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Drug therapy for heart failure in older patients —what do they want？

Journal of Geriatric Cardiology 2015年第2期12卷 165-173页

作者： Donah Zachariah jacqueline taylor Nigel Rowell Clare Spooner Paul R Kalra Portsmouth Hospitals NHS Trust Portsmouth P06 3L Y UK Glasgow Royal Infirmary Glasgow G40SF UK South Tees Hospitals NHS Foundation Trust TS4 3BW UK Servier Laboratories Ltd SL3 6P J UK

Chronic heart failure （CHF） is predominantly seen in older patients, and therefore real life medicine often requires the extrapolation of findings from trials conducted in much younger populations. Prescribing patterns and potential benefits in the elderly are heavily influenced by polypharmacy and co-morbid pathologies. Increasing longevity may become less relevant in the frail elderly, whereas improving quality of life （QoL） often becomes priority; the onus being on improving wellbeing, maintaining independence for longer, and delaying institution- alisation. Specific studies evaluating elderly patients with CHF are lacking and little is known regarding the tolerability and side-effect profile of evidence based drug therapies in this population. There has been recent interest on the impact of heart rate in patients with symptomatic CHF. Ivabradine, with selective heart rate lowering capabilities, is of benefit in patients with CHF and left ventricular systolic dysfunction in sinus rhythm, resulting in reduction of heart failure hospitalisation and cardiovascular death. This manuscript will focus on CHF and the older patient and will discuss the impact of heart rate, drug therapies and tolerability. It will also highlight the tmmet need for specific studies that focus on patient-centred study end points rather than mortality targets that characterise most therapeutic trials. An on-going study evalu- ating the impact of ivabradine on QoL that presents a unique opportunity to evaluate the tolerability and impact of an established therapy on a wide range of real life, older patients with CHF will be discussed.

关键词： Heart failure Heart rate Quality of life The elderly

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Genome and clonal hematopoiesis stability contrasts with immune,cfDNA,mitochondrial,and telomere length changes during short duration spaceflight

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Precision Clinical Medicine 2024年第1期7卷 1-13页

作者： J.Sebastian Garcia-Medina Karolina Sienkiewicz S.Anand Narayanan Eliah G.Overbey Kirill Grigorev Krista A.Ryon Marissa Burke jacqueline Proszynski Braden Tierney Caleb M.Schmidt Nuria Mencia-Trinchant Remi Klotz Veronica Ortiz Jonathan Foox Christopher Chin Deena Najjar Irina Matei Irenaeus Chan Carlos Cruchaga Ashley Kleinman JangKeun Kim Alexander Lucaci Conor Loy Omary Mzava Iwijn De Vlaminck Anvita Singaraju Lynn E.taylor Julian C.Schmidt Michael A.Schmidt Kelly Blease Juan Moreno Andrew Boddicker Junhua Zhao Bryan Lajoie Andrew Altomare Semyon Kruglyak Shawn Levy Min Yu Duane C.Hassane Susan M.Bailey Kelly Bolton Jaime Mateus Christopher E.Mason Department of Physiology and Biophysics Weill Cornell MedicineCornell UniversityNew YorkNY 10021USA The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine Weill Cornell MedicineNew YorkNY 10021USA Department of Immunology Weill Cornell MedicineCornell UniversityNew YorkNY 10021USA Department of Stem Cell Biology and Regenerative Medicine Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCA 90033USA Space Exploration Technologies Corporation HawthomeCA 90250USA Sovaris Aerospace BoulderCO 80302USA Advanced Pattern Analysis&Human Performance Group BoulderCO 80302USA Children's Cancer and Blood Foundation Laboratories Departments of Pediatrics and Cell and Developmental BiologyDrukier Institute for Children's HealthMeyer Cancer CenterWeill Cornell MedicineNew YorkNY 10021USA Meyer Cancer Center Weill Cornell MedicineNew YorkNY 10065USA Department of Nutrition and Integrative Physiology Florida State UniversityTallahasseeFL 32306USA Department of Systems Engineering Colorado State UniversityFort CollinsCO 80523USA Element Biosciences San DiegoCA 10055USA Department of Environmental and Radiological Health Sciences Colorado State UniversityFort CollinsCO 80523USA Cell and Molecular Biology Program Colorado State UniversityFort CollinsCO 80523USA BioAstra Inc New YorkNYUSA Washington University St Louis Oncology Division St.LouisMO 63100USA Meinig School of Biomedical Engineering Cornell UniversityIthacaNY 14853USA The Feil Family Brain and Mind Research Institute Weill Cornell MedicineNY 10021USA WorldQuant Initiative for Quantitative Prediction Weill Cornell MedicineNew YorkNY 10021USA

