Archives of Medical Sciences. Atherosclerotic Diseases最新文献

{"title":"Sodium-glucose co-transporter-2 inhibitor mediated cardio-protection: does increase of hematocrit finally matter? Sub-analysis of a prospective, observational study.","authors":"Dimitrios Patoulias, Christodoulos Papadopoulos, Asterios Karagiannis, Michael Doumas","doi":"10.5114/amsad.2022.116665","DOIUrl":"https://doi.org/10.5114/amsad.2022.116665","url":null,"abstract":"Hematocrit increase with sodium-glucose co-transporter-2 (SGLT-2) inhibitors has been proposed as a potential mechanism implicated in the well-established cardio- and reno-protection with this drug class [1]. According to a recent, large meta-analysis of randomized controlled trials in a total of 14,478 participants, SGLT-2 inhibitors led to a significant increase in hematocrit by 1.32% and in hemoglobin by 0.56 g/dl [2]. Increases in erythropoiesis and red-blood cell count, along with decreases in hepcidin, ferritin and transferrin saturation levels, have been observed [3–5]. In the present sub-analysis of a real-world study performed in the context of the COVID-19 pandemic we sought to determine the effect of different SGLT-2 inhibitors on hematocrit levels and their association with established cardiovascular risk factors. This is a sub-analysis of a single-center, prospective, observational study, conducted in","PeriodicalId":8317,"journal":{"name":"Archives of Medical Sciences. Atherosclerotic Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d6/e2/AMS-AD-7-149922.PMC9278171.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40624354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare coexistence of acute thrombotic occlusion of the left popliteal-tibioperoneal artery and the left iliofemoral vein: a case report","authors":"S. Yılmaz, Sabür Zengin","doi":"10.5114/amsad.2022.114939","DOIUrl":"https://doi.org/10.5114/amsad.2022.114939","url":null,"abstract":"Acute arterial occlusion (AAO) is a vascular emergency, which is char-acterized by a sudden interrupted perfusion of the limbs [1] and deep vein thrombosis (DVT) is a common complication of long-term hospital-izations and a preventable cause of in-hospital deaths [2, 3]. Although arterial and venous thrombosis are known as different clinical presen-tations due to risk factors, pathophysiology and treatment methods, two of these conditions have been shown to be associated [4]. The rupture of the atherosclerotic plaques leads to AAO known as platelet-rich white thrombus and decrease in blood flow usually may cause venous thrombosis [4]. AAO is associated with increased mortality and disability should be recognized rapidly since it will lead to loss of the limb [1]. It is important to distinguish venous and arterial thrombus for early diagnosis and treatment, and it is an uncommon condition to see both at the same patient [5]. Doppler ultrasound (DUS) is a valuable method to diagnose acute arterial thromboembolism","PeriodicalId":8317,"journal":{"name":"Archives of Medical Sciences. Atherosclerotic Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87074794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of comorbidities and symptoms stratified by severity of illness amongst adult patients with COVID-19: a systematic review.","authors":"Ritambhara Pandey, Devesh Rai, Muhammad Waqas Tahir, Abdul Wahab, Dhrubajyoti Bandyopadhyay, Emil Lesho, Maryrose Laguio-Vila, Emilio Fentanes, Raseen Tariq, Srihari S Naidu, Wilbert S Aronow","doi":"10.5114/amsad.2022.115008","DOIUrl":"10.5114/amsad.2022.115008","url":null,"abstract":"<p><strong>Introduction: </strong>We performed a systematic review of comorbidities and symptoms of adult patients with coronavirus disease 2019 (COVID-19) to evaluate comorbidities, symptoms, and severity.</p><p><strong>Material and methods: </strong>We searched databases and extracted comorbidities and symptoms from the included studies. We stratified the similar signs and symptoms in groups and on the basis of severity and compared them with stratified analysis. Individual case reports and case series with < 5 patients were excluded.