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Beta-blocker therapy in elderly patients with renal dysfunction and heart failure

Journal of Geriatric Cardiology 2021年第1期18卷 20-29页

作者： Juan martínez-Milla marcelino Cortés García Julia Anna Palfy Mikel Taibo Urquía marta López Castillo Ana Devesa Arbiol Ana Lucía Rivero Monteagudo maría luisa martín mariscal Inés Jiménez-Varas Sem Briongos Figuero Juan Antonio Franco-Pelaéz JoséTuñón Department of Cardiology Hospital Universitario Fundación Jiménez Díaz-Quirónsalud Centro nacional de Investigaciones Cardiovasculares MadridSpain Department of Cardiology Hospital Central de Asturias Department of Cardiology Hospital Universitario Ruber-Quirónsalud Department of Cardiology Hospital Universitario Infanta Leonor Department of Endocrinology Hospital Clínico San Carlos Universidad Autónoma de Madrid CIBERCV MadridSpain

OBJECTIVE To assess the role of beta-blockers(BB)in patients with chronic kidney disease(CKD)aged≥75 *** AnD RESULTS From January 2008 to July 2014,we included 390 consecutive patients≥75 years of age with ejection fraction≤35%and glomerular filtration rate(GFR)≤60 m L/min per 1.73 m^*** analyzed the relationship between treatment with BB and mortality or cardiovascular *** mean age of our population was 82.6±4.1 *** ejection fraction was 27.9%±6.5%.GFR was 60-45 m L/min per 1.73 m^2 in 50.3%of patients,45-30 m L/min per 1.73 m^2 in 37.4%,andn per 1.73 m^2 in 12.3%.At the conclusion of follow-up,67.4%of patients were receiving *** median follow-up was28.04(IR:19.41-36.67)*** the study period,211 patients(54.1%)died and 257(65.9%)had a major cardiovascular event(death or hospitalization for heart failure).BB use was significantly associated with a reduced risk of death(HR=0.51,95%CI:0.35-0.74;Pnts receiving BB consistently showed a reduced risk of death across the different stages of CKD:stage IIIa(GFR=30-45 m L/min per 1.73 m^2;HR=0.47,95%CI:0.26-0.86,Pn per 1.73 m^2;HR=0.55,95%CI:0.26-1.06,P=0.007),and stages IV and V(GFRn per 1.73 m~2;HR=0.29,95%CI:0.11-0.76;P=0.047).COnCLUSIOnS The use of BB in elderly patients with HFr EF and renal impairment was associated with a better *** of BB should be encouraged when possible.

关键词： CKD GFR Beta-blocker therapy in elderly patients with renal dysfunction and heart failure

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The Density and Momentum Distributions of 2-Dimensional Transonic Flow in an LP-Steam Turbine

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Energy and Power Engineering 2012年第5期4卷 365-371页

作者： Aldo Antonio Rueda martínez Fernando Rueda martínez Miguel Toledo Velázquez Florencio Sánchez Silva Ignacio Carvajal mariscal Juan Abugaber Francis Researching and Graduate Section Applied Hydraulics and Thermal Engineering Laboratory

Within turbine blade rows, particularly for cascades of high deflection angle, cross-channel gradients of steam properties may be appreciable. To determine the effects on spontaneous condensation of gradients of supersaturation normal to streamlines, the conservation equations can be incorporated in a two dimensional calculation procedure. With the help of program FORTRAn 90 a developed computational program of calculations is accomplished, whose results are communicated to the pressure and Mach number distribution, direction of flow and streamlines in the field and the drops distribution in the outlet of the stator blade mesh. The procedure contains a program section, which avoids difficulties in the strongly curved profile of the leading and trailing edge by a developed computational mesh construction.

关键词： Steam Turbines nucleation Two Phase Flow Erosion

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