Background The Inspiration4(I4)mission,the first all-civilian orbital flight mission,investigated the physiological effects of short-duration spaceflight through a multi-omic *** advances,there remains much to learn about human adaptation to spaceflight's unique challenges,including microgravity,immune system perturbations,and radiation *** To provide a detailed genetics analysis of the mission,we collected dried blood spots pre-,during,and post-flight for DNA *** length was measured by quantitative PCR,while whole genome and cfDNA sequencing provided insight into genomic stability and immune adaptations.A robust bioinformatic pipeline was used for data analysis,including variant calling to assess mutational *** Telomere elongation occurred during spaceflight and shortened after return to ***-free DNA analysis revealed increased immune cell signatures *** significant clonal hematopoiesis of indeterminate potential(CHIP)or whole-genome instability was *** long-term gene expression changes across immune cells suggested cellular adaptations to the space environment persisting months *** Our findings provide valuable insights into the physiological consequences of short-duration spaceflight,with telomere dynamics and immune cell gene expression adapting to spaceflight and persisting after return to *** sequencing data will serve as a reference point for studying the early development of CHIP in astronauts,an understudied phenomenon as previous studies have focused on career *** study will serve as a reference point for future commercial and non-commercial spaceflight,low Earth orbit(LEO)missions,and deep-space exploration.

关键词： genomes clonal hematopoiesis stability immune mitochondria ribosomes spaceflight

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Risk factors for clinical coronary events in patients with SLE:a multicentre case-control study

Risk factors for clinical coronary events in patients with S...

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The 8th International Congress on SLE

作者： Sahena Haque Donna taylor-Fesler Caroline Gordon Veronica Toescu David Isenberg Anisur Rahman Aubrey Bell Peter Lanyon Neil McHugh David GI Scott Paul Emery Lee Suan Teh jacqueline Andrews Hazem Youssef Bridget Griffiths John McLaren Ian Bruce The University of Manchester Oxford RoadManchesterMI3 910 The University of Manchester Oxford RoadManchesterMI3 910 British Isles Lupus Assessment Group BSR Lupus Special Interest Group BSR Lupus Special Interest Group British Isles Lupus Assessment Group BSR Lupus Special Interest Group British Isles Lupus Assessment Group BSR Lupus Special Interest Group BSR Lupus Special Interest Group BSR Lupus Special Interest Group British Isles Lupus Assessment Group BSR Lupus Special Interest Group BSR Lupus Special Interest Group British Isles Lupus Assessment Group BSR Lupus Special Interest Group British Isles Lupus Assessment Group BSR Lupus Special Interest Group BSR Lupus Special Interest Group BSR Lupus Special Interest Group BSR Lupus Special Interest Group BSR Lupus Special Interest Group The University of Manchester Oxford RoadManchesterM139HJ British Isles Lupus Assessment Group BSR Lupus Special Interest Group

＜正＞Purpose:To identify risk factors（RF）for clinical coronary heart disease（CHD）in SLE and to study the role of traditional RF,SLE disease distribution,serology and therapy. Methods:This was a multicentre case,control *** recruited 48 SLE patients with verified clinical CHD （myocardial infarction or angina pectoris）and 78 SLE

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