</p><p><strong>Results: </strong>A total of 163 studies with 43,187 patients were included. Mean age was 54.6 years. There were significantly fewer women in the study (43.9% vs. 56.1%, <i>p</i> < 0.0001). Prevalent cardiovascular comorbidities were hypertension (31.9%), obesity (27.9%), hyperlipidemia (26.4%), smoking (18.9%), diabetes mellitus (17.2%), atherosclerotic disease (9.2%) and arrhythmia (5.0%). The most frequently reported constitutional symptoms of COVID-19 were fever (73.9%), fatigue (33.4%), malaise (29.9%), myalgia and/or arthralgia (19.2%), generalized weakness (19.0%), and chills (11.3%). For the cardiovascular system, chest pain and/or tightness were most often reported (19.6%), followed by palpitations (5.2%). Hypertension and diabetes were common in severe disease. Obesity and congestive heart failure were not observed in any non-severe cases. Severe cases compared to non-severe cases more frequently had fever (87.8% vs. 58.5%, <i>p</i> < 0.001), shortness of breath (47.4% vs. 20.6%, <i>p</i> < 0.001), cough (66.8% vs. 62.9%, <i>p</i> < 0.001), sputum production (35.4% vs. 26.5%, <i>p</i> < 0.001) and rhinorrhea (32.2% vs. 7.3%, <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Hypertension, diabetes, and atherosclerotic diseases are common comorbidities across the world, with obesity as the second most common in the US and more common in men.</p>","PeriodicalId":8317,"journal":{"name":"Archives of Medical Sciences. Atherosclerotic Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9081912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80949655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ketone bodies and the heart.","authors":"Athanasia K Papazafiropoulou,&nbsp;Maximos M Georgopoulos,&nbsp;Nikolaos L Katsilambros","doi":"10.5114/amsad.2021.112475","DOIUrl":"https://doi.org/10.5114/amsad.2021.112475","url":null,"abstract":"<p><p>Ketone bodies are low chain organic substances with four carbon atoms, with β-hydroxybutyric acid and acetone being the main ketone bodies in blood circulation. Under physiological conditions their levels are low while during conditions of oxidative stress, such as exercise, fasting state and acute illness, ketone body levels are increased. Recent findings have shown that in patients with heart failure their plasma concentration is increased. There is a positive correlation between increased energy metabolism of myocardial cells and the levels of β-hydroxybutyric acid and acetone. Furthermore, it has been hypothesized that the mild ketosis caused by sodium glucose cotransporter 2 inhibitors is one of the possible pathogenetic mechanisms explaining the significant cardiovascular and renal benefits observed in patients with type 2 diabetes treated with these agents. The aim of the present review is to summarize the role of ketone bodies in both normal and pathological conditions, such as heart failure.</p>","PeriodicalId":8317,"journal":{"name":"Archives of Medical Sciences. Atherosclerotic Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f3/bc/AMS-AD-6-143267.PMC9487827.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33485860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Multiplate-measured aspirin resistance and vitamin D deficiency in stable coronary artery disease.","authors":"Semih Surmen,&nbsp;Pelin Karaca Ozer,&nbsp;Samim Emet,&nbsp;Elif Ayduk Govdeli,&nbsp;Ali Elitok","doi":"10.5114/amsad.2021.112242","DOIUrl":"https://doi.org/10.5114/amsad.2021.112242","url":null,"abstract":"<p><strong>Introduction: </strong>Insufficient inhibition of platelets in patients with atherosclerosis despite antiplatelet therapy leads to important clinical consequences. The present study evaluated the role of vitamin D (VD) deficiency in aspirin resistance (AR) in patients with stable coronary artery disease (CAD) treated with aspirin.</p><p><strong>Material and methods: </strong>This study included 70 patients with stable CAD who had been using 100 mg aspirin for at least seven days. Serum 25-hydroxyvitamin D [25-(OH)D] concentration was measured and patients with 25-(OH)D level < 20 ng/dl were defined as the VD deficient group. A Multiplate Platelet Function Analyzer (Multiplate) device was used to evaluate AR. Patients were defined as aspirin-sensitive (AS) when their AUC was ≤ 30 U, and aspirin resistant (AR) when their AUC was > 30 U.