Metoprolol and atenolol in mild-to-moderate chronic heart failure: The comparison of survival benefit

The clinical end-point of all causes of mortality and cardiovascular hospitalization (combined end-points) is a widely accepted indicator of heart failure survival. The primary aim of this study was to examine the effects of metoprolol and atenool on combined end-points in patients with mild-to-moderate heart failure. This study was designed to be comparative, prospective, and random. The criteria for study inclusion were: age of 70 years or less, New York Heart Association (NYHA) Functional Class II and III, and an ejection fraction of the left ventricle of 40% or less. The patients (a total of 150) on therapy with angiotensin-converting enzyme inhibitor and a diuretic were randomized into three numerically equal therapy groups: 1) an atenolol group; 2) a metoprolol group; and 3) a control group (without beta-blockers). The follow-up period was 12 months. The results were analyzed using: the hisquare test, variance analyses, Kaplan-Meier's model, Wilcox's statistics, and Cox's model. The cumulative survival rate for patients treated with metoprolol was 88%, 78% for patients treated with atenolol, and 48% for patients from the control group. It is clear that the cumulative survival rate for patients treated with metoprolol and atenolol is significantly higher compared to patients from the control group. In addition, the survival rate of patients treated with metoproiol was considerably higher compared to the survival rate of patients treated with atenolol. Metoprolol has significantly reduced the relative risk of combined end-points (71%) compared to atenolol (53%). The results of this comparative study clearly indicate that metoprolol and atenolol have a favorable effect on the survival rate of patients with chronic heart failure. In addition, metoprolol is considerably more effective than atenolol.

Download Full-text

The mechanism of adaptation of the organism of patients with chronic heart failure combined with vitamin D deficiency and the morphofunctional state of peripheral blood erythrocytes

Regulatory Mechanisms in Biosystems ◽

10.15421/021954 ◽

2019 ◽

Vol 10 (3) ◽

pp. 352-357

Author(s):

N. I. Baryla ◽

I. P. Vakaliuk ◽

S. L. Pоpеl’

Keyword(s):

Heart Failure ◽

Vitamin D ◽

Chronic Heart Failure ◽

Red Blood Cells ◽

Vitamin D Deficiency ◽

Peripheral Blood ◽

Blood Cells ◽

Functional Class ◽

Exercise Stress ◽

Control Group

The problem of structural changes in peripheral blood erythrocytes in patients with chronic heart failure in combination with vitamin D deficiency during exercise stress remains insufficiently studied. Vitamin receptors are located on smooth myocytes, endothelial cells, cardiomyocytes and blood cells. It affects the state of the cell membrane, the contractile function of the myocardium, the regulation of blood pressure, cardiac remodeling and reduction of left ventricular hypertrophy. Therefore, it is important to assess the level of vitamin D in blood plasma in individuals with chronic heart failure and to identify the effect of its deficiency on the state of peripheral red blood cells when performing a 6-minute walk test. A total of 75 patients of the main group with chronic heart failure stage II A, I–II functional class with different levels of vitamin D deficiency were examined. The control group included 25 patients with chronic heart failure stage II A, functional class I–II without signs of vitamin D deficiency. The average age of patients was 57.5 ± 7.5 years. All patients were asked to undergo the 6 minutes walking test. The level of total vitamin D in plasma was determined by enzyme immunoassay. Morphological studies of erythrocytes were performed on the light-optical and electron-microscopic level. The obtained results showed that patients of the main group with chronic heart failure had a decrease in vitamin D by 2.2 times compared with the control group. Correlation analysis showed a directly proportional relationship between vitamin D deficiency and the number of red blood cells of a modified form and red blood cells with low osmotic resistance. Dosed exercise stress in patients with chronic heart failure against a background of vitamin D deficiency leads to an increase in the number of reversibly and irreversibly deformed erythrocytes and a decrease in their osmotic stability. This indicates a disorder in the structural integrity of their membrane and can have negative consequences for the somatic health of such patients.

