Elementare Beweise f�r die Anwendbarkeit der Wang-Algebra in elektrischen Netzen

Edelmann, Hans

doi:10.1007/bf01407211

Cited by 5 publications

(8 citation statements)

References 10 publications

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“…Mottram et al 15 reported beneficial effects of low-dose spironolactone on myocardial relaxation in 30 treated hypertensive patients with exertional dyspnea and abnormal LV filling patterns. In the Aldo-DHF (Aldosterone-Diastolic Heart Failure) trial, 16 spironolactone improved slightly LV diastolic function, but had no effect on maximal exercise capacity and symptoms in patients with heart failure and preserved ejection fraction. Similarly, in Failure With an Aldosterone Antagonist) study, 17 spironolactone failed to reduce a composite cardiovascular end point in heart failure and preserved ejection fraction.…”

Section: Discussionmentioning

confidence: 99%

“…[15][16][17][18] Inconsistencies could be attributed to the use of conventional echocardiography in most of these studies and, most important, to possible interference of drugs used to treat hypertension or heart failure. 19 The aim of this study was, Abstract-Aldosterone has hypertrophic and profibrotic effects on the heart.…”

mentioning

confidence: 99%

“…11,12 However, results of studies that examined the possible contribution of plasma aldosterone levels to LV diastolic dysfunction in primary hypertension were inconsistent 13,14 and also studies that investigated the effects of MR antagonists on LV diastolic function and clinical outcomes in patients with heart failure and preserved ejection fraction reported controversial results. [15][16][17][18] Inconsistencies could be attributed to the use of conventional echocardiography in most of these studies and, most important, to possible interference of drugs used to treat hypertension or heart failure. 19 The aim of this study was, therefore, to investigate the relationship of plasma aldosterone levels with markers of LV diastolic dysfunction obtained at TDI in treatment-naïve patients with primary hypertension free of comorbidities that might affect LV filling properties.…”

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Plasma Aldosterone and Left Ventricular Diastolic Function in Treatment-Naïve Patients With Hypertension

et al. 2015

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Diastolic heart failure is detected with increasing frequency in patients with hypertension 1 and is anticipated by changes in left ventricular (LV) filling properties that reflect stiffening of the ventricular wall. These changes in diastolic function can occur even in the absence of hypertension-related LV hypertrophy and are associated with increased hospitalization rate and mortality.2 Therefore, identification of early LV diastolic abnormalities is critical in patients with high blood pressure to prevent subsequent cardiac functional deterioration heralding cardiac insufficiency.3 Conventional echocardiographic techniques cannot detect early changes of diastolic function in a relevant proportion of patients, 4 but pulsed tissue-Doppler imaging (TDI) with measurement of myocardial velocities at several segments of the LV wall permits more sensitive 5 and reproducible 6 detection of diastolic dysfunction. In addition to an increased blood pressure-related cardiac workload, other factors could contribute to the development of structural and functional abnormalities of the heart in patients with hypertension. Evidence obtained in experimental animal studies indicates that inappropriately elevated aldosterone levels and activation of mineralocorticoid receptors (MR) induce profibrotic and hypertrophic responses in the heart. 7-10 Also, studies conducted in patients with primary aldosteronism have consistently reported abnormal LV diastolic properties in association to excess LV hypertrophy in comparison with matched patients with primary hypertension.11,12 However, results of studies that examined the possible contribution of plasma aldosterone levels to LV diastolic dysfunction in primary hypertension were inconsistent 13,14 and also studies that investigated the effects of MR antagonists on LV diastolic function and clinical outcomes in patients with heart failure and preserved ejection fraction reported controversial results. [15][16][17][18] Inconsistencies could be attributed to the use of conventional echocardiography in most of these studies and, most important, to possible interference of drugs used to treat hypertension or heart failure. 19 The aim of this study was, Abstract-Aldosterone has hypertrophic and profibrotic effects on the heart. The relationship between plasma aldosterone levels and left ventricular diastolic function in hypertension, however, is unclear. The aim of this study was to examine this relationship in treatment-naïve hypertensive patients free of comorbidities that could affect left ventricular diastolic filling properties. In 115 patients with primary hypertension who were eating a standard diet and 100 matched normotensive controls, we measured plasma aldosterone and active renin levels and performed both conventional echocardiography and tissue-Doppler imaging for assessment of left ventricular diastolic function. Left ventricular hypertrophy was found in 21% of hypertensive patients, and diastolic dysfunction was detected in 20% by conventional echocardiography and in 58% by ...

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Plasma Aldosterone and Left Ventricular Diastolic Function in Treatment-Naïve Patients With Hypertension

et al. 2015

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“…In this network analysis, 11 855 publications were identified, and 19 RCTs, including a total of 20 633 patients with HF and an ejection fraction of 40% or more, were included after screening (eFigure 1 in the Supplement); 19 trials reported all-cause death, 16 Most of the included studies were double-blind, multicenter RCTs, and nearly all of the included RCTs had no significant risk of bias (eFigure 2 in the Supplement). The median trial duration ranged from 4 to 40 months, with the median duration of only 1 study being less than 6 months.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

Optimal Pharmacologic Treatment of Heart Failure With Preserved and Mildly Reduced Ejection Fraction