</p><p><strong>Results: </strong>AUC was > 30 U in 15 (21%) patients and these patients were considered AR. The mean 25-(OH)D level was 18.7 ±12.2 ng/ml in all patients. Forty-five (64%) patients were VD deficient. The rate of AR was higher in the VD deficient group than the sufficient group (29% vs. 8%, <i>p</i> = 0.041). The mean AUC was higher in the VD deficient group than the sufficient group (30.2 ±29.1 vs. 15.3 ±13.1 U; <i>p</i> = 0.018). In ROC analysis 25-(OH)D level < 19.25 ng/dl predicted AR with 86.7% sensitivity, 61.8% specificity (AUC = 0.696, 95% CI: 0.551-0.840, <i>p</i> = 0.021).</p><p><strong>Conclusions: </strong>In the current study, an association was found between VD deficiency and AR in patients with stable CAD. VD supplementation may reduce platelet aggregation and overcome AR.</p>","PeriodicalId":8317,"journal":{"name":"Archives of Medical Sciences. Atherosclerotic Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d2/04/AMS-AD-6-142996.PMC9487833.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33486311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protective effect of allopurinol in preventing contrast-induced nephropathy among patients undergoing percutaneous coronary intervention: a systematic review and meta-analysis.","authors":"Kanaan Mansoor,&nbsp;Mohamed Suliman,&nbsp;Mohammad Amro,&nbsp;Saad Malik,&nbsp;Ahmad Amro,&nbsp;Zachary Curtis,&nbsp;Mehiar El-Hamdani,&nbsp;Iheanyichukwu Ogu,&nbsp;Wilbert S Aronow","doi":"10.5114/amsad.2021.112226","DOIUrl":"https://doi.org/10.5114/amsad.2021.112226","url":null,"abstract":"<p><strong>Introduction: </strong>Contrast-induced nephropathy (CIN) is the third most common cause of iatrogenic acute renal failure and is triggered by administration of radiopaque contrast media. Periprocedural hydration is imperative in prevention of CIN, and uric acid has been recognized to have an integral role in development of renal disease. The aim of our study is to understand the efficacy of allopurinol in preventing CIN among patients undergoing percutaneous coronary intervention.</p><p><strong>Material and methods: </strong>A literature search was performed on PubMed (Medline), Science Direct and Cochrane Library using a combination of Mesh terms. We limited our search to randomized controlled trials (RCTs) and articles published in the English language. The PRISMA protocol was utilized to conduct this meta-analysis.</p><p><strong>Results: </strong>Six studies were included in the final analysis. All included studies were clinical trials conducted between 2013 and 2019. A total of 853 patients were included. There was a significant reduction in the risk of CIN among patients who were pretreated with adequate hydration plus allopurinol (100 to 600 mg) compared to hydration only before undergoing percutaneous coronary angiography (RR = 0.39, 95% CI: 0.21-0.73). A sensitivity analysis of studies using 300 mg of allopurinol only reported a significant reduction in CI-AKI compared to hydration alone (RR = 0.26, 95% CI: 0.11-0.57).</p><p><strong>Conclusions: </strong>Our study demonstrates that Allopurinol is effective in preventing contrast-induced nephropathy in patients undergoing percutaneous coronary intervention. Larger clinical trials are warranted to better understand this effect.</p>","PeriodicalId":8317,"journal":{"name":"Archives of Medical Sciences. Atherosclerotic Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/74/72/AMS-AD-6-142997.PMC9487829.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33486313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Change in hospitalization rates following transcatheter left atrial appendage occlusion.","authors":"Moghniuddin Mohammed,&nbsp;Sharma Kattel,&nbsp;Irfan Ahsan,&nbsp;Abdul J Samdani,&nbsp;Swati Chand,&nbsp;Devesh Rai,&nbsp;Dhrubajyoti Bandyopadhyay,&nbsp;Sagar Ranka,&nbsp;Amit Noheria,&nbsp;Sanjaya K Gupta,&nbsp;Seth H Sheldon,&nbsp;Mohan Rao,&nbsp;Wilbert S Aronow,&nbsp;James V Freeman,&nbsp;Madhu Reddy","doi":"10.5114/amsad.2021.111405","DOIUrl":"https://doi.org/10.5114/amsad.2021.111405","url":null,"abstract":"Introduction Left atrial appendage occlusion (LAAO) is recommended in patients with non-valvular atrial fibrillation (AF) who have contraindications to or are intolerant of long-term oral anticoagulants (OAC), but its impact on hospitalization rates has not been well described. The objective of our study is to describe the incidence of all-cause, bleeding-related, and thrombosis-related