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Management of Heart Failure with Reduced Ejection Fraction Globally and in Lebanon: Where Do SGLT-2is Stand?

World Journal of Cardiovascular Diseases 2023年第3期13卷 138-169页

作者： Hadi Skouri tony abdel massih Saiid Chaaban Elie Chammas Malek Mohamad Samer Nasr Fadi Turquieh Cardiology Division Department of Internal Medicine American University of Beirut Medical Center Beirut Lebanon Department of Cardiology Hôtel-Dieu de France University Medical Center Beirut Lebanon Cardiology Division Department of Internal Medicine Hammoud Hospital University Medical Center Sidon Lebanon Heart Center Clemenceau Medical Center Beirut Lebanon Department of Cardiology Sahel General Hospital Beirut Lebanon Department of Cardiology Mount Lebanon Hospital University Medical Center Hazmieh Lebanon Department of Cardiology Haykel Hospital El Koura Lebanon

Heart failure (HF) is a clinical syndrome due to structural and/or functional cardiac anomalies, accompanied by elevated natriuretic peptide levels and/or cardiogenic pulmonary or systemic congestion;severely compromising patients’ health, performance and quality of life. The advancement of novel treatment and their endorsement by international medical and scientific societies have shifted the treatment of HF with reduced ejection fraction (HFrEF) towards quadruple therapy: an angiotensin receptor-neprilysin inhibitor or an angiotensin-converting enzyme inhibitor, a beta-blocker, a mineralocorticoid receptor antagonist and a sodium/glucose co-transporter-2 inhibitor (SGLT2i). This paper reviews the available literature on state-of-the-art diagnostic and therapeutic advances in HFrEF, discusses landmark trials that shifted the paradigm towards quadruple therapy in HFrEF, visits the potential challenges in Lebanon and globally, proposes an algorithm for treatment introduction and sequencing in HFrEF and highlights clinical considerations for HFrEF management and patient education and follow-up. This practical guidance could serve cardiologists and other medical specialists in identifying clinical signs of HFrEF, diagnosing patients, referring them or prescribing the components of quadruple therapy, and offering medical advice and follow-up. We highlight the role of SGLT2is in HF management and their effectiveness in reducing rates of hospitalization for HF as well as cardiovascular deaths, with satisfactory safety profile.

关键词： Heart Failure HFrEF Management SGLT2i Clinical Guidance Quadruple Therapy

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The Lebanese Society of Cardiology Consensus Statement on the Use of Natriuretic Peptides for the Management of Heart Failure

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World Journal of Cardiovascular Diseases 2023年第6期13卷 297-308页

作者： tony abdel massih Hadi Skouri Antoine Sarkis Malek Mohammad Abbas Alaaeddine Jean Paul Sahakian James Januzzi Division of Cardiology Hotel Dieu de France Hospital and the St Joseph University Faculty of Medicine Beirut Lebanon Division of Cardiology American University Hospital and American University of Beirut Beirut Lebanon Department of Cardiology Bahman Hospital Beirut Lebanon Department of Cardiology Hammoud Hospital Saida Lebanon Massachusetts General Hospital Harvard Medical School and Baim Institute for Clinical Research Boston MA USA

Plasma concentration of Natriuretic Peptide (NP) is a valuable diagnostic tool for heart failure (HF). It can help rule out or confirm a diagnosis of HF based on symptoms, but its use is not clearly defined. NPs should be used in conjunction with physical examination and other diagnostic tests. However, it is important to note that several conditions besides the diagnosis of HF may cause NPs levels to be elevated. Additionally, there are situations when NP concentrations may be below diagnostic thresholds in [1]. This consensus statement aims to provide a straightforward diagnostic flowchart for clinicians in both the emergency department and outpatient settings to aid in diagnosing both acute and chronic HF. The diagnosis of acute HF can be ruled out with a BNP level of 100 pg/mL or NTproBNP level of 300 pg/mL, regardless of the patient’s age. To identify HF, a 3-level cut-off point based on the patient’s age is recommended. Chronic heart failure can be ruled out with a BNP level of 35 pg/mL or NTproBNP level of 125 pg/mL, regardless of thepatient’s age [1].

