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- Berry, C, et al.
(author)
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The survival of patients with heart failure with preserved or reduced left ventricular ejection fraction: an individual patient data meta-analysis.
- 2012
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In: European heart journal. - : Oxford University Press (OUP). - 1522-9645 .- 0195-668X. ; 33:14, s. 1750-7
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Journal article (peer-reviewed)abstract
- A substantial proportion of patients with heart failure have preserved left ventricular ejection fraction (HF-PEF). Previous studies have reported mixed results whether survival is similar to those patients with heart failure and reduced EF (HF-REF).We compared survival in patients with HF-PEF with that in patients with HF-REF in a meta-analysis using individual patient data. Preserved EF was defined as an EF ≥ 50%. The 31 studies included 41 972 patients: 10 347 with HF-PEF and 31 625 with HF-REF. Compared with patients with HF-REF, those with HF-PEF were older (mean age 71 vs. 66 years), were more often women (50 vs. 28%), and have a history of hypertension (51 vs. 41%). Ischaemic aetiology was less common (43 vs. 59%) in patients with HF-PEF. There were 121 [95% confidence interval (CI): 117, 126] deaths per 1000 patient-years in those with HF-PEF and 141 (95% CI: 138, 144) deaths per 1000 patient-years in those with HF-REF. Patients with HF-PEF had lower mortality than those with HF-REF (adjusted for age, gender, aetiology, and history of hypertension, diabetes, and atrial fibrillation); hazard ratio 0.68 (95% CI: 0.64, 0.71). The risk of death did not increase notably until EF fell below 40%.Patients with HF-PEF have a lower risk of death than patients with HF-REF, and this difference is seen regardless of age, gender, and aetiology of HF. However, absolute mortality is still high in patients with HF-PEF highlighting the need for a treatment to improve prognosis.
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- Boyajian, T., et al.
(author)
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Stellar diameters and temperatures - VI. High angular resolution measurements of the transiting exoplanet host stars HD 189733 and HD 209458 and implications for models of cool dwarfs
- 2015
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In: Monthly notices of the Royal Astronomical Society. - : Oxford University Press (OUP). - 0035-8711 .- 1365-2966. ; 447:1, s. 846-857
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Journal article (peer-reviewed)abstract
- We present direct radii measurements of the well-known transiting exoplanet host stars HD 189733 and HD 209458 using the CHARA Array interferometer. We find the limb-darkened angular diameters to be thetaLD = 0.3848 +/- 0.0055 and 0.2254 +/- 0.0072 milliarcsec for HD 189733 and HD 209458, respectively. HD 189733 and HD 209458 are currently the only two transiting exoplanet systems where detection of the respective planetary companion's orbital motion from high resolution spectroscopy has revealed absolute masses for both star and planet. We use our new measurements together with the orbital information from radial velocity and photometric time series data, Hipparcos distances, and newly measured bolometric fluxes to determine the stellar effective temperatures (Teff = 4875 +/- 43, 6093 +/- 103 K), stellar linear radii (R* = 0.805 +/- 0.016, 1.203 +/- 0.061 Rsun), mean stellar densities (rho* = 1.62 +/- 0.11, 0.58 +/- 0.14 rhosun), planetary radii (Rp = 1.216 +/- 0.024, 1.451 +/- 0.074 RJup), and mean planetary densities (rhop = 0.605 +/- 0.029, 0.196 +/- 0.033 rhoJup) for HD 189733 b and HD 209458 b, respectively. The stellar parameters for HD 209458, a F9 dwarf, are consistent with indirect estimates derived from spectroscopic and evolutionary modeling. However, we find that models are unable to reproduce the observational results for the K2 dwarf, HD 189733. We show that, for stellar evolutionary models to match the observed stellar properties of HD 189733, adjustments lowering the solar-calibrated mixing length parameter from 1.83 to 1.34 need to be employed.
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- Kervella, P., et al.
(author)
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The radii of the nearby K5V and K7V stars 61 Cygni A & B - CHARA/FLUOR interferometry and CESAM2k modeling
- 2008
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In: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 488:2, s. 667-674
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Journal article (peer-reviewed)abstract
- Context. The main sequence binary star 61 Cyg ( K5V+ K7V) is our nearest stellar neighbour in the northern hemisphere. This proximity makes it a particularly well suited system for very high accuracy interferometric radius measurements. Aims. Our goal is to constrain the poorly known evolutionary status and age of this bright binary star. Methods. We obtained high accuracy interferometric observations in the infrared K' band, using the CHARA/ FLUOR instrument. We then computed evolutionary models of 61 Cyg A & B with the CESAM2k code. As model constraints, we used a combination of observational parameters from classical observation methods (photometry, spectroscopy) as well as our new interferometric radii. Results. The measured limb darkened disk angular diameters are.LD( A) = 1.775 +/- 0.013 mas and.LD( B) = 1.581 +/- 0.022 mas, respectively for 61 Cyg A and B. Considering the high accuracy parallaxes available, these values translate into photospheric radii of R(A) = 0.665 +/- 0.005 R-circle dot and R(B) = 0.595 +/- 0.008 R-circle dot. The new radii constrain e. ciently the physical parameters adopted for the modeling of both stars, allowing us to predict asteroseismic frequencies based on our best- fit models. Conclusions. The CESAM2k evolutionary models indicate an age around 6 Gyr and are compatible with small values of the mixing length parameter. The measurement of asteroseismic oscillation frequencies in 61 Cyg A & B would be of great value to improve the modeling of this important fiducial stellar system, in particular to better constrain the masses.
