Background and Methods Aldosterone is important in the pathophysiology of heart failure. In a double-blind study, we enrolled 1663 patients who had severe heart failure and a left ventricular ejection fraction of no more than 35 percent and who were being treated with an angiotensin-converting–enzyme inhibitor, a loop diuretic, and in most cases digoxin. A total of 822 patients were randomly assigned to receive 25 mg of spironolactone daily, and 841 to receive placebo. The primary end point was death from all causes. Results The trial was discontinued early, after a mean follow-up period of 24 months, because an interim analysis determined that spironolactone was efficacious. There were 386 deaths in the placebo group (46 percent) and 284 in the spironolactone group (35 percent; relative risk of death, 0.70; 95 percent confidence interval, 0.60 to 0.82; P<0.001). This 30 percent reduction in the risk of death among patients in the spironolactone group was attributed to a lower risk of both death from prog...

https://www.nejm.org/doi/pdf/10.1056/NEJM199909023411001

The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators.

Preamble and Transition to ACC/AHA Guidelines to Reduce Cardiovascular Risk S2

The goals of the …

/pdf/2013-acc-aha-guideline-on-the-treatment-of-blood-cholesterol-pvngcav7fq.pdf

2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines

ACC/AHA
: American College of Cardiology/American Heart Association
ACCF/AHA
: American College of Cardiology Foundation/American Heart Association
ACE
: angiotensin-converting enzyme
ACEI
: angiotensin-converting enzyme inhibitor
ACS
: acute coronary syndrome
AF
: atrial fibrillation

/pdf/2016-esc-guidelines-for-the-diagnosis-and-treatment-of-acute-53v7yllhiz.pdf

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins.

ALAT
: alanine aminotransferase
ASAT
: aspartate aminotransferase
APAH
: associated pulmonary arterial hypertension
BAS
: balloon atrial septostomy
BMPR2
: bone morphogenetic protein receptor 2
BNP
: brain natriuretic peptide
BPA
: balloon pulmonary angioplasty
BREATHE
: Bosentan

/pdf/2015-esc-ers-guidelines-for-the-diagnosis-and-treatment-of-y26yabnnom.pdf

2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT).

Simulation of a mechanical approach to treat aortic dissection

SUMMARY

1 The haemodynamic effects of prenalterol, a new sympathomimetic agent, have been studied in anaesthetized open-chest pigs with acute myocardial ischaemia provoked by left anterior descending coronary artery ligation A group of eight animals was infused with saline and served as control (C)



2 In both groups the ligation of the left anterior descending coronary artery determined a significant (P<005) reduction of aortic flow, maximum left ventricular (LV) dp/dt with no changes in heart rate



3 The infusion of a first dose of 30 mg/kg of prenalterol restored the depressed haemodynamics but increased significantly the heart rate in the prenalterol group while the saline infused group did not show any significant changes The haemodynamic effects of prenalterol were still evident 25 min after the infusion



4 The subsequent administration of a second dose of 60 mg/kg of prenalterol resulted in a further improvement of the aortic flow, LV dp/dt and heart rate which reached values higher than in the basal condition



5 The positive inotropic effect was not associated with changes in stroke volume, therefore the increase in aortic flow was essentially due to an increase of the heart rate



6 It is concluded that prenalterol is a powerful inotropic agent in acutely infarcted animals Its action on aortic flow appears to be related to an increase in heart rate in contrast to some previous observations

Haemodynamic effects of prenalterol in acute myocardial ischaemia in open chest pigs.

Stable and unstable angina pectoris.

Echocardiographic determination of left atrial volume

Purpose: The problem of false positives for ST-segment elevation myocardial infarction (FP-STEMI) is emerging as an unavoidable issue within primary coronary angioplasty (PCI) networks. It is unkno...

Abstract 16726: False Positive Coronary Angiography Activation in a Primary Coronary Angioplasty Network: Does Direct Ambulance-based Access Influence The Prevalence Rate?

Angelo Branzi

Papers

Simulation of a mechanical approach to treat aortic dissection

Haemodynamic effects of prenalterol in acute myocardial ischaemia in open chest pigs.

Stable and unstable angina pectoris.

Echocardiographic determination of left atrial volume

Abstract 16726: False Positive Coronary Angiography Activation in a Primary Coronary Angioplasty Network: Does Direct Ambulance-based Access Influence The Prevalence Rate?