Philip A Poole-Wilson

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

..These data indicate that cardiovascular benefit may be obtained from switching patients from metoprolol tartrate to carvedilol...

..Current recommendations can be confusing and often do not reflect the complexities of modern personalized medicine...

..These are small but important advances that increase our knowledge of the pathophysiology of acute heart failure, and also provide an indication of which drugs are preferable for the treatment of this distressing condition...

..Most trials have included patients 10 years younger than those in the general population. There is little evidence for efficacy in patients with a near normal ejection fraction. Few women have been included in trials...

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..To determine whether, in acute non-ST elevation coronary syndrome, the benefit from early invasive coronary intervention compared with a conservative strategy of later symptom-guided intervention varies over time...

..Too many vested interests obstruct progress in the prevention of cardiovascular disease...

..We aimed to investigate the effect of the calcium antagonist nifedipine on long-term outcome in patients with stable angina pectoris...

..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...

..Congenital heart disease in adults may be amenable to novel anti-inflammatory therapies in selected patients...

..This study sought to assess the cardiac dimensions, mass, and function and changes in these parameters over time in patients with chronic heart failure with and without cachexia...

..Increased V(E)/V(CO2) slope is the strongest exercise predictor of death in noncyanotic ACHD patients...

..To describe the clinical characteristics of patients with stable angina pectoris who develop heart failure and the events preceding its onset...

..2 g/dL, P<0.0001), with no difference between captopril and losartan groups (P>0.3). CONCLUSION: Haemoglobin is an independent predictor of mortality in CHF patients, with anaemic and polycythaemic patients having the worst survival...

..Production of IL-1RA is not affected. This resembles a picture indicative of LPS desensitization occurring in patients with severe CHF...

..The adverse effects of anaemia on survival might be a consequence of chronic heart failure rather than a separate process causing disease progression...

..To assess the relation of anemia in noncyanotic adults with congenital heart disease (ACHD) to functional capacity and mortality...

..Published clinical trial data rarely allow assessment of the health care resource utilization implications of treatment. We give an example of how these can be assessed given appropriate tabulation of data...

..This study demonstrated that noradrenaline and isoproterenol inhibit TNF-alpha production in patients with CHF in ex vivo whole blood in a dose-dependent fashion. The beta-blocker bisoprolol abolishes this effect...

..Heart rate reserve is a simple and inexpensive way to identify ACHD patients at higher mortality risk...

..8%) on nebivolol and 192 (18.1%) on placebo (HR 0.88, 95% CI 0.71-1.08; P=0.21). CONCLUSION: Nebivolol, a beta-blocker with vasodilating properties, is an effective and well-tolerated treatment for heart failure in the elderly...

..We hypothesized that ASV would be effective at reducing sleep apnea and improving both cardiac status and quality of life...

..The cortisol/DHEA ratio was independently and inversely associated with hemoglobin concentrations, suggesting that alterations of the steroid milieu may play a role in the pathogenesis of anemia in CHF...

..We tested the hypothesis that intravenous iron improves exercise tolerance in anemic and nonanemic patients with symptomatic chronic heart failure (CHF) and iron deficiency...

..In conclusion, increased QT dispersion is not associated with increased mortality in patients with heart failure, and is not suitable to examine drug efficacy in these patients...

..53/100 patient years for patients assigned nifedipine and 2.37/100 patient years for patients assigned placebo (HR 1.06, 95% CI 0.93-1.22). CONCLUSION: Overall nifedipine GITS was well tolerated by patients with stable symptomatic angina...

..To describe the clinical course of patients with stable angina due to coronary heart disease without a history of cardiovascular (CV) events or revascularization (isolated angina)...

..The aim of this study was to comprehensively delineate iron metabolism and its implications in patients with chronic heart failure (CHF)...

..Poor exercise capacity identifies ACHD patients at risk for hospitalization or death...

..We studied the prevalence of hyponatraemia and its prognostic implications in a large population of adult patients with congenital heart disease (ACHD)...

..CONCLUSIONS: Serum lipoproteins may play an important role in regulating LPS bioactivity in CHF. Very low LPS activity, at levels seen in vivo in CHF, can induce significant TNF-alpha production ex vivo...

..Innate immune activation mediated by myocardial Toll-like receptors (TLRs) is involved in cardiovascular disease. The function and role of TLRs on peripheral leukocytes in human chronic heart failure (CHF) are not known...