Download Full-text

Effects of the Wenyang Zhenshuai Granule on the Expression of LncRNA-MiR143HG/miR-143 Regulating ERK5 in H9C2 Cardiomyocytes

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/6431007 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Zelin Xu ◽

Xinyu Chen ◽

Qingyang Chen ◽

Huzhi Cai

Keyword(s):

Heart Failure ◽

Survival Rate ◽

Chronic Heart Failure ◽

Clinical Symptoms ◽

Malignant Tumors ◽

Clinical Syndrome ◽

Control Group ◽

Heart Insufficiency ◽

Injury Model ◽

H9c2 Cardiomyocytes

Chronic heart failure (CHF) is a complex clinical syndrome caused by a variety of heart problems, with a high incidence. The 5-year survival rate of patients with clinical symptoms is similar to that of malignant tumors. Wenyang Zhenshuai granules are a safe and effective granule of traditional Chinese medicine components, including aconite, dried ginger, licorice, and red ginseng. In contemporary clinical applications, it is widely used in acute and chronic heart insufficiency, coronary heart disease, and arrhythmia. This research cultured H9C2 cardiomyocytes and divided them into the normal control group, LncRNA-MiR143HG overexpression group, LncRNA-MiR143HG silence group, Adriamycin (ADR) group, ADR + medicated serum group, ADR + LncRNA-MiR143HG overexpression + medicated serogroup, and ADR + LncRNA-MiR143HG silence + medicated serogroup. The cells of each group were treated differently, and the survival rate of each group of cells and the expression levels of LncRNA-MiR143HG/miR-143 and ERK5 were detected at the end of the experiment, and the expression of LncRNA-MiR143HG/miR-143 in H9C2 cardiomyocytes was regulated by Wenyang Zhenshuai granules’ impact. The results of this study showed that, in the doxorubicin-induced H9C2 cardiomyocyte injury model, the expression of miR-143 was upregulated, and the expression of LncRNA-MiR143HG and ERK5 was significantly downregulated. Wenyang Zhenshuai granules can downregulate the expression of miR-143 to promote ERK5 protein expression and phosphorylation. The process is regulated by LncRNA-MiR143HG/miR-143, which may be one of its important mechanisms for the treatment of chronic heart failure.

Download Full-text

Clinical Effects of Jiawei Danggui Beimu Kushen Pills in the Treatment of Prostate Cancer and Their Influence on the Expression of Serum Prostate Specific Antigen

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/1036068 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Haiyang Zhao ◽

Zhiqiang Ren ◽

Guangwen Wang

Keyword(s):

Quality Of Life ◽

Prostate Cancer ◽

Survival Rate ◽

Cumulative Survival Rate ◽

Control Group ◽

Observation Group ◽

Cumulative Survival ◽

The Difference ◽

Tcm Syndrome

Objective. To observe the clinical effects of Jiawei Danggui Beimu Kushen pills in treating prostate cancer and their influence on the expression of serum prostate specific antigen. Methods. A total of 234 prostate cancer patients were selected and randomly divided into observation group and control group, with 117 cases in each group. The control group was given oral bicalutamide tablets, while the observation group was treated with Jiawei Danggui Beimu Kushen pills on the basis of the control group. The treatment efficacy, IPSS score, TCM syndrome score, VAS score, quality-of-life score, and immune function of the two groups were compared before and after treatment. The serum PSA and f-PSA levels of patients before treatment and after 30 days, 90 days, and 180 days of treatment in the two groups were compared. The five-year cumulative survival rate and the incidence of adverse reactions were compared between the two groups. Results. After treatment, the total effective rate of the observation group was 88.03% (103/117), which was higher than that of the control group 69.23% (81/117); the difference was statistically significant ( P < 0.05 ). After treatment, the IPSS score, TCM syndrome score, and VAS score of the two groups were reduced, and those in the observation group were lower than those in the control group; the difference was statistically significant ( P < 0.05 ). After treatment, the quality-of-life scores of the two groups increased, and the observation group was higher than the control group; the difference was statistically significant ( P < 0.05 ). Before treatment, there was no significant difference in serum PSA levels and f-PSA levels when comparing between the two groups of patients ( P > 0.05 ). With the increase of treatment time, the two index levels of the two groups were gradually decreased. After 180 days of treatment, the two index levels of the two groups of patients were significantly lower than those before treatment, and the two index levels of the observation group were significantly lower than those of the control group; the difference was statistically significant ( P < 0.05 ). After treatment, the levels of IgM and IgA in the two groups were decreased, and the level of IgG was increased. The difference between the two groups in the levels of each index before and after treatment was statistically significant ( P < 0.05 ), and the difference between the two groups in the levels of each index after treatment was also statistically significant ( P < 0.05 ). The five-year cumulative survival rate of the observation group was 69.23%, and the five-year cumulative survival rate of the control group was 46.15% ( P < 0.05 ). There was no statistically significant difference between the two groups in the incidence of dizziness, fatigue, and gastrointestinal reactions ( P > 0.05 ), but the difference in the incidence of dysuria as well as dysuria and hematuria was statistically significant ( P < 0.05 ). Conclusion. Jiawei Danggui Beimu Kushen pills are effective in treating prostate cancer, which can effectively reduce the patients’ IPSS score and TCM syndrome scores, relieve the pain, and improve the quality of life of patients. They also have a potential role in regulating serum PSA levels, clearing tumor lesions, reducing postoperative complications, and improving related symptoms.