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- Lodge, J. P., et al.
(author)
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Efficacy and safety of repeated perioperative doses of recombinant factor VIIa in liver transplantation
- 2005
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In: Liver transplantation. - : Ovid Technologies (Wolters Kluwer Health). - 1527-6465 .- 1527-6473. ; 11:8, s. 973-9
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Journal article (peer-reviewed)abstract
- Patients undergoing orthotopic liver transplantation (OLT) have excessive blood loss during surgery that requires blood transfusions, leading to increased postoperative morbidity and mortality. We studied the efficacy and safety of activated recombinant factor VII (rFVIIa) in reducing transfusion requirements in OLT. This multicenter, randomized, double-blind, placebo-controlled trial enrolled patients undergoing OLT because of cirrhosis (Child-Turcotte-Pugh class B or C). Patients received a repeated intravenous bolus regimen of rFVIIa 60 or 120 microg/kg or placebo. The primary efficacy endpoint was the total number of red blood cell (RBC) units transfused during the perioperative period. A total of 182 patients were analyzed for efficacy and 183 for safety. No significant effect of rFVIIa was observed on the number of RBC units transfused or intraoperative blood loss compared with the placebo group. A significantly higher number of patients in the rFVIIa study groups avoided RBC transfusion. Administration of rFVIIa but not placebo restored the preoperative prolonged prothrombin time to normal value during surgery. Patients receiving rFVIIa and placebo did not experience a significant difference in rate of thromboembolic events. Additionally, there was no statistically significant effect of rFVIIa treatment on hospitalization rate, total surgery time, and the proportion of patients undergoing retransplantation. In conclusion, use of rFVIIa during OLT significantly reduced the number of patients requiring RBC transfusion. There was no increase in thromboembolic events with rFVIIa administration compared with placebo.
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- Padwal, R., et al.
(author)
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The obesity paradox in heart failure patients with preserved versus reduced ejection fraction: a meta-analysis of individual patient data
- 2014
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In: International Journal of Obesity. - : Springer Science and Business Media LLC. - 0307-0565 .- 1476-5497. ; 38:8, s. 1110-1114
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Journal article (peer-reviewed)abstract
- Background:In heart failure (HF), obesity, defined as body mass index (BMI) >/=30 kg m-2, is paradoxically associated with higher survival rates compared with normal-weight patients (the 'obesity paradox'). We sought to determine if the obesity paradox differed by HF subtype (reduced ejection fraction (HF-REF) versus preserved ejection fraction (HF-PEF)).Patients and Methods:A sub-analysis of the MAGGIC meta-analysis of patient-level data from 14 HF studies was performed. Subjects were divided into five BMI groups: <22.5, 22.5-24.9 (referent), 25-29.9, 30-34.9 and >/=35 kg m-2. Cox proportional hazards models adjusted for age, sex, aetiology (ischaemic or non-ischaemic), hypertension, diabetes and baseline blood pressure, stratified by study, were used to examine the independent association between BMI and 3-year total mortality. Analyses were conducted for the overall group and within HF-REF and HF-PEF groups.Results:BMI data were available for 23 967 subjects (mean age, 66.8 years; 32% women; 46% NYHA Class II; 50% Class III) and 5609 (23%) died by 3 years. Obese patients were younger, more likely to receive cardiovascular (CV) drug treatment, and had higher comorbidity burdens. Compared with BMI levels between 22.5 and 24.9 kg m-2, the adjusted relative hazards for 3-year mortality in subjects with HF-REF were: hazard ratios (HR)=1.31 (95% confidence interval=1.15-1.50) for BMI <22.5, 0.85 (0.76-0.96) for BMI 25.0-29.9, 0.64 (0.55-0.74) for BMI 30.0-34.9 and 0.95 (0.78-1.15) for BMI >/=35. Corresponding adjusted HRs for those with HF-PEF were: 1.12 (95% confidence interval=0.80-1.57) for BMI <22.5, 0.74 (0.56-0.97) for BMI 25.0-29.9, 0.64 (0.46-0.88) for BMI 30.0-34.9 and 0.71 (0.49-1.05) for BMI >/=35.Conclusions:In patients with chronic HF, the obesity paradox was present in both those with reduced and preserved ventricular systolic function. Mortality in both HF subtypes was U-shaped, with a nadir at 30.0-34.9 kg m-2.International Journal of Obesity advance online publication, 26 November 2013; doi:10.1038/ijo.2013.203.
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