To determine the clinical and echocardiographic outcome of left ventricular hypertrophy a prospective study was undertaken of 104 nondiabetic dialysis patients without dilated cardiomyopathy, who were followed for 3–5 years. 33% of patients had normal echocardiogram, 41% mild and 21% severe hypertrophy (left ventricular wall thickness > 1.4 cm in diastole). In the first 2 groups 16%o progressed to severe hypertrophy, 23% were admitted with congestive heart failure after starting dialysis therapy, and 2-year cumulative survivals were 97 and 85%. In the group with severe hypertrophy 88% already had severe hypertrophy on starting dialysis therapy, it was persistent in 87%, 50% were admitted at least once with congestive heart failure, and the 2-year cumulative survival was 53%. 71% of those who died in the severe group died from cardiac or cerebrovascular causes compared to none of those with normal echocardiogram, which accounted for the significantly worse (p = 0.001) survival. We conclude that severe left ventricular hypertrophy occurs frequently in dialysis patients, is often present at the start of end-stage renal disease therapy, is persistent, may predispose to congestive heart failure, and is associated with a high mortality.
The conventional gravity modcl is revised for a single commodity and applicd to meat markets to determine factors affccting trade flows of meat. This study dcrnonstratcs that the gravit y model for a single agricultural commodity can be paramcterized more effectively by using tirnc series and cross-section data rather than cross-section data alonc. This study rcvcals that tradc policies and subsidics uscd by cxporting and importing coun tries, Iivestock production capacity in countrics, and distances play an important role in detcrrnining trade Ilows of meat.Long-terni agreements achievc the highcst performance toward cnhancing international meat trade. lmport quotas and the hoof-and-rnouth disease on becf greatly impair meat trade.
The AFFIRM Study enrolled 4060 predominantly elderly patients with atrial fibrillation to compare ventricular rate control with rhythm control. The patients in the AFFIRM Study were representative of patients at high risk for complications from atrial fibrillation, which indicates that the results of this large clinical trial will be relevant to patient care.
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