Xiang

Zhang

et al. 2022

JAMA Netw Open

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ImportanceIn recent years, significant progress has been made in the pharmacologic treatment of heart failure (HF) with reduced ejection fraction (HFrEF), but there is still insufficient evidence for drug therapy for HF with preserved ejection fraction (HFpEF) and mildly reduced ejection fraction (HFmrEF).ObjectiveTo compare the outcomes associated with different drug combinations for the treatment of HFpEF and HFmrEF.Data SourcesA search of the PubMed, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) databases was conducted for studies published from inception to October 9, 2021.Study SelectionRandomized clinical trials on the use of angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), angiotensin receptor-neprilysin inhibitors (ARNIs), mineralocorticoid receptor antagonists (MRAs), β-blockers, and sodium-glucose cotransporter 2 (SGLT2) inhibitors for patients with HFpEF or HFmrEF.Data Extraction and SynthesisData extraction and bias assessment were independently performed by 2 reviewers following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline. All data for 3 outcomes were pooled with a fixed-effect model.Main Outcomes and MeasuresThe main outcomes were first hospitalization for HF, all-cause mortality, and cardiovascular mortality. Hazard ratios (HRs) and 95% credible intervals (CrIs) were evaluated using a bayesian network meta-analysis model.ResultsIn this analysis, 19 randomized clinical trials, including 20 633 patients with HF and an ejection fraction of 40% or more, without a remarkable risk of bias were included. Compared with placebo, no treatments were associated with a significant reduction in the risk of all-cause death or cardiovascular death. SGLT2 inhibitors, ARNIs, and MRAs were associated with a significant decrease in the risk of HF hospitalization compared with placebo (SGLT2 inhibitors: HR, 0.71 [95% CrI, 0.60-0.83]; ARNIs: HR, 0.76 [95% CrI, 0.61-0.95]; MRAs: HR, 0.83 [95% CrI, 0.69-0.99]), and SGLT2 inhibitors were the optimal drug class in terms of reducing the risk for HF admission. Sensitivity analysis results demonstrated a progressive decrease in the risk of HF admission and an advance in mean rank associated with the increasing use of drug classes.Conclusions and RelevanceThe findings of this study suggest that SGLT2 inhibitors were the optimal drug class for HFpEF and HFmrEF, consistent with the most recent guideline recommendation. The incremental use of combinations of SGLT2 inhibitors, ACE inhibitors or ARBs, and β-blockers may be associated with accumulative benefits in HF hospitalization rather than all-cause death among patients with HFpEF and HFmrEF.

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“…However, the recently published results of the Aldosterone Receptor Blockade in Diastolic HF (Aldo-DHF) trial, which included 422 patients with chronic HF, left ventricular (LV) ejection fraction of 50%, and echocardiographic evidence of LV diastolic dysfunction, showed that long-term aldosterone receptor blockade improved LV diastolic function but had no effect on maximal exercise capacity, HF symptoms, or quality of life in HFpEF. 3 A few days ago, a meta-analysis of 15 prospective studies, involving 45 110 patients, addressed the issue of statin treatment for HF. 4 The study included patients with both preserved and reduced ejection fraction.…”

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Treating Heart Failure With Preserved Ejection Fraction

2013

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Not long ago we wrote a review on the treatment of heart failure (HF) with preserved ejection fraction (HFpEF). 1 We concluded that careful use of diuretics and statins was the only possible readily available modalities useful in treating HfpEF 1 ; there is no universally accepted treatment for this condition. 2 Until some months ago, there was a hope that spironolactone would improve the prognosis of HFpEF. However, the recently published results of the Aldosterone Receptor Blockade in Diastolic HF (Aldo-DHF) trial, which included 422 patients with chronic HF, left ventricular (LV) ejection fraction of 50%, and echocardiographic evidence of LV diastolic dysfunction, showed that long-term aldosterone receptor blockade improved LV diastolic function but had no effect on maximal exercise capacity, HF symptoms, or quality of life in HFpEF. 3 A few days ago, a meta-analysis of 15 prospective studies, involving 45 110 patients, addressed the issue of statin treatment for HF. 4 The study included patients with both preserved and reduced ejection fraction. Additional statin treatment was associated with reduced all-cause mortality (risk ratios [RRs] ¼ 0.71, 95% confidence intervals [CIs] 0.61-0.83) and reduced rehospitalization rate for HF (RR ¼ 0.84, 95% CI 0.74-0.96). 4 Statin treatment, however, had little impact on pump failure mortality, cardiovascular mortality, and sudden cardiac death. Atorvastatin treatment appeared to reduce all-cause mortality (RR ¼ 0.61, P ¼ .05) and rehospitalization for HF (RR ¼ 0.44, P ¼ .04) compared with nonatorvastatin therapy. 4 These effects were also seen in the GREek Atorvastatin and Coronary-heart-disease Evaluation (GREACE) study 5 and the large Treating to New Targets (TNT) study. 6 According to TNT, improvement in kidney function may be related to the beneficial effect of high-dose atorvastatin on HF hospitalizations. 7 This was also confirmed by GREACE, 8 which a few years before TNT had shown that there is a clinically significant improvement in renal function that is independent of the hypolipidemic action of atorvastatin. 9 The renal function protection, even improvement, with statins has been recently reported by a meta-analysis. 10 If statins are underused in HF, there should probably be an effort to generalize their use in these patients.

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Elementare Beweise f�r die Anwendbarkeit der Wang-Algebra in elektrischen Netzen

Cited by 5 publications

References 10 publications

Plasma Aldosterone and Left Ventricular Diastolic Function in Treatment-Naïve Patients With Hypertension

Plasma Aldosterone and Left Ventricular Diastolic Function in Treatment-Naïve Patients With Hypertension

Optimal Pharmacologic Treatment of Heart Failure With Preserved and Mildly Reduced Ejection Fraction

Treating Heart Failure With Preserved Ejection Fraction

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