In HF patients, including those with CIEDs, home-based telemonitored NW is safe and effective. NW was well accepted by patients and adherence was high and promising.

No abstract

Using external vascular ultrasound, we measured brachial artery diameter (Diam) at rest, after release of 4 min of limb ischemia, i. e., endothelium-dependent dilation (EDD), and after sublingual nitroglycerin, i.e., non-endothelium-dependent dilation (NonEDD), in 35 healthy men aged 61-83 yr: 12 endurance athletes (A) and 23 controls (C). As anticipated, treadmill exercise maximal oxygen consumption (VO(2 max)) was significantly higher in A than in C (40. 2 +/- 6.6 vs. 27.9 +/- 3.8 ml. kg(-1). min(-1); respectively, P < 0. 0001). With regard to arterial physiology, A had greater EDD (8.9 +/- 4.2 vs. 5.7 +/- 3.5%; P = 0.02) and a tendency for higher NonEDD (13.9 +/- 6.7 vs. 9.7 +/- 4.2%; P = 0.07) compared with C. By multiple linear regression analysis in the combined sample of older men, only baseline Diam (beta = -2.0, where beta is the regression coefficient; P = 0.005) and VO(2 max) (beta = 0.23; P = 0.003) were independent predictors of EDD; similarly, only Diam (beta = -4.0; P = 0.003) and VO(2 max) (beta = 0.27; P = 0.01) predicted NonEDD. Thus endurance-trained older men demonstrate both augmented EDD and NonEDD, consistent with a generalized enhanced vasodilator responsiveness, compared with their sedentary age peers.

No abstract

The aim of our study was to evaluate renal resistive index (RI) value in never treated hypertensive patients in relation to ambulatory blood pressure measurement (ABPM) values and early target organ damage. The study included 318 subjects: 223 patients with never treated essential hypertension (mean age 37.1 years) and 95 normotensive healthy subjects (mean age 37.9 years). ABPM, echocardiography and carotid and renal arteries duplex color Doppler examinations were performed. RI values in patients with never treated essential hypertension were no different from the normotensive control group (0.59 +/- 0.05 vs 0.59 +/- 0.05; NS). In the untreated patients RI correlated significantly with 24-h pulse pressure (r=0.234; p<0.01) and ambulatory arterial stiffness index (AASI) values (r=0.274; p<0.001), intima-media thickness (IMT) (r=0.249; p<0.001), E'/A' (rho= -0.279; p<0.001) and relative wall thickness (RWT; r=0.185; p<0.01). In the multivariate stepwise analysis, RI values correlated independently with carotid IMT (beta=0.272; p=0.020) and 24-h AASI values (beta=0.305; p=0.009). In normotensive healthy controls, significant independent correlation between RI and carotid IMT and 24-h AASI values were also found. Our study may indicate limited value of RI in differentiating patients with uncomplicated hypertension with healthy controls. Renal resistive values were independently correlated with carotid IMT and AASI. These may suggest that renal vascular resistance is related to two markers for cardiovascular events both in the hypertensive and normotensive subjects.

