Terapevt Arkh
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Рulmonary hypertension (PH) is a common complication of left heart diseases. In addition to a passive increase of pressure in the venous bed of the pulmonary circulation, leading to an increase of mean pulmonary pressure, signs of precapillary PH could be detected in some patients. Since 2013, a hemodynamic subtype of PH due to left heart diseases combined post/precapillary PH has been identified, with a more unfavorable prognosis and high mortality.
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To analyze the frequency of resumption of anticoagulant therapy (ACT) after major and clinically significant bleeding among AF patients who received oral anticoagulants and were observed in the Department of clinical problems of atherothrombosis from 1999 to 2019 within the retro-prospective register Regata-2, and to search for clinical factors associated with recurrence of hemorrhagic complications among patients who resumed anticoagulant therapy after a bleeding episode. ⋯ During the 20-year follow-up, the frequency of all major and clinically significant bleeding was 2.6/100 patients-years, the frequency of first bleeding was 5.86/100 patients-years, while the frequency of repeated hemorrhagic complications was 7.06/100 patients-years. Patients with a high thromboembolic risk should receive anticoagulants, provided that the modifiable risk factors for bleeding are carefully corrected.
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Upper gastrointestinal (UGI) bleeding is a common complication of antiplatelet therapy. Data from real clinical practice that characterize the range of risk factors for UGI bleeding, prophylactic proton pump inhibitors (PPIs) therapy, bleeding frequency and their long-term effects in patients with stable coronary artery disease (CAD) are limited. ⋯ In a prospective analysis of patients with stable CAD, we identified UGI bleeding was a significant risk factor for late thromboembolism and death, compared with patients without bleeding. Predictors of UGI bleeding and poor prognosis are factors that indicate atherothrombotic burden abdominal aortic aneurysm, peripheral atherosclerosis and HF. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04347200.
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to evaluate the effectiveness of cardiac contractility modulation (MSS) in patients with chronic heart failure (CHF) and atrial fibrillation (AF). ⋯ The use of MSS may be promising for the treatment of heart failure in patients with CHF and AF.
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The angle between theQRSandTvectors reflects the consistency or inconsistency of the processes of de- and repolarization of the ventricles of the heart and is considered one of the indicators of global electrical heterogeneity of myocardium. In recent years, the prognostic value of theQRS-Tangle has been demonstrated in relation to total and cardiovascular mortality, both in the population and in various groups of patients. ⋯ Possible mechanisms for increasing theQRS-Tangle are discussed. Data are given on the use of theQRS-Tangle in diagnostic and prognostic scales, including in combination with other indicators of global electrical heterogeneity of myocardium.