Search

Background Heart failure exhibits sex‐based differences in prevalence, clinical characteristics, and outcomes. However, these differences may have an interaction with age. This study investigates these disparities in Asian patients with acute heart failure according to age. Methods and Results We pooled data from the KorHF (Korea Heart Failure) and the KorAHF (Korean Acute Heart Failure) registries including 3200 patients between 2005 and 2009 and 5625 patients between 2011 and 2014, respectively, hospitalized for acute heart failure in Korea. Patients were categorized by their age into 2 groups: those with age ≥70 years and those with age

Abstract The authors evaluated the efficacy, safety, and characteristics of patients who respond well to standard dose triple combination therapy including chlorthalidone 25 mg with telmisartan 80 mg plus amlodipine 5 mg in hypertensive patients. This is a multicenter, double‐blind, active‐controlled, phase 3, randomized trial. Patients are randomized to triple combination (telmisartan 40 mg/amlodipine 5 mg/chlorthalidone 12.5 mg, TEL/AML/CHTD group) or dual combination (telmisartan 40 mg/amlodipine 5 mg, TEL/AML group) treatment and then dose up titration to TEL 80/AML5/CHTD25mg and TEL80/AML5, respectively. The primary endpoint is the change of mean sitting systolic blood pressure (MSSBP) at week 8. A Target BP achievement rate, a response rate, and the safety endpoints are also evaluated. Total 374 patients (mean age = 60.9 ± 10.7 years, male = 78.3%) were randomized to the study. The baseline MSSBPs/diastolic BPs were 149.9 ± 12.2/88.5 ± 10.4 mm Hg. After 8 weeks treatment, the change of MSSBPs at week 8 are −19.1 ± 14.9 mm Hg (TEL/AML/CHTD) and −11.4 ± 14.7 mm Hg (TEL/AML) (p

Objective There has been no definite consensus on the ideal depth of acetabuloplasty, especially in cases of global pincer femoroacetabular impingement (FAI). This study aims to determine whether the depth of acetabuloplasty influences postoperative outcomes in cases of global pincer FAI. Methods Data were retrospectively collected from patients with global pincer FAI who underwent hip arthroscopy with a minimum follow‐up period of 2 years from May 2014 to December 2018. Patients with global pincer FAI were subdivided into low or high resection depth groups based on whether the intraoperative acetabular rim was resected by more than 3 mm. Radiographic measurements; arthroscopic procedures; preoperative and postoperative PROs were recorded. Achievement of MCID and PASS was compared for the VAS, mHHS, HOS‐ADL, and iHOT‐12. A paired Student t‐test was used to evaluate the significance of preoperative and postoperative PROs and two‐tailed unpaired Student t‐test was used to compare demographic data and PROs between different groups. MCID and PASS were evaluated using the chi‐square test or the Fisher's exact test. Results A total of 41 hips with global pincer FAI (15 and 26 patients in low or high resection depth groups, respectively) were included in this study. Both groups showed significant postoperative improvements in the scores of all PROs (p < 0.001). Compared to the low resection depth group, the high resection depth group had a lower degree of improvement through hip arthroscopy, which manifested as lower postoperative mHHS scores (94.29 vs. 85.08, p = 0.006), higher VAS scores (0.93 vs. 2.54, p = 0.002), and lower improvements in VAS (−5.00 vs. −3.35, p = 0.028), HOS‐ADL (34.99 vs. 23.90, p = 0.017) and iHOT‐12 (39.89 vs. 29.27, p = 0.036). Patients in high resection depth group were less likely to achieve the MCID for the VAS score compared to low resection depth group in significant (73.3 vs. 26.9%, p = 0.004). Conclusions For patients with global pincer, the outcomes in high resection depth group were slightly worse than the the low resection depth group. It is indicated that excessive resection of the acetabular rim during the procedure should be avoided.