Aims To assess the proportion of patients with heart failure and reduced ejection fraction (HFrEF) who are eligible for sacubitril/valsartan (LCZ696) based on the European Medicines Agency/Food and Drug Administration (EMA/FDA) label, the PARADIGM‐HF trial and the 2016 ESC guidelines, and the association between eligibility and outcomes. Methods and results Outpatients with HFrEF in the ESC‐EORP‐HFA Long‐Term Heart Failure (HF‐LT) Registry between March 2011 and November 2013 were considered. Criteria for LCZ696 based on EMA/FDA label, PARADIGM‐HF and ESC guidelines were applied. Of 5443 patients, 2197 and 2373 had complete information for trial and guideline eligibility assessment, and 84%, 12% and 12% met EMA/FDA label, PARADIGM‐HF and guideline criteria, respectively. Absent PARADIGM‐HF criteria were low natriuretic peptides (21%), hyperkalemia (4%), hypotension (7%) and sub‐optimal pharmacotherapy (74%); absent Guidelines criteria were LVEF>35% (23%), insufficient NP levels (30%) and sub‐optimal pharmacotherapy (82%); absent label criteria were absence of symptoms (New York Heart Association class I). When a daily requirement of ACEi/ARB ≥ 10 mg enalapril (instead of ≥ 20 mg) was used, eligibility rose from 12% to 28% based on both PARADIGM‐HF and guidelines. One‐year heart failure hospitalization was higher (12% and 17% vs. 12%) and all‐cause mortality lower (5.3% and 6.5% vs. 7.7%) in registry eligible patients compared to the enalapril arm of PARADIGM‐HF. Conclusions Among outpatients with HFrEF in the ESC‐EORP‐HFA HF‐LT Registry, 84% met label criteria, while only 12% and 28% met PARADIGM‐HF and guideline criteria for LCZ696 if requiring ≥ 20 mg and ≥ 10 mg enalapril, respectively. Registry patients eligible for LCZ696 had greater heart failure hospitalization but lower mortality rates than the PARADIGM‐HF enalapril group.

Thus, ischemic ST-segment changes developing during recovery from treadmill exercise in apparently healthy individuals have adverse prognostic significance similar to those appearing during exercise.

IntroductIon Data regarding standardized trends in mortality from heart failure (HF) in the general population are limited.objEctIvEs The aim of the study was to evaluate trends in HF mortality in Poland in the years 1980-2010. PAtIEnts And mEthods An analysis of a database of mortality records from 1980-2010 based on National Statistics was performed. Mortality trends for HF by age and sex were analyzed by polynomial or linear regression.rEsuLts Total crude numbers of HF deaths in 1980 were 21,519 and 23,008 for women and men, respectively, whereas, in 2010, there were 23,304 and 19,558. There was a significant change in mortality trends for HF, from a decline during the first phase of the study to an increase during the most recent years, 2005-2010 (P <0.005 for changes of trends for both sexes). The lowest value reached in 2005 constituted 47% and 41% of the baseline for women and men, respectively. These ratios increased to 59% and 52% in 2010. Stratification by age and sex brought similar results, with the exception of the youngest groups, which showed initial increases in the rates for the years 1980-1985. concLusIons There was a significant decline in the rates of HF mortality in the Polish population for both men and women, showing a maximal reduction of about 50% around 2005. However, between 2005 and 2010, a significant increase in the rates of HF mortality was observed (crude difference equaled 12% for women and 11% for men). It is unknown whether this is a temporary or permanent trend, and the issue requires further investigation. KEy wordsheart failure, mortality, prognosis orIGInAL ArtIcLE Trends in heart failure mortality in Poland between 1980 and 2010 665 rates of HF deaths declined for both women and men. The lowest values registered were 141.8 for women and 214.2 for men in 2005, which constituted 47% and 41% of the 1980 death rates, respectively. Subsequently, death rates increased between 2005 and 2010 (women -176.5 and men -268.7), reaching 59% and 52% of the baseline values (FIGurE 1). A polynomial analysis (FIGurE 2) showed that the trends changed significantly twice during the follow-up in men and women, from a declining trend through 2005, followed by a recently emerging increase (P <0.005).Age groups Stratifying by age groups revealed a positive association between age and crude HF mortality rates for both sexes with the highest values in the oldest subjects throughout the study period (FIGurEs 3 and 4).Trend analysis in the youngest groups (45-64 years) showed that for both sexes death rates for HF increased during the initial phase of the study, reaching their peak around [1985][1986][1987][1988][1989][1990]. After that, the rates declined reaching their nadir around 2005. The rates of HF deaths for this younger subgroup declined from 51.7 to 19.9 for women (38% of the initial values) and from 135.0 to 65.1 for men (48%) between 1980 and 2005. However, during the years 2005-2010, an increase was observed. As a result, standardized HF rates reached 27.8 for women and 95.6 f...