosis, prediction, and prognosis: review

Globally, cardiovascular diseases take the lives of over 17 million people each year, mostly through myocardial infarction, or MI, and heart failure (HF). This comprehensive literature review examines various aspects related to the diagnosis, prediction, and prognosis of HF in the context of machine learning (ML). The review covers an array of topics, including the diagnosis of HF with preserved ejection fraction (HFpEF) and the identification of high-risk patients with HF with reduced ejection fraction (HFrEF). The prediction of mortality in different HF populations using different ML approaches is explored, encompassing patients in the ICU, and HFpEF patients using biomarkers and gene expression. The review also delves into the prediction of mortality and hospitalization rates in HF patients with mid-range ejection fraction (HFmrEF) using ML methods. The findings highlight the significance of a multidimensional approach that encompasses clinical evaluation, laboratory assessments, and comprehensive research to improve our understanding and management of HF. Promising predictive models incorporating biomarkers, gene expression, and consideration of epigenetics demonstrate potential in estimating mortality and identifying high-risk HFpEF patients. This literature review serves as a valuable resource for researchers, clinicians, and healthcare professionals seeking a comprehensive and updated understanding of the role of ML diagnosis, prediction, and prognosis of HF across different subtypes and patient populations.

Vericiguat and Cardiovascular Outcomes in Heart Failure by Baseline Diabetes Status: Insights From the VICTORIA Trial

BackgroundType 2 diabetes mellitus (T2DM) significantly worsens heart failure (HF) prognosis. ObjectivesThis study sought to investigate the impact of T2DM on outcomes in patients enrolled in VICTORIA and assess the efficacy of vericiguat in patients with and without T2DM. MethodsPatients with HF with reduced ejection fraction were randomized to receive vericiguat or placebo in addition to standard therapy. The primary outcome was a composite of cardiovascular death or first heart failure hospitalization (HFH). A Cox proportional hazards model was used to calculate HRs and 95% CIs to assess if the effect of vericiguat differed by history of T2DM. ResultsOf 5,050 patients enrolled, 3,683 (72.9%) had glycosylated hemoglobin (HbA1c) measured at baseline. Of these, 2,270 (61.6%) had T2DM, 741 (20.1%) had pre-T2DM, 449 (12.2%) did not have T2DM, and 178 (4.8%) had undiagnosed T2DM. The risks of the primary outcome, HFH, and all-cause and cardiovascular mortality were high across all categories. The efficacy of vericiguat on the primary outcome did not differ in patients stratified by T2DM by history (HR: 0.92; 95% CI: 0.81-1.04), T2DM measured by HbA1c (HR: 0.77; 95% CI: 0.49-1.20), and pre-T2DM measured by HbA1c (HR: 0.88; 95% CI: 0.68-1.13) and in those with normoglycemia (HR: 1.02: 95% CI: 0.75-1.39; P for interaction = 0.752). No significant differences were observed in subgroups with respect to the efficacy of vericiguat on HFH and all-cause or cardiovascular death. ConclusionsIn this post hoc analysis of VICTORIA, vericiguat compared with placebo significantly reduced the risk of cardiovascular death or HFH in patients with worsening HF with reduced ejection fraction regardless of T2DM status. (A Study of Vericiguat in Participants With Heart Failure With Reduced Ejection Fraction [HFrEF] [Mk-1242-001] [VICTORIA]; NCT02861534)

Comparison of the Value of Four Objective Nutritional Indices in Assessing the Long-Term Prognosis of Elderly Patients with Heart Failure with Preserved Ejection Fraction.

The long-term prognosis of heart failure with preserved ejection fraction (HFpEF) is influenced by malnutrition. Currently, there's a deficit in objective and comprehensive nutritional assessment methods to evaluate the nutritional status and predicting the long-term outcomes of HFpEF patients. Our retrospective study included two hundred and eighteen elderly HFpEF patients admitted to the cardiovascular ward at the Air Force Medical Centre from January 2016 to December 2021. Based on follow-up outcomes, patients were categorized into all-cause death (99 cases) and Survival (119 cases) groups. We compared general data, laboratory results, and nutritional indexes between groups. Differences in subgroups based on Triglyceride-Total Cholesterol-Body Weight Index (TCBI), Geriatric Nutritional Risk Index (GNRI), Prognostic Nutritional Index (PNI), and Controlled Nutrition Score (CONUT) were analyzed using Kaplan-Meier survival curves and log-rank test. COX regression was used to identify all-cause mortality risk factors, and the predictive accuracy of the four nutritional indices was assessed using receiver operating characteristic (ROC) curves and Delong test analysis. A total of 101 (45.41%) HFpEF patients experienced all-cause mortality during 59.02 1.79 months of follow-up. The all-cause mortality group exhibited lower GNRI and PNI levels, and higher CONUT levels than the Survival group (p 0.05). Kaplan-Meier analysis revealed lower cumulative survival in the low GNRI ( 96.50) and low PNI ( 43.75) groups, but higher in the low CONUT ( 2) group, compared to their respective medium and high-value groups. Multifactorial COX regression identified low PNI ( 43.75) as an independent all-cause mortality risk factor in elderly HFpEF patients. ROC and Delong's test indicated PNI (area under the curve [AUC] = 0.698, 95% confidence interval [CI] 0.629-0.768) as a more effective predictor of all-cause mortality than TCBI (AUC = 0.533, 95% CI 0.456-0.610) and CONUT (AUC = 0.621, 95% CI 0.547-0.695; p 0.05). However, there was no significant difference compared to GNRI (AUC = 0.663, 95% CI 0.590-0.735; p 0.05). In elderly HFpEF patients a PNI 43.75 was identified as an independent risk factor for all-cause mortality. Moreover, PNI demonstrates superior prognostic performance in predicting all-cause mortality in elderly patients with HFpEF when compared to TCBI, GNRI, and COUNT.