hospitalizations before and after LAAO. Material and methods We used the Nationwide Readmission Database to include patients aged ≥ 18 years with a diagnosis of AF who underwent transcatheter LAAO during the months of February-November in each year between 2016 and 2018. Patients who died during the index procedure or had missing length of hospital stay or mortality information were excluded. Results A total of 27,633 patients were included (median age: 77 years, 41% female) with an average pre- and post-LAAO monitoring period of 6.5 and 5.5 months respectively. Of these, 10,808 (39.1%) patients had one or more admissions prior to the procedure compared to 7,196 (26.0%) after the procedure. There was a 26% reduction in incidence of all-cause admissions (rate ratio (RR) = 0.74, 95% confidence interval (CI): 0.71–0.76; p < 0.001), 49% reduction in bleeding-related admissions (RR = 0.51, 95% CI: 0.48–0.55; p < 0.001), and 71% reduction in thrombosis-related readmissions (RR = 0.29, 95% CI: 0.26–0.33; p < 0.001) after LAAO. Conclusions In a contemporary, nationally representative dataset, we found that LAAO is associated with a significant decrease in all-cause, bleeding-related, and thrombosis-related admissions. These findings lend support to the current use of transcatheter LAAO in clinical practice for patients with contraindications to OAC and/or at high risk of bleeding.","PeriodicalId":8317,"journal":{"name":"Archives of Medical Sciences. Atherosclerotic Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c5/df/AMS-AD-6-141817.PMC9487831.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33485859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statin-associated side effects in patients attending a lipid clinic: evidence from a 6-year study.","authors":"Fotios Barkas,&nbsp;Petros Adamidis,&nbsp;Amalia-Despoina Koutsogianni,&nbsp;George Liamis,&nbsp;Evangelos Liberopoulos","doi":"10.5114/amsad.2021.111313","DOIUrl":"https://doi.org/10.5114/amsad.2021.111313","url":null,"abstract":"<p><strong>Introduction: </strong>There is conflicting evidence regarding the actual incidence of statin-associated side effects in clinical practice. We aimed to record the incidence of statin-associated side effects in the setting of a lipid clinic. We focused on clinically relevant liver enzyme increase and statin-associated muscle symptoms (SAMS).</p><p><strong>Material and methods: </strong>This was a retrospective study including adult patients with dyslipidemia followed up for ≥ 3 years in a university hospital lipid clinic in Greece. We recorded the incidence of clinically relevant liver enzyme increase (> 3 × upper limit of normal (ULN) on 2 occasions) and SAMS (muscle crumps, creatine kinase (CK) increase > 10 × ULN and rhabdomyolysis) during follow-up.</p><p><strong>Results: </strong>Among study participants (<i>n</i> = 1,334), 3.1% and 2.8% presented with clinically relevant liver enzyme increase and SAMS at least once during a median follow-up of 6 years (4-10). Only 11% (<i>n</i> = 5) of subjects with a clinically relevant liver enzyme increase and 6% (<i>n</i> = 2) of those with SAMS did not tolerate any statin at any dose. Most subjects with a history of a clinically relevant liver enzyme increase or SAMS were eventually treated with a moderate- or high-intensity statin (76% and 80%, respectively) or with combination treatment of a statin plus another lipid-lowering drug (15% and 36%, respectively). No risk factors for these statin-associated side effects were identified.</p><p><strong>Conclusions: </strong>The incidence of statin-associated side effects is low in the setting of a lipid clinic. The vast majority of these individuals were still able to tolerate statin treatment.</p>","PeriodicalId":8317,"journal":{"name":"Archives of Medical Sciences. Atherosclerotic Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0e/3e/AMS-AD-6-142830.PMC9487797.