Abstract Background Most extramedullary plasmacytomas (EMPs) aresolitary and located in the head and neck region. They may also occur in the visceral parts of the body. Objectives Here, we report a case of oral EMP followed by neoplastic plasma cell metastasis to both kidneys in a neutered male Pomeranian. Methods Oral plasmacytoma recurred 11 months aftersurgical removal of an oral mass and partial maxillectomy was performed. Eighteen months after partial maxillectomy, neoplastic masses were detected in both kidneys on computed tomography. The dog died 12 months after detection of bilateral kidney neoplasms. The resected neoplastic masses were routinely processed for histopathological observation and immunohistochemistry against pan‐cytokeratin, desmin, CD3, and MUM‐1. Results The recurred mass mainly consisted of well‐differentiated plasma cells and contained a small portion of aggressive cells with malignant features. Monoclonal gammopathy was not observed on serumelectrophoresis performed to exclude multiple myeloma. The mass was composed of plasma cells with high nuclear pleomorphism and abundant mitotic figures. The neoplasm stained positive for MUM‐1 with a more aggressive morphology than in oral EMP. Conclusion Based on serum biomarker and pathological observations, a diagnosis of recurrence and metastasis of oral‐to‐renal EMP was established. To the best of our knowledge, metastasis of oral EMP into the bilateral kidneys, as described in the current case, has not been previously reported in dogs.

Objective Global pincer is a relatively rare form of pincer deformity and is typically associated with technical challenges during surgery. So far, controversy remains whether patients with global pincer have equivalent surgical outcomes compared to patients with focal pincer. This study compares the clinical outcomes of arthroscopic treatment between patients with global pincer femoroacetabular impingement (FAI) and focal pincer FAI in the Chinese population. Methods Data were retrospectively collected from patients with global and focal pincer FAI who underwent hip arthroscopy with a minimum two‐year follow‐up between April 2016 and December 2018. Radiographic measurements, arthroscopic procedures, preoperative and postoperative patient‐reported outcomes (PROs) including modified Harris hip score (mHHS), hip outcome score‐activities of daily living (HOS‐ADL), international hip outcome tool–12 (iHOT‐12), and visual analogue scale (VAS) scores, rates of revision surgery and conversion to total hip arthroplasty (THA) were recorded. Achievement of minimal clinically important difference (MCID) and patient acceptable symptomatic state (PASS) was compared for the VAS, mHHS, HOS‐ADL, and iHOT‐12 scores between groups. Results The total of 33 and 167 patients were included in the global and focal group, respectively. There were no intergroup differences in age, gender, body mass index or follow‐up times. Lateral center‐edge angle (LCEA) was reduced in both groups postoperatively. Both groups demonstrated significant improvements in PROs compared with preoperative levels at the final follow‐up. The preoperative scores showed significant differences in terms of mHHS (60.34 vs 62.90, P = 0.031) and HOS‐ADL (61.45 vs 64.74, P = 0.022) scores between two groups, and the improvement of HOS‐ADL score was significantly higher in global group (P = 0.027). However, the postoperative scores, including VAS, mHHS, HOS‐ADL, and iHOT‐12 scores, showed no significant differences between two groups. And there were no significant differences in the rate of meeting the PASS and MCID between groups. One (3.0%) in the global group and six (3.6%) patients in the focal group underwent revision arthroscopy respectively, with no significant difference (P = 0.876). There were no conversions to THA in both groups. Conclusions Arthroscopic management of global pincer FAI can achieve excellent functional scores at minimum 2‐year follow‐up. The outcomes were similar to focal pincer FAI patients with a low rate of secondary procedure.

Abstract Aims Increased blood pressure (BP) and decreased heart rate (HR) are signs of stabilization in patients admitted for acute HF. Changes in BP and HR during admission and their correlation with outcomes were assessed in hospitalized patients with heart failure (HF) with reduced ejection fraction (HFrEF). Methods A novel modified reverse shock index (mRSI), defined as the ratio between changes in systolic BP and HR during admission, was devised, and its prognostic value in the early outcomes of acute HF was assessed using the Korean Acute HF registry. Results Among 2697 patients with HFrEF (mean age 65.8 ± 14.9 years, 60.6% males), patients with mRSI ≥1.25 at discharge were significantly younger and were more likely to have de novo HF. An mRSI ≥1.25 was associated with a significantly lower incidence of 60‐day and 180‐day all‐cause mortality [hazard ratio (HR) 0.49, 95% confidence interval (CI) 0.31–0.77; HR 0.62, 95% CI 0.45–0.85, respectively], compared with 1 ≤ mRSI

