Marco Metra

..The aim of this study was to assess the effects of serelaxin on short-term changes in markers of organ damage and congestion and relate them to 180-day mortality in patients with acute heart failure...

..The prevention of renal dysfunction with new therapies might also improve outcomes although strong evidence is still lacking...

..With this aim, we assessed the clinical and prognostic significance of high serum cTnT levels at the time of admission and that of cTnT release in 198 consecutive patients admitted for AHF and with no signs of acute coronary syndrome...

..New biomarkers of glomerular and tubular function might allow an earlier and more accurate detection of worsening renal function...

..We hypothesized that these discrepancies may be caused by the interaction between WRF and congestion in AHF patients...

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..Ongoing, large-scale clinical testing will provide additional insights into the potential role of relaxin in the treatment of heart failure...

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..Beta-adrenergic receptors (AR) single nucleotide gene polymorphisms (SNPs) may influence the sensitivity and density of beta-AR. We assessed the relation between three common beta-AR SNPs and the response to carvedilol administration...

..Finally, the results of other trials of percutaneous patent foramen ovale closure and atrial fibrillation treatment in elderly patients are summarised...

..Different pathophysiologic mechanisms and clinical presentations may coexist in the same patient. Identification and, whenever possible, treatment of underlying pathophysiologic mechanisms may become important for acute HF management...

..Further data will become available with the SHIFT trial in which patients with heart failure and HR > or =70 b/min are included and reduction in cardiovascular mortality and heart failure hospitalizations is the primary endpoint...

..Although dyspnoea is the most common cause of admission for acute heart failure (AHF), more needs to be known about its clinical course and prognostic significance...

..We hypothesised that these polymorphisms could influence the prevalence of heart failure...

..These patients deserve effective therapeutic options and should be potential targets for future clinical research initiatives...

..Brain natriuretic peptide (BNP), NT-proBNP and troponins are useful for the assessment of patients with heart failure. Few data exist about their serial changes and their prognostic value in patients with acute heart failure (AHF)...

..We studied the relationship between changes in beta-blocker dose and outcome in patients surviving a HF hospitalisation in COMET...

..Renal function is a powerful prognostic variable in patients with heart failure (HF). Hospitalisations for acute HF (AHF) may be associated with further worsening of renal function (WRF)...

..Given the limitations of the currently available clinical trial data, we cannot recommend any specific agent as first line therapy, although nitrates in different formulations are still the most widely used in clinical practice...

..Identification and, whenever possible, treatment of underlying pathophyisiological mechanisms should be a primary objective of acute HF management...

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..However, also more effective and prolonged blockade of beta1 adrenergic receptors may occur with carvedilol compared to metoprolol...

..We have summarized the characteristics of the main inotropic agents for heart failure treatment, the data from randomized controlled trials, and future perspectives for this class of drugs...

..We compared the hemodynamic effects of dobutamine and enoximone administration before and after long-term beta-blocker therapy with metoprolol or carvedilol in patients with chronic heart failure (HF)...

..Further studies are, however, needed...

..Coronary angiography is also indicated in all the patients who are candidates to heart transplantation or whose symptoms are secondary to a mechanical complication of myocardial infarction...

..It is however, unclear whether these differences may also influence the patients' outcome...

..Better treatment of congestion in heart failure remains a major unmet need...

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..These characteristics might allow a haemodynamic improvement in the absence of untoward effects on the clinical course and prognosis of the patients...

..Dyspnoea is the most common symptom leading to hospitalization for acute heart failure (AHF). Its early and persistent relief is an important goal of therapy, but little is known about its course, determinants, and prognostic significance...

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..Prevention of heart failure has also become a major goal. We summarise here the major issues regarding the pharmacological treatment of chronic heart failure as indicated by the European and US guidelines...

..In this review we provide an updated summary of the epidemiological, pathophysiological and clinical characteristics of comorbidities as well as their potential impact for heart failure treatment...

..We compared the clinical characteristics and the prognosis of these patients with those of other patients...

..We therefore compared the polymorphisms of the beta1-adrenoceptor gene (Arg389Gly), the beta2-adrenoceptor gene (Arg16Gly, Gln27Glu) and their combinations in patients with HF and normal subjects living in the same area...

..metoprolol tartrate, a beta1-selective blocker, in patients with mild-to-severe chronic heart failure (CHF). Patients on treatment with metoprolol might benefit from switching to carvedilol...

..CONCLUSION: Concomitant diabetes does not influence the efficacy and tolerability of carvedilol administration in patients with chronic heart failure...

..Cardiopulmonary exercise testing parameters did not change. In conclusion, administration of spironolactone to patients with NYHA class I to II HF has beneficial effects on LV remodeling and diastolic function...

..In this review, we focus on the strategies to detect renal dysfunction in acute HF, the underlying pathophysiological mechanisms, and the potential treatments...

..Tezosentan, an intravenous endothelin receptor antagonist, improved hemodynamics in patients with AHF; however, its effects on morbidity and mortality have not been evaluated...

..We assessed the correlation with other clinical and echocardiographic measurements and the prognostic value of MPI in patients with HF...

..We have assessed changes in dyspnoea, their relationship with mortality, and the effects of the adenosine A1 receptor antagonist rolofylline on these endpoints in patients enrolled in the PROTECT trial...

..The aim of our study was to determine the prognostic factors for mortality in patients with type 2 diabetes (T2DM) and coronary artery disease (CAD) who underwent coronary angiography and percutaneous coronary intervention...

..We assessed the dose response of relaxin's effect on symptom relief, other clinical outcomes, and safety...

