Suspension model for blood flow through catheterized curved artery with time-variant overlapping stenosis

This paper is concerned with the analysis of a particle-fluid suspension model for the axi-symmetric flow of blood through curved coaxial tubes where the outer tube with mild overlapping stenosis while the inner tube is uniform rigid representing catheter. The governing equations written in rectangular toroidal coordinates and the problem is formulated using a perturbation expansion in terms of a variant of curvature parameter to obtain explicit forms for the axial velocities of fluid and particulate phases, the stream function, the resistance impedance, pressure drop and the wall shear stress distribution also the results were studied for various values of the physical parameters, such as the curvature parameter ε, the radius of catheter σ, the volume fraction density of the particles C, the taper angle ϕ and the maximum height of stenosis δ∗. The obtained results show that there is a significant deference between curvature and non-curvature annulus flows through catheterized stenosed arteries. This study provides a scope for estimating the influence of the problem parameters on different flow characteristics and to ascertain which of the parameters has the most dominating role

Physicians' guideline adherence is associated with long-term heart failure mortality in outpatients with heart failure with reduced ejection fraction: the QUALIFY international registry

Background: Physicians' adherence to guideline-recommended therapy is associated with short-term clinical outcomes in heart failure (HF) with reduced ejection fraction (HFrEF). However, its impact on longer-term outcomes is poorly documented. Here, we present results from the 18-month follow-up of the QUALIFY registry. Methods and results: Data at 18 months were available for 6118 ambulatory HFrEF patients from this international prospective observational survey. Adherence was measured as a continuous variable, ranging from 0 to 1, and was assessed for five classes of recommended HF medications and dosages. Most deaths were cardiovascular (CV) (228/394) and HF-related (191/394) and the same was true for unplanned hospitalizations (1175 CV and 861 HF-related hospitalizations, out of a total of 1541). According to univariable analysis, CV and HF deaths were significantly associated with physician adherence to guidelines. In multivariable analysis, HF death was associated with adherence level [subdistribution hazard ratio (SHR) 0.93, 95% confidence interval (CI) 0.87–0.99 per 0.1 unit adherence level increase; P = 0.034] as was composite of HF hospitalization or CV death (SHR 0.97, 95% CI 0.94–0.99 per 0.1 unit adherence level increase; P = 0.043), whereas unplanned all-cause, CV or HF hospitalizations were not (all-cause: SHR 0.99, 95% CI 0.9–1.02; CV: SHR 0.98, 95% CI 0.96–1.01; and HF: SHR 0.99, 95% CI 0.96–1.02 per 0.1 unit change in adherence score; P = 0.52, P = 0.2, and P = 0.4, respectively). Conclusion: These results suggest that physicians' adherence to guideline-recommended HF therapies is associated with improved outcomes in HFrEF. Practical strategies should be established to improve physicians' adherence to guidelines. © 2019 The Authors. European Journal of Heart Failure © 2019 European Society of Cardiolog