Treatment of atrial fibrillation in patients with enhanced sympathetic tone by pulmonary vein isolation or pulmonary vein isolation and renal artery denervation:clinical background and study design

Background Hypertension is an important, modifiable risk factor for the development of atrial fibrillation (AF). Even after pulmonary vein isolation (PVI), 20-40% experience recurrent AF. Animal studies have shown that renal denervation (RDN) reduces AF inducibility. One clinical study with important limitations suggested that RDN additional to PVI could reduce recurrent AF. Objective The goal of this multicenter randomized controlled study is to investigate whether RDN added to PVI reduces AF recurrence. Methods The main end point is the time until first AF recurrence according to EHRA guidelines after a blanking period of 3 months. Assuming a 12-month accrual period and 12 months of follow-up, a power of 0.80, a two-sided alpha of 0.05 and an expected drop-out of 10% per group, 69 patients per group are required. We plan to randomize a total of 138 hypertensive patients with AF and signs of sympathetic overdrive in a 1:1 fashion. Patients should use at least two antihypertensive drugs. Sympathetic overdrive includes obesity, exercise-induced excessive blood pressure (BP) increase, significant white coat hypertension, hospital admission or fever induced AF, tachycardia induced AF and diabetes mellitus. The interventional group will undergo PVI + RDN and the control group will undergo PVI. Results Patients will have follow-up for 1 year, and continuous loop monitoring is advocated. Conclusion This randomized, controlled study will elucidate if RDN on top of PVI reduces AF recurrence

Osmium(II)–bis(dihydrogen) complexes containing caryl,CNHC–chelate ligands: Preparation, bonding situation, and acidity

The hexahydride complex OsH6(PiPr3)2 (1) reacts with the BF4-salts of 1-phenyl-3-methyl-1-H-benzimidazolium, 1-phenyl-3-methyl-1-H-5,6-dimethyl-benzimidazolium, and 1-phenyl-3-methyl-1-H-imidazolium to give the respective trihydride-osmium(IV) derivatives OsH3(κ2-Caryl,CNHC)(PiPr3)2 (2–4). The protonation of these compounds with HBF4·OEt2 produces the reduction of the metal center and the formation of the bis(dihydrogen)-osmium(II) complexes [Os(κ2-Caryl,CNHC)(η2-H2)2(PiPr3)2]BF4 (5–7). DFT calculations using AIM and NBO methods reveal that the Os–NHC bond of the Os-chelate link tolerates a significant π-backdonation from a doubly occupied dπ(Os) atomic orbital to the pz atomic orbital of the carbene carbon atom. The π-accepting capacity of the NHC unit of the Caryl,CNHC-chelate ligand, which is higher than those of the coordinated aryl group and phosphine ligands, enhances the electrophilicity of the metal center activating one of the coordinated hydrogen molecules of 5–7 toward the heterolysis. As a result, these compounds are strong Brønsted acids with pKawater values between 2.5 and 2.8. In acetonitrile the hydrogen molecules of 5 and 6 are displaced by the solvent, the resulting bis(solvento) compounds [Os(κ2-Caryl,CNHC)(CH3CN)2(PiPr3)2]BF4 (8, 9) react with acetylacetonate (acac) and cis-1,2-bis(diphenylsphosphino)ethylene (bdppe) to give Os(κ2-Caryl,CNHC)(acac)(bdppe) (10, 11) as a mixture of the two possible isomers, namely with P trans to the aryl group or to the NHC moiety.Financial support from the Spanish MINECO (Projects CTQ2011-23459 and CTQ2013-44303-P), the Red de Excelencia Consolider (CTQ2014-51912-REDC), the DGA (E35), the European Social Fund (FSE) and FEDER, and Universal Display Corporation is acknowledged. T.B. thanks the Spanish MINECO for funding through the Juan de la Cierva programme.Peer reviewe

Azole assisted C-H bond activation promoted by an osmium-polyhydride: Discerning between N and NH