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33486312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-year mortality rates after minor and major amputations of the lower limbs.","authors":"Jose M Pereira de Godoy,&nbsp;Germano Giroldo Tazinaffo,&nbsp;Barbara Lasmine Gomes Abreu Christo,&nbsp;Maria de Fátima Guerreiro Godoy","doi":"10.5114/amsad.2021.111314","DOIUrl":"https://doi.org/10.5114/amsad.2021.111314","url":null,"abstract":"<p><strong>Introduction: </strong>Critical limb ischemia is the most severe form of peripheral arterial disease. The anatomic and clinical severity of the disease is often heterogeneous and the choice of treatment is affected by different clinical and patient-related factors. The aim of the present study was to evaluate the mortality rate in a period of 1 year following minor and major amputations and compare the rates with that related to major amputation of lower limbs in 2005.</p><p><strong>Material and methods: </strong>A cross-sectional study evaluated minor and major amputations of the lower limbs at the School Hospital affiliated with the São Jose do Rio Preto School of Medicine in the period from July 2018 to July 2019. It was conducted using the charts of 233 patients who had undergone minor and major amputations of the lower limbs.</p><p><strong>Results: </strong>The 1-year mortality rate was analyzed among 108 patients submitted to minor amputations and the mortality rate of 80 patients submitted to major amputations in 2019 was compared to that among 50 patients submitted to major amputations in 2005.</p><p><strong>Conclusions: </strong>Significant 1-year mortality rates were found following minor and major amputations, with a higher rate among patients submitted to the latter procedure. Moreover, there has been no reduction in the mortality rate among patients submitted to major amputation in the past 15 years.</p>","PeriodicalId":8317,"journal":{"name":"Archives of Medical Sciences. Atherosclerotic Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ec/d4/AMS-AD-6-142464.PMC9487835.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33486310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The early effect of dapagliflozin on strain and tissue Doppler parameters of diastolic function in diabetic patients with heart failure with reduced ejection fraction.","authors":"Spyridon Maragkoudakis,&nbsp;Maria Marketou,&nbsp;Vasiliki Katsi,&nbsp;Alexandros Patrianakos,&nbsp;Labrini Tsigkriki,&nbsp;Maria Mamaloukaki,&nbsp;Kostas Tsioufis,&nbsp;George Kochiadakis,&nbsp;Fragkiskos Parthenakis","doi":"10.5114/amsad.2021.109685","DOIUrl":"https://doi.org/10.5114/amsad.2021.109685","url":null,"abstract":"<p><strong>Introduction: </strong>Heart failure (HF) with reduced ejection fraction (HFrEF) remains a challenging problem due to its high mortality rate. The PARADIGM HF trial and a new class of drugs - angiotensin receptor-neprilysin inhibitors (ARNIs) - managed to change the current perception of HF treatment by reducing cardiovascular mortality and morbidity as well as HF hospitalizations compared with enalapril and have emerged as an evidence-based therapy for HFrEF. Another novelty in HF therapy is dapagliflozin, a sodium-glucose transporter-2 inhibitor (SGLT2i) which decreased the rates of cardiac death and worsening of HF in the DAPA-HF trial, when added in other guideline recommended therapy. A recent study evaluated the potency of dapagliflozin in terms of mortality and deterioration of HF, in patients taking sacubitril/valsartan and in patients who were naive.</p><p><strong>Material and methods: </strong>A prospective cohort study of 30 symptomatic HF patients with EF < 35% (aged 65 ±10 years) was conducted. Diabetic (2TDM) patients of NYHA status II-III, previously treated with ARNI, β-blocker, and mineralocorticoid receptor antagonists (MRA) were included. Dapagliflozin was added to their therapy.</p><p><strong>Results: </strong>Echocardiographic evaluation revealed improvement of both conventional tissue Doppler and diastolic strain parameters by dapagliflozin addition on HF therapy.</p><p><strong>Conclusions: </strong>Dapagliflozin impact on diastolic function may explain the symptom amelioration and the improvement of quality of life. And more specifically, the ratio of early diastolic transmitral flow velocity to global strain rate at the early filling phase of diastole (E/SRE)may be considered a reliable index of HF therapy responders.</p>","PeriodicalId":8317,"journal":{"name":"Archives of Medical Sciences. Atherosclerotic Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c3/b8/AMS-AD-6-45356.PMC8525245.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39561865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}