The heart failure specialists of tomorrow: a network for young cardiovascular scientists and clinicians

The "Heart failure specialists of Tomorrow" (HoT) group gathers young researchers, physicians, basic scientists, nurses and many other professions under the auspices of the Heart Failure Association of the European Society of Cardiology. After its foundation in 2014, it has quickly grown to a large group of currently 925 members. Membership in this growing community offers many advantages during, before, and after the 'Heart Failure and World Congress on Acute Heart Failure'. These include: eligibility to receive travel grants, participation in moderated poster sessions and young researcher and clinical case sessions, the HoT walk, the career cafe, access to the networking opportunities, and interaction with a large and cohesive international community that constantly seeks multinational collaborations.Peer reviewe

Left ventricular function, congestion, and effect of empagliflozin on heart failure risk after myocardial infarction

Background Empagliflozin reduces the risk of heart failure (HF) hospitalizations but not all-cause mortality when started within 14 days of acute myocardial infarction (AMI). Objective To evaluate the association between left ventricular ejection fraction (LVEF), congestion, or both on outcomes and the impact of empagliflozin in reducing HF risk post-MI. Methods In the EMPACT-MI trial, patients were randomized within 14 days of an AMI complicated by either newly reduced LVEF<45%, congestion, or both to empagliflozin 10 mg daily or placebo and followed for a median of 17.9 months. Results Among 6522 patients, the mean baseline LVEF was 41%+9%; 2648 patients (40.6%) presented with LVEF<45% alone, 1483 (22.7%) presented with congestion alone, and 2181 (33.4%) presented with both. Among patients in the placebo arm, multivariable adjusted risk for each 10-point reduction in LVEF included all-cause death or HF hospitalization (hazard ratio [HR] 1.49; 95%CI, 1.31-1.69; P<0.0001), first HF hospitalization (HR, 1.64; 95%CI, 1.37-1.96; P<0.0001), and total HF hospitalizations (rate ratio [RR], 1.89; 95%CI, 1.51-2.36; P<0.0001). Presence of congestion was also associated with a significantly higher risk for each of these outcomes (HR 1.52, 1.94, and RR 2.03, respectively). Empagliflozin reduced the risk for first (HR 0.77, 95%CI 0.60-0.98) and total (RR 0.67, 95%CI 0.50-0.89) HF hospitalization, irrespective of LVEF or congestion or both. The safety profile of empagliflozin was consistent across baseline LVEF and irrespective of congestion status. Conclusions In patients with AMI, severity of LV dysfunction and the presence of congestion was associated with worse outcomes. Empagliflozin reduced first and total HF hospitalizations across the range of LVEF with and without congestion

Effect of empagliflozin on heart failure outcomes after acute myocardial infarction: insights from the EMPACT-MI trial

Background: Empagliflozin reduces the risk of heart failure events in patients with type 2 diabetes at high cardiovascular risk, chronic kidney disease, and in those with prevalent heart failure irrespective of ejection fraction. While EMPACT-MI showed empagliflozin does not reduce the risk of the composite of hospitalization of heart failure and all-cause mortality, the impact of empagliflozin on first and recurrent heart failure events in patients after myocardial infarction is unknown. Methods: EMPACT-MI was a double-blind, randomized, placebo-controlled, event-driven trial that randomized 6522 patients hospitalized for acute myocardial infarction at risk for heart failure based on newly developed left ventricular ejection fraction of <45% and/or signs or symptoms of congestion to receive empagliflozin 10 mg daily or placebo within 14 days of admission. In prespecified secondary analyses, treatment groups were analyzed for heart failure outcomes. Results: Over a median of follow-up of 17.9 months, the risk for first heart failure hospitalization and total heart failure hospitalizations was significantly lower in the empagliflozin compared with the placebo group (118 (3.6%) vs. 153 (4.7%) patients with events, HR 0.77 [95% CI 0.60, 0.98], P=0.031 for first heart failure hospitalization and 148 vs. 207 events, RR 0.67 [95% CI 0.51, 0.89], P=0.006 for total heart failure hospitalizations). Subgroup analysis showed consistency of empagliflozin benefit across clinically relevant patient subgroups for first and total heart failure hospitalizations. Post-discharge need for new use of diuretics, renin-angiotensin modulators, and mineralocorticoid receptor antagonists were less in patients randomized to empagliflozin than placebo (all p<0.05). Conclusions: In patients after acute myocardial infarction with left ventricular dysfunction or congestion, empagliflozin reduced the risk of heart failure