关键词： Acute Heart Failure Chronic Heart Failure Natriuretic Peptides NT-proBNP BNP Algorithm

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A Novel Technique to Maintain Radial Arterial Catheter Position: The Arterial Catheter Stabilizer

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Open Journal of Anesthesiology 2016年第12期6卷 193-197页

作者： Amir abdel-Kader Nikhil Kaushal Ronak Shah Michal Gomulka tony Wang Steven Shulman Department of Anesthesiology Rutgers-New Jersey Medical School Newark USA Department of Anesthesiology Mt. Sinai School of Medicine New York USA Department of Anesthesiology New York University School of Medicine New York USA

Despite widespread use of arterial catheters, there is remarkably little described about their stabilization in the literature. A brief review of arterial catheterization techniques is included. The fixation techniques described in the literature and in commercial product information are essentially to tape or suture the arterial catheter flat against the skin. Often the wrist is immobilized in the dorsiflexed position to prevent kinking or dislodging of the catheter. We describe a simple device made from a gauze pad and tape to elevate and protect the arterial line while minimizing its kinking during wrist flexion.

关键词： Arterial Catheters Arterial Blood Pressure Radial Arterial Catheter Position

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Fungal diversity notes 111-252-taxonomic and phylogenetic contributions to fungal taxa

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Fungal Diversity 2015年第6期75卷 27-274页

作者： Hiran A.Ariyawansa Kevin D.Hyde Subashini C.Jayasiri Bart Buyck K.W.Thilini Chethana Dong Qin Dai Yu Cheng Dai Dinushani A.Daranagama Ruvishika S.Jayawardena Robert Lücking Masoomeh Ghobad-Nejhad Tuula Niskanen Kasun M.Thambugala Kerstin Voigt Rui Lin Zhao Guo-Jie Li Mingkwan Doilom Saranyaphat Boonmee Zhu L.Yang Qing Cai Yang-Yang Cui Ali H.Bahkali Jie Chen Bao Kai Cui Jia Jia Chen Monika C.Dayarathne Asha J.Dissanayake Anusha H.Ekanayaka Akira Hashimoto Sinang Hongsanan E.B.Gareth Jones Ellen Larsson Wen Jing Li Qi-Rui Li Jian Kui Liu Zong Long Luo Sajeewa S.N.Maharachchikumbura Ausana Mapook Eric H.C.McKenzie Chada Norphanphoun Sirinapa Konta Ka Lai Pang Rekhani H.Perera Rungtiwa Phookamsak Chayanard Phukhamsakda Umpava Pinruan Emile Randrianjohany Chonticha Singtripop Kazuaki Tanaka Cheng Ming Tian Saowaluck Tibpromma Mohamed A.abdel-Wahab Dhanushka N.Wanasinghe Nalin N.Wijayawardene Jin-Feng Zhang Huang Zhang Faten A.abdel-Aziz Mats Wedin Martin Westberg Joseph F.Ammirati Timur S.Bulgakov Diogo X.Lima tony M.Callaghan Philipp Callac Cheng-Hao Chang Luis F.Coca Manuela Dal-Forno Veronika Dollhofer Kateřina Fliegerová Katrin Greiner Gareth W.Griffith Hsiao-Man Ho Valerie Hofstetter Rajesh Jeewon Ji Chuan Kang Ting-Chi Wen Paul M.Kirk Ilkka Kytövuori James D.Lawrey Jia Xing Hong Li Zou Yi Liu Xing Zhong Liu Kare Liimatainen H.Thorsten Lumbsch Misato Matsumura Bibiana Moncada Salilaporn Nuankaew Sittiporn Parnmen AndréL.C.M.de Azevedo Santiago Sujinda Sommai Yu Song Carlos A.F.de Souza Cristina M.de Souza-Motta Hong Yan Su Satinee Suetrong Yong Wang Syuan-Fong Wei Ting Chi Wen Hai Sheng Yuan Li Wei Zhou Martina Réblová Jacques Fournier Erio Camporesi J.Jennifer Luangsa-ard Kanoksri Tasanathai Artit Khonsanit Donnaya Thanakitpipattana Sayanh Somrithipol Paul Diederich Ana M.Millanes Ralph S.Common Marc Stadler Ji Ye Yan XingHong Li Hye Won Lee Thi T.T.Nguyen Hyang Burm Lee Eliseo Battistin Orlando Marsico Alfredo Vizzini Jordi Vila Enrico Ercole Ursula Eberhardt Giampaolo Simonini Hua-An Wen Xin-Hua Chen Otto Mie Guizhou Key Laboratory of Agricultural Biotechnology Guizhou Academy of Agricultural SciencesGuiyang 550006GuizhouChina Key Laboratory for Plant Diversity and Biogeography of East Asia Kunming Institute of BotanyChinese Academy of ScienceKunming 650201YunnanChina Centre of Excellence in Fungal Research Mae Fah Luang UniversityChiang Rai 57100Thailan Département Systématique et Evolution CP 39ISYEBUMR 7205 CNRS MNHN UPMC EPHEMuséum National d’Histoire Naturelle12 Rue BuffonF-75005 ParisFrance Institute of Plant and Environment Protection Beijing Academy of Agriculture and Forestry SciencesNo.9 of Shu Guang Hua Yuan Zhong LuHaidian DistrictBeijing 10097China Microbial Drugs Helmholtz-Centre for Infection Research Inhoffenstrasse 738124 BraunschweigGermany Staatliches Museum für Naturkunde Stuttgart Rosenstein 1D-70191StuttgartGermany Institute of Microbiology Beijing Forestry UniversityPO Box 61Beijing 100083China State Key Laboratory of Mycology Institute of MicrobiologyChinese Academy of SciencesNo 31st West Beichen RoadChaoyang DistrictBeijing 100101China The Herbarium(ANDA) Universitas AndalasPadangSumatera Barat 25163Indonesia Botanischer Garten&Botanisches Museum Berlin Freie Universität BerlinKönigin-Luise-Straße 6-814195 BerlinGermany Department of Biotechnology Iranian Research Organization for Science and Technology(IROST)P.O.Box 3353-5111Tehran ***Iran Jodrell Laboratory Royal Botanic GardensKew TW93DSUK Leibniz Institute for Natural Product Research and Infection Biology Jena Microbial Resource CollectionAdolf-Reichwein-Strasse 2307745 JenaGermany Department of Botany and Microbiology College of ScienceKing Saud UniversityP.O.Box:2455Riyadh 1145Saudi Arabia The United Graduate School of Agricultural Sciences Iwate University18-8 Ueda 3 ChomeMorioka 020-8550Japan Faculty of Agriculture and Life Sciences Hirosaki University3 Bunkyo-choHirosakiAomori 036-8561Japan Department of Biological and Environmental Sciences University of GothenburgBox 461SE