Download Full-text

Prognostic role of metabolic risk factors (hyperhomocysteinemia) in the development of chronic heart failure

Patologiya krovoobrashcheniya i kardiokhirurgiya ◽

10.21688/1681-3472-2014-1-20-25 ◽

2015 ◽

Vol 18 (1) ◽

pp. 20

Author(s):

Ye. N. Berezikova ◽

M. G. Pustovetova ◽

S. N. Shilov ◽

A. V. Yefremov ◽

A. T. Teplyakov ◽

...

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Blood Serum ◽

Homocysteine Level ◽

Functional Class ◽

Enzyme Linked Immunosorbent Assay ◽

Control Group ◽

Relationship Of ◽

The Relationship

The aim of the study was to assess the relationship of homocysteine levels in the blood serum with the severity and nature of chronic heart failure (CHF) in patients with coronary heart disease. 94 patients with CHF were examined. The control group included 32 patients without cardiovascular disorders. At baseline and after 12 months of observation the homocysteine levels in the blood serum were determined by enzyme-linked immunosorbent assay. Correlative relationship of hyperhomocysteinemia with ischemic myocardial remodeling and with reduced inotropic function in CHF patients was observed. The homocysteine level in the blood serum of CHF patients significantly exceeded that of the control group and moderately increased with the progression of the disease severity of functional class. In the group with an unfavorable course of CHF the baseline homocysteine level proved to have the greatest value as compared to that in the group with a favorable course. In patients with a favorable course of CHF the homocysteinemia level tended to decrease towards the end of prospective study, whereas in patients with an unfavorable course, on the contrary, hyperhomocysteinemia persisted (p<0.01). In case the hyperhomocysteinemia baseline exceeds 18.5 mkmol/L (ROC-AreaSE = 0.860.04, sensitivity 71 %, specificity 90%), the severity and characteristics of the ischemic CHF could be most likely predicted. Thus, hyperhomocysteinemia is related with the severity and nature of CHF. Determining the level of homocysteine in the blood serum can be recommended for early prediction of the severity and nature of CHF.

Download Full-text

Expression of B Cell Translocation Gene 1 Protein in Colon Carcinoma and its Clinical Significance

Recent Patents on Anti-Cancer Drug Discovery ◽

10.2174/1574892815666200109113114 ◽

2020 ◽

Vol 15 (1) ◽

pp. 78-85 ◽

Cited By ~ 3

Author(s):

Junhe Zhang ◽

Weihua Dong

Keyword(s):

Colon Cancer ◽

Survival Rate ◽

B Cell ◽

Lymphatic Metastasis ◽

Clinicopathological Features ◽

Cumulative Survival Rate ◽

Control Group ◽

Observation Group ◽

Cox Regression Analysis ◽

Cumulative Survival

Background: Colon cancer is one of the most common malignant tumors, and B cell Translocation Gene (BTG)1 is involved in the occurrence and development of colon cancer, however, the underlying molecular mechanism remains unclear. Objective: In this study, we investigated the expression of BTG1 protein in colon cancer, and its association with clinicopathology and prognosis. Methods: The tumor specimens from 59 patients with colon cancer who had undergone radical colectomy were selected as the observation group. Para-carcinoma tissues from the same patients were selected as the control group. The expressions of BTG1 mRNA and protein in the specimen of two groups were analyzed by quantitative Real-Time Polymerase Chain Reaction (qRT-PCR) and Western blot. According to the immunohistochemical results, the patients were divided into BTG1-negative and BTG1-positive groups. The postoperative cumulative survival rate in the two groups was analyzed. The association of the expression of BTG1 protein with the clinicopathological features and postoperative survival was investigated. Results: Compared with the control group, the expression levels of BTG1 mRNA and BTG1 protein were significantly decreased in the observation group (P < 0.05). Immunohistochemical analysis revealed that there were 12 positive tumor samples and 47 negative samples. The expression of BTG1 was negatively associated with the degree of differentiation and lymphatic metastasis. The cumulative survival rate of BTG1-positive patients was significantly increased compared with that of BTG1- negative patients (P < 0.05). Stepwise Cox regression analysis showed that lymphatic metastasis, tumor size and BTG1 expression level were independent prognostic factors for overall survival in patients with colon cancer. Conclusion: BTG1 protein in colon cancer tissues were expressed at low levels, which was associated with the clinicopathological features, postoperative recurrence and survival of patients.