Treatment of Patients in the Vulnerable Phase (at Discharge or Early After Discharge)

The clinical course of heart failure includes a period in which the patient is at increased risk of death or rehospitalisation for HF. This period is termed the “vulnerable phase” and occurs during the peri-acute HF phase, due to microenvironmental changes in the cardiovascular system. Typically, the vulnerability phase starts from the onset of an acute HF event leading to admission, continues through a peri-discharge period and lasts up to 6 months after discharge.These poor post-discharge outcomes also represent a significant socioeconomic burden. This articles reviews treatments that are beneficial in this important phase

The Management of Heart Failure in Kidney and Urinary Tract Syndromes

Kidney dysfunction and other related abnormalities are extremely common in all HF syndromes, both because of the similarity of risk factors and the similarity of demography of the two types of patients but also because of the common renal effects of agents used for the treatment of HF. Important renal syndromes for the HF patient include including chronic kidney disease, acute kidney injury, cardio-renal syndrome, and prostatic obstruction. In HF (all types including HFrEF, HFmrEF and especially HFpEF) chronic kidney disease (CKD) frequently co-exists and almost as frequently complicates the HF management. The two groups of syndromes share many risk factors (diabetes, hypertension, hyperlipidaemia) and often interact to worsen the prognosis of each other in a way that makes the patient with combined HF and renal disease at extremely high risk. This article reviews this common co-morbidity and how to manage it

The Management of Co-Morbidities in Patients with Heart Failure – Hypertension

The 2016 ESC/HFA HF guidelines carry an important section on the treatments of co- morbidities in HF. Foremost of these in terms of frequency and its relevance to the aetiology of HF, especially HFpEF is hypertension. In this artcile we will review what the recent guidelines say about the management of hypertension in the setting of HF, both HFrEF and HFpEF and expand on some of the practical advice

The Efficiency of Application of Magnetic Polymer Composites as Radio-absorbing Materials

Byla zkoumána komplexní permitivita a permeabilita polymerních kompozitních materiálů ve frekvenčním rozsahu od 1 MHz do 10 GHz. Je uvedeno jak lze u hybridních kompozitů na bázi různých magnetických plniv měnit jejich frekvenční spektrum komplexní permitivity a permeability. Následně je pro tyto systémy analyzována jejich účinnost coby absorberů elektromagnetického záření v radiové a mikrovlnné části spektra.The results of investigation of the complex permittivity and permeability of polymer composite materials with different magnetic fillers in the frequency range of 1 MHz to 10 GHz are presented. The possibility of controlling the frequency characteristics of permeability and permittivity and the absolute values of these parameters via the formation of hybrid composites with multicomponent magnetic filler is shown. The efficiency of application of magnetic polymer composites as absorbing materials for the RF and microwave bands is analyzed

Extension of the operating frequency range of a dielectric radio absorber with the help of frequency-selective surfaces

A detailed study of the efficiency of frequency-selective surfaces for extension of the operating frequency range of a dielectric radio absorber is presented. The radio absorber is fabricated from the layer of a homogeneous carbon black filled material and a frequency-selective surface made of thin metal rings placed inside or on the surface of the absorber. It is shown theoretically and experimentally that insertion of a frequency-selective surface into a dielectric radio absorber makes it possible to almost double the range of operating frequencies without increasing the thickness of the absorber. © 2011 Pleiades Publishing, Ltd