..Furthermore, fluctuations of CA125 serum levels over time may reflect changes induced by therapy. Therefore, measurements of CA 125 serum levels might be proposed for the serial assessment of CHF patients...

..New biomarkers of renal injury seem promising but still need to be validated. Thus, despite the epidemiological evidence, we are still lacking of satisfactory tools to assess renal injury and function and its prognostic significance...

..Hyponatremia is a well known predictor of short-term outcomes in heart failure (HF); however, its impact on long-term survival in HF patients with systolic dysfunction is not well established...

..This article will summarize evidence for the efficacy of bisoprolol in the treatment of HF...

..CA 125 could be used as an additional, noninvasive, easily determinable, and low-cost marker of the clinical condition of patients affected by heart failure...

..The role of antiplatelet agents, warfarin, and statins is clear in the prevention of the coronary artery disease. However, it has not been adequately assessed in patients with HF and awaits the results of ongoing trials...

..Thus, although the two beta-blockers have a similar antihypertensive action, nebivolol administration was associated with a greater hemodynamic improvement, compared to atenolol...

..We investigated whether off-pump coronary artery bypass (OPCAB) surgery should be the procedure of choice in total arterial myocardial revascularization with composite grafts...

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..Aortic valve calcification (AVC) and/or mitral annulus calcification (MAC) is considered to be a marker of atherosclerosis and has been demonstrated to predict cardiovascular morbidity and mortality...

..This case provides a rare example of BD, in which we found-at the same time-heart and pulmonary manifestations, with the presence of right ventricular thrombus and pulmonary thrombi in situ...

..Their effects in patients with heart failure caused by idiopathic dilated cardiomyopathy (IDC) are unknown...

..We report the case of a successful switch to sitaxsentan in a HIV-infected patient with PAH initially receiving bosentan who developed a late treatment-related side-effect...

..We assessed the hypothesis that full arterial revascularization (FAR) may improve clinical outcome even in elderly and at short term...

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..It appears likely, however, that mechanical circulatory supports will play a major role in the management of patients with advanced HF...

..Further studies are needed to determine optimal dosing and the relative ratio of DHA and EPA that provide maximal cardioprotection...

..This article will review clinical experience with ezetimibe/simvastatin combination, commenting upon its place and potential value in the prevention of cardiovascular disease...

..The EC system represents a new target for weight control and the improvement of lipid and glycemic metabolism (6, 7)...

..Dihydroergotoxine administration induced only a significant 9% decrease in mean arterial pressure (MAP), with a 13% reduction in SVR.(ABSTRACT TRUNCATED AT 250 WORDS)..

..If they are, the potential for even greater benefit with certain agents exists. It is hoped that these issues will be clarified by the results of ongoing multicenter trials...

..MIBG scanning has a very promising prognostic value in patients with heart failure...

..Ouabain has a less potent positive inotropic activity and a slight negative chronotropic action, whereas xamoterol inotropic effect is accompanied by an increase of heart rate.(ABSTRACT TRUNCATED AT 250 WORDS)..

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..The purpose of this report is to describe in greater detail the heterogeneity of this population at baseline with particular reference to the impact of symptomatic severity, age and gender on patient characteristics...

..Atrial fibrillation is common in patients with chronic heart failure (CHF). We analysed the risk associated with atrial fibrillation in a large cohort of patients with chronic heart failure all treated with a beta-blocker...

..Finally, the development of new multidisciplinary and effective models for the management of the ever-growing number of patients with heart failure is of utmost urgency...

..The target dose for carvedilol is 25 mg bid and for metoprolol tartrate 50 mg bid. This manuscript outlines the rationale, design and possible outcomes of COMET...

..We aimed to compare the effects of carvedilol and metoprolol on clinical outcome...

..We evaluated the potential advantages of the use of left internal thoracic artery-radial artery composite grafts compared with conventional coronary artery bypass grafts in elderly patients...

..Beta-blockers with different receptor bindings reduce mortality in patients with chronic heart failure. We compared the effects of the beta1-blocker metoprolol tartrate and the beta1-, beta2-, and alpha1-blocker carvedilol...

..Accordingly, symptoms need to be effectively evaluated not only because symptom alleviation is a target for treatment, but also because they guide prognosis in patients with CHF...

..In the COMET study, carvedilol improved survival compared to metoprolol tartrate in 3029 patients with NYHA II-IV heart failure and EF <35%, followed for an average of 58 months...

..Uncertainty persists about the safety and efficacy of amiodarone for the management of heart failure...

..Beta-blockers (BB) may influence these levels but it is unclear whether changes in NT-pro BNP reflect concomitant changes in prognosis...

..v.) inotropic support. Chronic parenteral inotropic therapy in UA-HF is costly and requires an indwelling catheter. An effective and safe oral inotrope would have value...

..We explored whether vascular protection by carvedilol could contribute to its superior effects in the treatment of heart failure (HF) compared with metoprolol tartrate in the COMET (Carvedilol Or Metoprolol European Trial) study...

..This study was designed to investigate the loss of well-being, in terms of life-years, overall and in patients randomized to metoprolol versus carvedilol in the Carvedilol Or Metoprolol European Trial (COMET)...

..To investigate the effects of cardiac resynchronization therapy (CRT) on survival in heart failure (HF) patients with permanent atrial fibrillation (AF) and the role of atrio-ventricular junction (AVJ) ablation in these patients...

..Anaemia is a common comorbidity in chronic heart failure (CHF). The predictors of new onset anaemia (NOA) and its long-term prognostic value, particularly in patients treated with beta-blockers, are not known...

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..Beta blocker treatment may worsen glucose metabolism...

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