Chitinase 3‐like 1 (Chi3L1) is associated with various biological processes, such as inflammation, tissue repair, proliferation, cell survival, invasion, and extracellular matrix remodeling. Recent studies indicated that Chi3L1 is critical for cancer development and metastasis. In this study, we demonstrate that Chi3L1 serum and tissue levels were significantly increased in lung cancer patients compared with controls. We previously developed an anti‐Chi3L1‐humanized antibody, and here, we investigate its antitumor and antimetastatic effect. The anti‐Chi3L1 antibody attenuated tumor growth and metastasis both in vitro and in vivo in a lung cancer mouse model. These inhibitory effects are associated with signal transducer and activator of transcription 6 (STAT6)‐dependent M2 polarization inhibition. Proteomics analysis revealed that plasminogen (PLG) interacts with Chi3L1 and affects M2 polarization. Chi3L1 plays a critical role in lung cancer progression, and the anti‐Chi3L1 antibody could be a new anticancer therapy.

Abstract Aims In 2021, vericiguat was approved by the US Food and Drug Administration (FDA) and the European Commission (EC) for reducing cardiovascular mortality and heart failure (HF) hospitalizations in patients with HF with reduced ejection fraction (HFrEF) based on the Vericiguat Global Study in Subjects with Heart Failure with Reduced Ejection Fraction (VICTORIA) trial. However, there has been no report for characterizing the generalizability of vericiguat to real‐world clinical practice. Methods and results The Korean Acute Heart Failure (KorAHF) registry is a multicentre prospective cohort study. A total of 5625 patients who were admitted for HF decompensation were consecutively enrolled. We excluded the patients without left ventricular ejection fraction (LVEF) quantification, patients with LVEF > 45%, patients with in‐hospital death or urgent heart transplantation, and patients without natriuretic peptide measurement. Among a total of 3014 enrolled patients, there were 21.9% patients with lower systolic blood pressure (SBP) (

Conductive cement composites have attracted high attention in recent years due to the possibility of achieving multifunctional materials. The usual approach has been to incorporate steel fiber, carbon fiber, graphite, and carbon nanotube/or carbon nanofiber into the cement matrix. In this article, an experimental comparative study was conducted on the electrical resistivity and compressive strength properties of cement composites incorporating carbon fiber (CF) and steel fiber (SF), which are conductive materials. The electrical resistivity of the conductive fiber-reinforced cement composites (FRCCs) was measured using the four-probe method, and compressive strength was conducted based on the KS L ISO 679 and ASTMC109/C109M test methods. Their performance was compared and analyzed with plain cement composites (PCCs). Afterwards, the fracture surfaces of the conductive SFRCCs (steel fiber-reinforced cement composites) and CFRCCs (carbon fiber-reinforced cement composites) were also analyzed using a scanning electron microscope (SEM). The experimental results showed that, in all specimens, the electrical resistivity gradually increased as the curing ages elapsed, while the electrical resistivity decreased significantly as the fiber volume fractions increased. Overall, the addition of SF up to a fiber volume fraction of 1.25% did not significantly affect the electrical resistivity of cement composites. In contrast, however, the electrical resistivity of CF decreased slightly even at a low dosage (i.e., 0.1–0.3%), and thereafter, it was significantly decreased. The percolation threshold of the conductive CFRCC incorporating CF used in this experiment was 0.4%, and this seemed to be the optimal CF dosage that can greatly improve the conductive cement composites while maintaining the maximum performance of compressive strength. In addition, the compressive strength of conductive SFRCC was higher than that of PCC, whereas in the case of conductive CFRCC, it showed a greater tendency to decrease significantly as the fiber volume fractions increased. We expect the results of SEM image analysis to be useful as basic data for establishing microstructure mechanisms of reinforcement fibers in the cement matrix.