This paper is a compilation of notes on 142 fungal taxa,including five new families,20 new genera,and 100 new species,representing a wide taxonomic and geographic *** new families,Ascocylindricaceae,Caryosporaceae and Wicklowiaceae(Ascomycota)are introduced based on their distinct lineages and unique *** new Dothideomycete genera Pseudomassariosphaeria(Amniculicolaceae),Heracleicola,Neodidymella and Pseudomicrosphaeriopsis(Didymellaceae),Pseudopithomyces(Didymosphaeriaceae),Brunneoclavispora,Neolophiostoma and Sulcosporium(Halotthiaceae),Lophiohelichrysum(Lophiostomataceae),Galliicola,Populocrescentia and Vagicola(Phaeosphaeriaceae),Ascocylindrica(Ascocylindricaceae),Elongatopedicellata(Roussoellaceae),Pseudoasteromassaria(Latoruaceae)and Pseudomonodictys(Macrodiplodiopsidaceae)are *** newly described species of Dothideomycetes(Ascomycota)are Pseudomassariosphaeria bromicola(Amniculicolaceae),Flammeascoma lignicola(Anteagloniaceae),Ascocylindrica marina(Ascocylindricaceae),Lembosia xyliae(Asterinaceae),Diplodia crataegicola and Diplodia galiicola(Botryosphaeriaceae),Caryospora aquatica(Caryosporaceae),Heracleicola premilcurensis and Neodidymella thailandicum(Didymellaceae),Pseudopithomyces palmicola(Didymosphaeriaceae),Floricola viticola(Floricolaceae),Brunneoclavispora bambusae,Neolophiostoma pigmentatum and Sulcosporium thailandica(Halotthiaceae),Pseudoasteromassaria fagi(Latoruaceae),Keissleriella dactylidicola(Lentitheciaceae),Lophiohelichrysum helichrysi(Lophiostomataceae),Aquasubmersa japonica(Lophiotremataceae),Pseudomonodictys tectonae(Macrodiplodiopsidaceae),Microthyrium buxicola and Tumidispora shoreae(Microthyriaceae),Alloleptosphaeria clematidis,Allophaeosphaeria cytisi,Allophaeosphaeria subcylindrospora,Dematiopleospora luzulae,Entodesmium artemisiae,Galiicola pseudophaeosphaeria,Loratospora luzulae,Nodulosphaeria senecionis,Ophiosphaerella aquaticus,Populocrescentia forlicesenensis and Vagicola vagans(Phaeosphaeriaceae),Elon

关键词： Fungi Taxonomy New genus New species Phylogeny

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