Sex- and age-related differences in the management and outcomes of chronic heart failure: an analysis of patients from the ESC HFA EORP Heart Failure Long-Term Registry

Aims: This study aimed to assess age- and sex-related differences in management and 1-year risk for all-cause mortality and hospitalization in chronic heart failure (HF) patients. Methods and results: Of 16 354 patients included in the European Society of Cardiology Heart Failure Long-Term Registry, 9428 chronic HF patients were analysed [median age: 66 years; 28.5% women; mean left ventricular ejection fraction (LVEF) 37%]. Rates of use of guideline-directed medical therapy (GDMT) were high (angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers and mineralocorticoid receptor antagonists: 85.7%, 88.7% and 58.8%, respectively). Crude GDMT utilization rates were lower in women than in men (all differences: P\ua0 64 0.001), and GDMT use became lower with ageing in both sexes, at baseline and at 1-year follow-up. Sex was not an independent predictor of GDMT prescription; however, age >75 years was a significant predictor of GDMT underutilization. Rates of all-cause mortality were lower in women than in men (7.1% vs. 8.7%; P\ua0=\ua00.015), as were rates of all-cause hospitalization (21.9% vs. 27.3%; P\ua075 years. Conclusions: There was a decline in GDMT use with advanced age in both sexes. Sex was not an independent predictor of GDMT or adverse outcomes. However, age >75 years independently predicted lower GDMT use and higher all-cause mortality in patients with LVEF 6445%

Synthesis, structural, optical, and electrical characterization of biochitosan/Na_0.5Bi_0.5TiO₃ composite thin-film materials

International audienceThe purpose of this research work was to synthesis bioderived nanocomposite films by incorporating Na0.5Bi0.5TiO3 (NBTO) nanoparticles into a chitosan matrix. The NBTO nanoparticles were synthesized using a traditional solid-state technique. Then, through a solution-casting approach, flexible composite films were fabricated using chitosan polymer. The study presents a range of compelling findings. For structural and morphological insights, scanning electron microscopy (SEM) reveals a fascinating morphology where NBTO nanoparticles are uniformly dispersed and interlocked with other particles, forming interconnected grains with significant interspaces within the chitosan matrix. For the optical properties, the spectral response within the 300–800 nm range is primarily governed by light scattering attributed to NBTO particles with diameter sizes ranging from 100 to 400 nm, as well as the distinctive bandgap exhibited by the NBTO phase. The investigation of dielectric properties demonstrates that composite films exhibit markedly higher dielectric values in comparison to pure chitosan films. It is noteworthy that an increase in the NBTO content results in a corresponding increase in dielectric values, enhancing the versatility of these materials. Local piezoelectric measurements utilizing piezoresponse force microscopy confirm the expected piezoelectric and ferroelectric behavior of NBTO particles when dispersed within the chitosan matrix. This research introduces a novel class of biocompatible nanocomposite materials, combining impressive structural attributes, enhanced dielectric properties, and piezoelectric capabilities. The outcomes of this study hold substantial promise for advanced applications in opto- and piezoelectric technologies, marking a significant advancement in biologically sourced materials with multifunctional properties