Propafenone in complex anti-recurrent therapy of persistent atrial fibrillation

Effectiveness and safety of Class IС antiarrhythmic agent, propafenone (Propanorm, PRO. MED. CS Praha a.s., Czech Republic), was studied inpatients with persistent atrial fibrillation (PAF) after sinus rhythm conversion, during long-term ant-recurrent treatment. The study included 30 men and women; mean age 57, 97± 1, 2 years. PAF was caused by essential arterial hypertension, or its combination with stable coronary heart disease. To treat PAF paroxysms, propanorm was administered in the loading dose of 600 mg, continued by anti-recurrent therapy (450 mg/d for 12 months). All participants also received ACE inhibitor lisinopril (Dapril, PRO. MED. CS Praha a.s., Czech Republic). During anti-recurrent propanorm therapy (450 mg/d), no recurrent AF paroxysms were registered in 63, 3 % of the patients; paroxysm frequency reduced in 23, 3 %; paroxysms remained frequent in 13, 3 %. No adverse events were registered. Twelve-month propanorm and dapril treatment was associated with significant improvements in intracardiac hemodynamics and chronic heart failure functional class, as early as by Month 6

Propafenone efficacy in paroxysmal atrial fibrillation

Efficacy and safety of class IС antiarrhythmic agent, propafenone, was investigated in patients with paroxysmal atrial fibrillation (PAF), after single-dose load and during long-term preventive treatment. The study included 20 male and female patients (mean age 53,8+2,4 years). PAF was caused by coronary heart disease (CRT)) and/or essential arterial hypertension. For terminating PAF, a single dose of propafenone, 600 mg, was used. In 75% of cases, the medication was effective. In one patient (6%), long PW, wide QRS, and sinus rhythm deceleration to 48 bpm were observed. These symptoms disappeared without any additional therapy, 4 hours after sinus rhythm being restored. All patients with restored sinus rhythm received 6-month preventive treatment with propafenone (450 mg/d). In 9 patients (60%), there were no recurrent PAF episodes, in 4 (27%) - one PAF episode was registered, in 2 (13%), with BP higher than target levels - two PAF episodes. Extra-cardiac adverse effects of propafenone were not observed. Therefore, propafenone can be regarded as an effective and safe first-line medication for treating PAF. Long-term therapy, together with antianginal and antihypertensive treatment, significantly decreased the number of recurrent arrhythmic episodes

Quinine Binding by the Cocaine-Binding Aptamer. Thermodynamic and Hydrodynamic Analysis of High-Affinity Binding of an Off-Target Ligand

The cocaine-binding aptamer is unusual in that it tightly binds molecules other than the ligand it was selected for. Here, we study the interaction of the cocaine-binding aptamer with one of these off-target ligands, quinine. Isothermal titration calorimetry was used to quantify the quinine-binding affinity and thermodynamics of a set of sequence variants of the cocaine-binding aptamer. We find that the affinity of the cocaine-binding aptamer for quinine is 30−40 times stronger than it is for cocaine. Competitive binding studies demonstrate that both quinine and cocaine bind at the same site on the aptamer. The ligand-induced structural-switching binding mechanism of an aptamer variant that contains three base pairs in stem 1 is retained with quinine as a ligand. The short stem 1 aptamer is unfolded or loosely folded in the free form and becomes folded when bound to quinine. This folding is confirmed by NMR spectroscopy and by the short stem 1 construct having a more negative change in heat capacity of quinine binding than is seen when stem 1 has six base pairs. Small-angle X-ray scattering (SAXS) studies of the free aptamer and both the quinine- and the cocaine-bound forms show that, for the long stem 1 aptamers, the three forms display similar hydrodynamic properties, and the ab initio shape reconstruction structures are very similar. For the short stem 1 aptamer there is a greater variation among the SAXS-derived ab initio shape reconstruction structures, consistent with the changes expected with its structural-switching binding mechanism

Cohort profile. the ESC-EORP chronic ischemic cardiovascular disease long-term (CICD LT) registry

The European Society of cardiology (ESC) EURObservational Research Programme (EORP) Chronic Ischemic Cardiovascular Disease registry Long Term (CICD) aims to study the clinical profile, treatment modalities and outcomes of patients diagnosed with CICD in a contemporary environment in order to assess whether these patients at high cardiovascular risk are treated according to ESC guidelines on prevention or on stable coronary disease and to determine mid and long term outcomes and their determinants in this population

Heart failure in Europe: Guideline-directed medical therapy use and decision making in chronic and acute, pre-existing and de novo, heart failure with reduced, mildly reduced, and preserved ejection fraction – the ESC EORP Heart Failure III Registry

Aims We analysed baseline characteristics and guideline-directed medical therapy (GDMT) use and decisions in theEuropean Society of Cardiology (ESC) Heart Failure (HF) III Registry. Methods and results Between1November 2018and31December 2020,10162 patients with acute HF (AHF, 39%, age 70 [62-79],36% women) or outpatient visit for HF (61%, age 66 [58-75], 33% women), with HF with reduced (HFrEF, 57%),mildly reduced (HFmrEF,17%) or preserved (HFpEF, 26%) ejection fraction were enrolled from 220 centres in 41European or ESC-affiliated countries. With AHF, 97% were hospitalized, 2.2% received intravenous treatment in theemergency department, and 0.9% received intravenous treatment in an outpatient clinic. AHF was seen by most bya general cardiologist (51%) and outpatient HF most by a HF specialist (48%). A majority had been hospitalized forHF before, but 26% of AHF and 6.1% of outpatient HF had de novo HF. Baseline use, initiation and discontinuation ofGDMT varied according to AHF versus outpatient HF, de novo versus pre-existing HF, and by ejection fraction. Afterthe AHF event or outpatient HF visit, use of any renin-angiotensin system inhibitor, angiotensin receptor-neprilysininhibitor, beta-blocker, mineralocorticoid receptor antagonist and loop diuretics was 89%, 29%, 92%, 78%, and 85%in HFrEF; 89%, 9.7%, 90%, 64%, and 81% in HFmrEF; and 77%, 3.1%, 80%, 48%, and 80% in HFpEF. ConclusionUse and initiation of GDMT was high in cardiology centres in Europe, compared to previous reports from cohortsand registries including more primary care and general medicine and regions more local or outside of Europe andESC-affiliated countries....................................