Abstract Aims A waiting period of more than 3 months is recommended for patients before undergoing cardiac resynchronization therapy (CRT). However, due to an anticipated high mortality rate, early implementation of CRT might be beneficial for some patients. We aimed to evaluate the rate and the probability of left ventricular (LV) function improvement and their predictors in patients with heart failure (HF) with indications for CRT. Methods and results From March 2011 to February 2014, a total of 5625 hospitalized patients for acute HF were consecutively enrolled in 10 tertiary hospitals. Among them, we analysed 1792 patients (mean age 63.96 ± 15.42 years, female 63.1%) with left ventricular ejection fraction (LVEF) ≤ 35% at the baseline echocardiography and divided them into three groups: 144 with left bundle branch block (LBBB), 136 with wide QRS complexes without LBBB, and 1512 not having these findings (control). We compared and analysed these three groups for improvement of LV function at follow‐up echocardiography. In patients who met CRT indications (patients with LBBB or wide QRS complexes without LBBB), logistic regression was performed to identify risk factors for no improvement of LV. No improvement of LV was defined as LVEF ≤ 35% at follow‐up echocardiography or the composite adverse outcomes: death, heart transplantation, extracorporeal membrane oxygenation, or use of a ventricular assist device before follow‐up echocardiography. A classification tree was established using the binary recursive partitioning method to predict the outcome of patients who met CRT indications. In a median follow‐up of 11 months, LVEF improvement was observed in 24.3%, 15.4%, and 40.5% of patients with LBBB, wide QRS complexes without LBBB, and control, respectively. Patients meeting CRT indications had higher 3 month mortality rates than the control (24.6% vs. 17.7%, P = 0.002). Multivariable logistic regression analysis revealed that large LV end‐systolic dimension [odds ratio (OR) 1.10, 95% confidence interval (CI) 1.05–1.15, P

Our previous big data analyses showed a high level of association between chitinase 3 like1 (CHI3L1) expression and lung tumor development. In the present study, we investigated whether a CHI3L1‐inhibiting chemical, 2‐({3‐[2‐(1‐cyclohexen‐1‐yl)ethyl]‐6,7‐dimethoxy‐4‐oxo‐3,4‐dihydro‐2‐quinazolinyl}sulfanyl)‐N‐(4‐ethylphenyl)butanamide (K284), could inhibit lung metastasis and studied its mechanism of action. We investigated the antitumor effect of K284 both in vitro and in vivo. K284 (0.5 mg·kg−1 body weight) significantly inhibited lung metastasis in in vivo models after injection of murine melanoma cells (B16F10) or adenocarcinomic human alveolar basal epithelial cells (A549). K284 significantly and concentration‐dependently also inhibited cancer cell proliferation and migration in the A549 and H460 lung cancer cell lines. We found that the binding of K284 to the chitin‐binding domain (CBD) of CHI3L1 prevented the binding of CHI3L1 to its receptor, interleukin‐13 receptor subunit alpha‐2 (IL‐13Rα2), thereby suppressing the CHI3L1 signal. This blocking of the CHI3L1‐IL‐13Rα2 signal caused the inhibition of c‐Jun N‐terminal kinase (JNK)‐activator protein 1 (AP‐1) signals, resulting in the prevention of lung metastasis and cancer cell growth. Our data demonstrate that K284 may serve as a potential candidate anticancer compound targeting CHI3L1.

Abstract Aims Tachycardia is a reversible event that may cause hemodynamic decompensation but may not necessarily cause direct damages to the myocardium. To evaluate the clinical outcomes of patients with heart failure (HF) and atrial fibrillation (AF), whose acute decompensation was tachycardia mediated. Methods and results The Korean Acute Heart Failure registry was a prospective registry that consecutively enrolled 5625 patients with acute HF. Patients were classified into three groups according to the rhythm and aggravating factor: (i) 3664 (65.1%) patients with sinus rhythm (SR), (ii) 1033 (18.4%) patients with AF whose decompensation was tachycardia‐mediated, AF‐TM (+), and (iii) N = 928 (16.5%) patients with AF whose decompensation was not tachycardia‐mediated, AF‐TM (−). The primary outcomes were in‐hospital and post‐discharge 1 year all‐cause mortality. At admission, the mean heart rate was 90.8 ± 23.4, 86.8 ± 26.8, and 106.3 ± 29.7 beats per minute for the SR, AF‐TM (−), and AF‐TM (+) groups, respectively. The AF‐TM (+) group had more favourable characteristics such as de novo onset HF, less diabetes, ischaemic heart disease, and higher blood pressure than the AF‐TM (−) group. In‐hospital mortality rates were 5.1%, 6.5%, and 1.7% for SR, AF‐TM (−), and AF‐TM (+) groups, respectively. In logistic regression analysis, the AF‐TM (+) group had lower in‐hospital mortality after adjusting the significant covariates (odds ratio, 0.49; 95% confidence interval, 0.26–0.93). The mortality rate did not differ between SR and AF‐TM (−) groups. During 1 year follow‐up, 990 (18.5%) patients died. In univariate and multivariate Cox proportional regression analyses, there was no difference in 1‐year all‐cause mortality between the three groups. Conclusions In patients with HF and AF, patients whose acute decompensation is tachycardia‐mediated have better in‐hospital, but similar post‐discharge outcomes compared with those with SR or those with AF whose decompensation is not tachycardia‐mediated. Clinical Trial Registration: ClinicalTrial.gov NCT01389843.