Download Full-text

Role of soluble Fas ligand in myocardial remodeling, severity and outcomes of chronic heart failure

Terapevticheskii arkhiv ◽

10.17116/terarkh201688910-16 ◽

2016 ◽

Vol 88 (9) ◽

pp. 10-16 ◽

Cited By ~ 1

Author(s):

A T Teplyakov ◽

E N Berezikova ◽

S N Shilov ◽

E V Grakova ◽

Yu Yu Torim ◽

...

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Fas Ligand ◽

Functional Class ◽

Control Group ◽

Myocardial Remodeling ◽

Soluble Fas ◽

Soluble Fas Ligand

Aim. To reveal the specific features of Fas ligand-mediated ischemic myocardial remodeling and those of chronic heart failure (CHF) development during a 12-month prospective follow-up. Subjects and methods. A total of 94 patients with ischemic CHF were examined and divided into 3 groups according to NYHA Functional Class (FC): 1) FC II CHF in 35 patients; 2) FC III CHF in 31; 3) FC IV CHF in 28. According to the results of the 12-month follow-up, the patients were randomized into 2 groups: A) 49 patients with a favorable course of cardiovascular disease and B) 45 patients with its poor course. Serum soluble Fas ligand (sFas-L) levels were measured by enzyme immunoassay. Results. In the patients with CHF, the baseline sFas-L levels substantially exceeded that in the control group by 3—6 times (p

Download Full-text

Assessment of clinical status and characteristics of patients with chronic heart failure and concomitant chronic obstructive pulmonary disease

Clinical Medicine (Russian Journal) ◽

10.18821/0023-2149-2017-95-6-558-562 ◽

2017 ◽

Vol 95 (6) ◽

pp. 558-562

Author(s):

N. T. Vatutin ◽

Anna S. Smyrnova ◽

E. S. Gasendich

Keyword(s):

Heart Failure ◽

Chronic Obstructive Pulmonary Disease ◽

Chronic Heart Failure ◽

Pulmonary Disease ◽

Clinical Status ◽

Functional Class ◽

Control Group ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Β Blockers

Pathology of cardiovascular and respiratory systems still dominants in the structure of morbidity and mortality of the population. Comorbidity of these conditions is characterized by the phenomenon of mutual complications and a significantly worsened prognosis in these patients. Purpose of study. Evaluation of the clinical status and the efficiency of treatment of patients with chronic heart failure (CHF) and concomitant chronic obstructive pulmonary disease (COPD). Material and methods. The study included 102 patients (58 men and 44 women, mean age 65.7 ± 4.5 years). Based on the results of spirometry, the patients were divided into 2 groups: the main group included 54 patients suffering from CHF in conjunction with COPD, the control group included 48 patients with CHF without bronchopulmonary pathology. All patients underwent the Six Minute Walk Test (SMWT); severity of dyspnea was measured by the Borg scale. Results. Patients with comorbid disorders had a higher functional class (FC) of CHF and a more pronounced decrease in exercise tolerance accompanied by a greater degree of dyspnea. They more frequently used diuretics and less frequently β-blockers. Conclusion. The combination of CHF and COPD is associated with a higher CHF FC which negatively affects the clinical status of patients and is accompanied by more frequent use of diuretics and rare intake of β-blockers.

Download Full-text

Modern approaches to evaluating the effectiveness of treatment of chronic heart failure

Vestnik of Russian military medical Academy ◽

10.17816/brmma20693 ◽

2019 ◽

Vol 21 (3) ◽

pp. 67-68

Author(s):

N P Potekhin ◽

A N Fursov ◽

S P Kazakov ◽

S B Putkov ◽

O R Pestovskaya ◽

...

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Clinical Status ◽

Functional Class ◽

New Combination ◽

Control Group ◽

Study Group ◽

Combination Drug ◽

Nyha Functional Class

The efficacy of therapy for patients with chronic heart failure, a new combination drug valsartan/sacubitrile according to the levels of biomarkers ST2 and NT-proBNP was evaluated. In all patients of the study group, valsartan/sacubitrile therapy improved the NYHA functional class, in the control group - only in 75%. The dynamics of indicators of biomarkers ST2 and NT-proBNP coincided with the improvement of the clinical status of patients against the background of therapy, and to a greater extent this trend reflects the indicator NT-proBNP.

Download Full-text