Chronic heart failure with preserved left ventricular ejection fraction accounts for about 50% of the incidence of heart failure. A proven principle to improve outcomes in patients with chronic heart failure with reduced left ventricular ejection fraction is to lower the heart rate. The article discusses situations in which treatment with ß-adrenoblockers is ineffective or adversely affects outcomes. The results of our own study and the EDIFY project, in which ivabradine was used in patients with CHF-CSF, are compared. The importance of phenotyping of patients with CHF-CSF is argued to improve the efficacy of their treatment.
One of the major issues in modern medicine is the determination of the limit of normal human phenotype, its variability, and the individual risk threshold for disease. Plethysmography is a way of recording changes in body volume, or part of it, related to the dynamics of blood flow.
The pattern of hyperinsulinemia was studied in patients with metabolic syndrome. The levels of basal insulinemia (BI), malondialdehyde (MDA) and catalaze (CA) as an index of oxidative stress and some metabolic parameters have been studied in men and women with metabolic syndrome. Basal insulinemia correlated significantly with malondialdehyde levels both in men and women. Close relationship was also found between basal insulinemia and waist circumference.
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