The hip joint is the largest weight‐bearing joint in the body and is surrounded by dense capsules and thick muscles. Hip arthroscopic techniques are suitable for the treatment of hip‐related conditions. These minimally invasive techniques have rapidly developed in China since 2007. Moreover, they have been used in the treatment of gluteal muscle contracture, snapping hip syndrome, femoral acetabular impingement, acetabular labral injury, hip labral calcification, synovial chondroma, osteoid osteoma, synovitis, osteonecrosis of the femoral head, and developmental dysplasia of the hip. This technique has showed its advantage in the total debridement of lesions, precision treatment, and less trauma. However, we lack understanding of the overall development of arthroscopic techniques in China. This review illustrates the recent development of hip arthroscopic techniques in China and related research progress.

Background Chronic vasodilator therapy with long‐acting nitrate is frequently used to treat vasospastic angina. However, the clinical benefits of this approach are controversial. We investigated the prognostic impact of vasodilator therapy in patients with vasospastic angina from the multicenter, prospective VA‐KOREA (Vasospastic Angina in KOREA) registry. Methods and Results We analyzed data from 1895 patients with positive intracoronary ergonovine provocation test results. The patients were divided into 4 groups: no vasodilator (n=359), nonnitrate vasodilator (n=1187), conventional nitrate (n=209), and a combination of conventional nitrate and other vasodilators (n=140). The primary end point was a composite of cardiac death, acute coronary syndrome, and new‐onset arrhythmia at 2 years. Secondary end points were the individual components of the primary end point, all‐cause death, and rehospitalization due to recurrent angina. The groups did not differ in terms of the risk of the primary end point. However, the acute coronary syndrome risk was significantly higher in the conventional nitrate (hazard ratio [HR], 2.49; 95% CI, 1.01–6.14; P=0.047) and combination groups (HR, 3.34; 95% CI, 1.15–9.75, P=0.027) compared with the no‐vasodilator group, as assessed using the inverse probability of treatment weights. Subgroup analyses revealed prominent adverse effects of nitrate in patients with an intermediate positive ergonovine provocation test result and in those with low Japanese Coronary Spasm Association scores. Conclusions Long‐acting nitrate‐based chronic vasodilator therapy was associated with an increased 2‐year risk of acute coronary syndrome in patients with vasospastic angina, especially in low‐risk patients.

Abstract Biodegradable electronics are disposable green devices whose constituents decompose into harmless byproducts, leaving no residual waste and minimally invasive medical implants requiring no removal surgery. Stretchable and flexible form factors are essential in biointegrated electronic applications for conformal integration with soft and expandable skins, tissues, and organs. Here a fully biodegradable MgZnCa metallic glass (MG) film is proposed for intrinsically stretchable electrodes with a high yield limit exploiting the advantages of amorphous phases with no crystalline defects. The irregular dissolution behavior of this amorphous alloy regarding electrical conductivity and morphology is investigated in aqueous solutions with different ion species. The MgZnCa MG nanofilm shows high elastic strain (≈2.6% in the nano‐tensile test) and offers enhanced stretchability (≈115% when combined with serpentine geometry). The fatigue resistance in repeatable stretching also improves owing to the wide range of the elastic strain limit. Electronic components including the capacitor, inductor, diode, and transistor using the MgZnCa MG electrode support its integrability to transient electronic devices. The biodegradable triboelectric nanogenerator of MgZnCa MG operates stably over 50 000 cycles and its fatigue resistant applications in mechanical energy harvesting are verified. In vitro cell toxicity and in vivo inflammation tests demonstrate the biocompatibility in biointegrated use.