Set of heart failure early mortality prevention methods

Heart failure is a common chronic disease with a poor prognosis that often ends in death. The research thus aims to thoroughly investigate ways in which the prognosis of heart failure could be improved. For this purpose, a 9-month study was conducted with a group of people who followed the Mediterranean diet, and the effects of this diet on the cardiovascular system and the state of the body as a whole were assessed. The study found that adherence to the principles of the Mediterranean diet improved the quality of life of patients, according to the quality-of-life questionnaire (the average score was 81.3 at the beginning of the study and 87 points at the end of the study), and the level of adherence to the Mediterranean diet in the study group increased from 30 points to 39.7, according to the MedDietScore (MDS) scale. There was also an improvement in appetite and sleep quality. A decrease in the average blood pressure in the group was recorded (from 140/95 to 137/88 mmHg). It was found that due to proper nutrition, the participant’s Body Mass Index (BMI) was reduced (from 31.2 kg/m2 to 29.6 kg/m2), and the percentage of overweight people in the study group was also reduced from 44% to 26%. It was noted that no deterioration in heart failure class or functional class was recorded during the study. The left ventricular ejection fraction remained unchanged.

Failure Prognosis using Dynamic Bayesian Networks and Decision Trees

Failure Prognosis using Dynamic Bayesian Networks and Decision Trees

Supersulfide catabolism participates in maladaptive remodeling of cardiac cells

The atrophic myocardium resulting from mechanical unloading and nutritional deprivation is considered crucial as maladaptive remodeling directly associated with heart failure, as well as interstitial fibrosis. Conversely, myocardial hypertrophy resulting from hemodynamic loading is perceived as compensatory stress adaptation. We previously reported the abundant presence of highly redox-active polysulfide molecules, termed supersulfide, with two or more sulfur atoms catenated in normal hearts, and the supersulfide catabolism in pathologic hearts after myocardial infarction correlated with worsened prognosis of heart failure. However, the impact of supersulfide on myocardial remodeling remains unclear. Here, we investigated the involvement of supersulfide metabolism in cardiomyocyte remodeling, using a model of adenosine 5′-triphosphate (ATP) receptor-stimulated atrophy and endothelin-1 receptor-stimulated hypertrophy in neonatal rat cardiomyocytes. Results revealed contrasting changes in intracellular supersulfide and its catabolite, hydrogen sulfide (H2S), between cardiomyocyte atrophy and hypertrophy. Stimulation of cardiomyocytes with ATP decreased supersulfide activity, while H2S accumulation itself did not affect cardiomyocyte atrophy. This supersulfide catabolism was also involved in myofibroblast formation of neonatal rat cardiac fibroblasts. Thus, unraveling supersulfide metabolism during myocardial remodeling may lead to the development of novel therapeutic strategies to improve heart failure.

Simulation of Mechanical Properties of Injection‐Molded Thermoplastic Foam Structures

This article presents an approach regarding the interlinking of simulation programs to determine mechanical properties of foamed polymers. The software Moldex3D is used to simulate the heterogeneous foam structure, which serves as a database for material modeling. This material modeling is performed with the software Digimat and evaluated using various modeling approaches. The material models are characterized on one side by a homogeneous structure and on the other by the simulated heterogeneous foam structure. In addition, different failure indicators are used and evaluated, which were originally developed for fiber‐reinforced materials. The simulation of the tensile test is carried out with the software Marc‐Mentat. Herein, local stresses and strains are calculated, which reach a maximum value due to the influence of the failure indicators. The results are used to show the extent to which the integration of the heterogeneous foam structure proves to be beneficial. It is additionally demonstrated that the applied failure indicators cannot be used for the prediction of maximum stress and strain simultaneously. Thus, for the time of this study, it is formulated to include both indicators to calculate the maximum stress and strain or to evaluate alternative approaches regarding failure prognosis.