..5 and 15.7+/-6.0 pg/ml (P=0.01). In conclusion, CNP is synthesized and secreted into the circulation by the normal human kidney, where it may have paracrine actions. Net renal secretion of CNP appears to be blunted in patients with CHF...

..In addition, midwall fibrosis by CMR predicts SCD/VT. This suggests a potential role for CMR in the risk stratification of patients with DCM, which may have value in determining the need for device therapy...

..This leads to reduced scar formation, repressed myocardial apoptosis, and improved cardiac outcome...

..If further studies provide more support for the idea that ACE inhibitors prevent ischemic episodes and delay the onset of heart failure, then a new indication for ACE inhibitors will be the prevention of heart failure...

..Indeed, the very mechanism of benefit from resynchronization is controversial. Resynchronization may work by improving ventricular filling: we tested the hypothesis that benefit from resynchronization depends on filling pattern...

..Second, little of this increment in CO is achieved by AV delay shortening alone. Third, under native activation, long t-IVT during peak stress is the single best predictor of resynchronization-mediated increment in peak stress CO...

..We aimed to assess the frequency of weight loss in patients with this disease, whether the degree of weight loss predicts mortality, and whether weight loss can be prevented by angiotensin-converting-enzyme (ACE) inhibitors...

..Treatment with statins may lead to a lower mortality in CHF, independent of cholesterol levels, CHF etiology and clinical status...

..This effect is greatest at the apical myocardium, in which the beta-adrenoceptor density is greatest. Our hypothesis has implications for the use of drugs or devices in the treatment of patients with stress cardiomyopathy...

..We tested the hypothesis that this might be due to Epo resistance and investigated whether any defects apparent were due to Epo receptor (EpoR) downregulation and/or impaired Epo-induced signal transduction...

..90, inferior 0.77). CONCLUSIONS: The QW/NQW distinction is useful, but it is determined by the total size rather than transmural extent of underlying MI...

..A critical question is whether SERCA2a gene therapy predisposes to increased sarcoplasmic reticulum calcium (SR Ca(2+)) leak, cellular triggered activity, and ventricular arrhythmias in the failing heart...

..Currently there is good evidence for treatment of obstructive sleep apnea (OSA) in CHF with continuous positive airway pressure; however, for central sleep apnea (CSA) the treatment is less clear...

..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...

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

..We aimed to assess tolerability and dose-related effects of the beta-blocker nebivolol in elderly patients from the SENIORS trial...

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

..Prediction of mode of death may facilitate decisions about specific medications or devices...

..Little data is available concerning the prognostic implications of renal function abnormalities, their evolution over time and the effects of nifedipine on such abnormalities in patients with stable angina pectoris...

..After extensive laboratory testing, we began clinical trials with an axial flow pump for long-term treatment of New York Heart Association class IV, transplant-ineligible patients...

..Whether blood pressure (BP) reduction is a necessary prerequisite for cardiovascular risk reduction or an epiphenomenon has not been definitively established. We used an innovative analytic method to address this question...

..To evaluate the relationship between echocardiographic cardiac function and outcome in patients with stable symptomatic angina...

..Evaluate the prevalence, incidence and impact on prognosis of existing and new onset atrial fibrillation (AF) in patients with stable, symptomatic coronary artery disease...

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..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...

..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...

..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)...

..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...

..An echocardiographic substudy was designed to evaluate the effects of nebivolol on systolic and diastolic left ventricular (LV) function in patients stratified according to the presence or absence of systolic LV dysfunction...

..CONCLUSION: This risk score is an objective aid in deciding on further management of patients with stable angina with the aim of reducing serious outcome events. The score can also be used in planning future trials...

..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...

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..HF is common in the general population, increases sharply with age, and has a poor prognosis...

..We compared effects of losartan to captopril on mortality, morbidity, and functional status for patients in the ELITE II study...

..The objective of this study was to determine the safety and efficacy of renin-angiotensin system (RAS) inhibitors and beta-blockers in chronic Chagas cardiomyopathy...

..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 sought to investigate whether darbepoetin alfa, an erythropoiesis-stimulating protein (ESP), improves exercise capacity in patients with symptomatic chronic heart failure (CHF) and anemia...

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

..03). CONCLUSION: Adjustment for lean tissue instead for body weight increases the prognostic power of pVO2, particularly in patients with mild heart failure...

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..To examine the effects of nifedipine GITS on clinical outcome in patients with concurrent stable angina and hypertension...

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