This is an open access article published under a Creative Commons Attribution (CC-BY) License.The capacity of the hexahydride complex OsH6(PiPr3)2 (1) to discern between the nitrogen atom and the NH unit in the azole assisted aryl C−H bond activation has been investigated. Complex 1 reacts with 2-phenylimidazole to give OsH3{κ2-C,N-(C6H4-imidazole)}(PiPr3)2 (2), which has been characterized by X-ray diffraction analysis. The structure proves the higher affinity of the metal center for the N atom in the presence of the NH unit, which remains unchanged, and reveals that in the solid state the molecules of this complex form infinite chains by means of intermolecular asymmetric 3-center bifurcated dihydrogen bonds. In solution, 1HDOSY NMR experiments suggest that the association degree decreases as the temperature increases. The fused six-membered ring of benzimidazole weakens the NH bond, enhancing its reactivity. As a consequence, complex 1 cannot discern between the N atom and the NH unit of 2-phenylbenzimidazole. Thus, the treatment of 1 with this substrate leads to a mixture of OsH3{κ2-C,N-(C6H4-benzimidazole)}(PiPr3)2 (3) and the dinuclear species (PiPr3)2H3Os(C6H4-benzimidazolate)OsH(η2-H2)(PiPr3)2 (4). The latter is the result of a N-assisted ortho-C−H bond activation of the phenyl group promoted by 0.5 equiv of 1 and the N−H bond activation promoted by the remaining 0.5 equiv of hexahydride 1 along with the agostic coordination of the remaining ortho-C−H bond to the metal center of the unsaturated fragment OsH(η 2-H2)(PiPr3)2. The comparison of the redox properties of 3 and 4 suggests that the interaction between the metal centers in the dinuclear compound is negligible. The replacement of the NH group of the azoles by a sulfur atom does not modify the behavior of the substrates. Thus, the reactions of 1 with 2-phenylthiazole and 2-phenylbenzothiazole afford OsH3{κ 2-C,N-(C6H4-thiazole)}(PiPr3)2 (5) and OsH3{κ2-C,N-(C6H4-benzothiazole)}(PiPr3)2 (6). In turn, complexes 2, 3, 5, and 6 are phosphorescent.Financial support from the Spanish MINECO and FEDER (Projects CTQ2013-46459-C2-01-P to M.A.S., CTQ2014-52799-P to M.A.E., CTQ2013-44303-P to I.F., CTQ2014-54071-P to A.L., and CTQ2014-51912-REDC, the DGA (E35), and the European Social Fund (FSE) is acknowledged.Peer Reviewe

Hydride alkenylcarbyne osmium complexes versus cyclopentadienyl type half-sandwich ruthenium derivatives

The dihydride complex OsH2Cl2(PiPr 3)2 (1) reacts with 2-methyl-1-hexen-3-yne and 2,4-dimethyl-1,3-pentadiene to give the hydride alkenylcarbyne derivatives OsHCl2{≡CC(Me)=CHR}(PiPr3)2 (R = nPr (2), iPr (3)), which have been characterized by X-ray diffraction analysis. DFT calculations (B3PW91) suggest that the enyne is initially hydrogenated to afford a conjugated diene. The latter evolves into the hydride alkenylcarbyne derivative by means of two hydrogen migrations. The first migration is a 1,4-hydrogen shift within the diene (from the terminal CH2 group to the internal double bond) which takes place through the metal center. The second migration is a 1,2-hydrogen shift from the terminal CH2 group to the osmium atom. In contrast to the case for 1, the ruthenium counterpart RuH2Cl2(PiPr 3)2 (16) reacts with 2-methyl-1-hexen-3-yne to give a complex mixture of compounds, from which the derivatives Ru(η5- C5HR1R2R3R4)Cl(P iPr3) (17; R1 = C(CH3)=CH 2, R2 = Et, R3 = nPr, R4 = Me) and RuCl2{=C(Et)CH=CMe2}(PiPr 3)2 (18, traces) are isolated. Both 17 and 18 have been also characterized by X-ray diffraction analysis. DFT calculations (B3PW91) on the formation of 17 suggest that in the ruthenium case the hydrogenation of the enyne leads to an alkenylcarbene intermediate, which reacts with a second enyne molecule to afford the tetrasubstituted cyclopentadienyl group. © 2011 American Chemical Society.Financial support from the Spanish MICINN (Project numbers CTQ2008-00810 and Consolider Ingenio 2010 CSD2007-00006), the DGA (E35), and the European Social Fund is acknowledged. A.C. thanks the CSIC for her JAE grant.Peer Reviewe