This paper presents the results of an experimental investigation conducted to evaluate the mechanical properties, including strength and flexural toughness of hybrid fiber-reinforced mortar (FRM) containing various combinations of steel and carbon fibers with different material characteristics. The mortar specimens were mixed with steel and carbon fibers in the mix proportions of 100 + 0%, 75 + 25%, 50 + 50%, 25 + 75%, and 0 + 100% by volume at a total volume fraction of 1.0%. The flexural performance (flexural strength and toughness) of the mortar specimens was obtained using the third-point loading arrangement stipulated in the test methods of ASTM C 1609/C 1609/M and KS F 2566. In addition, compressive strength was also measured according to the KS F ISO 679 test method. Their mechanical properties were examined and compared with plain mortar (PM) at the age of 28 days. The test results showed the highest compressive and flexural strengths in the hybrid FRM reinforced with 75% steel fibers + 25% carbon fibers, confirming the synergistic reinforcing effect of the steel and carbon hybrid fibers. However, the hybrid FRM reinforced with 50% steel fibers + 50% carbon fibers has obtained slightly low flexural strength but owned the highest flexural toughness and hence can be judged as the most appropriate combination to be employed in hybrid FRM to improve the flexural toughness. Moreover, the fractured FRM surface was also observed via scanning electron microscopy (SEM) after platinum coating in vacuum. These results would be of great help in establishing the microstructural mechanism of hybrid reinforcing fibers in the cement matrix.

In many situations, it would be practical for a computer system user interface to have a model of where a person is looking and what the user is paying attention to. In this study, the authors describe a novel feature coding method for head pose estimation. The widely‐used sparse coding (SC) method encodes a test sample using a sparse linear combination of training samples. However, it does not consider the underlying structure of the data in the feature space. In contrast, locality‐constrained linear coding (LLC) utilises locality constraints to project each input data into its local‐coordinate system. Based on the recent success of LLC, the authors introduce locality‐constrained sparse coding (LSC) to overcome the limitation of Sparse Coding. The authors also propose kernel locality‐constrained sparse coding, which is a non‐linear extension of LSC. By using kernel tricks, the authors implicitly map the input data into the kernel feature space associated with the kernel function. In experiments, the proposed algorithm was applied to a head pose estimation application. Experimental results demonstrated the increased effectiveness and robustness of the method.

Background Many patients with heart failure (HF) with reduced ejection fraction (HFrEF) experience improvement or recovery of left ventricular ejection fraction (LVEF). Data on clinical characteristics, outcomes, and medical therapy in patients with HF with improved ejection fraction (HFiEF) are scarce. Methods and Results Of 5625 consecutive patients hospitalized for acute HF in the KorAHF (Registry [Prospective Cohort] for Heart Failure in Korea) study, 5103 patients had baseline echocardiography and 2302 patients had follow‐up echocardiography at 12 months. HF phenotypes were defined as persistent HFrEF (LVEF ≤40% at baseline and at 1‐year follow‐up), HFiEF (LVEF ≤40% at baseline and improved up to 40% at 1‐year follow‐up), HF with midrange ejection fraction (LVEF between 40% and

Background Many hospitalized patients with heart failure and reduced ejection fraction (HFrEF) have a slow heart rate at discharge, and the effect of β‐blockers may be reduced in those patients. We sought to examine the variable effect of β‐blockers on clinical outcomes according to the discharge heart rate of hospitalized HFrEF patients. Methods and Results The KorAHF (Korean Acute Heart Failure) registry consecutively enrolled 5625 patients hospitalized for acute heart failure. In this analysis, we included patients with HFrEF (left ventricular ejection fraction ≤40%). Slow heart rate was defined as

Background Although current guidelines now define heart failure with midrange ejection fraction (HFmrEF) as HF with a left ventricular EF of 40% to 49%, there are limited data on response to guideline‐directed medical therapy in patients with HFmrEF. The current study aimed to evaluate the association between β‐blocker, renin‐angiotensin system blocker (RASB), or aldosterone antagonist (AA) treatment with clinical outcome in patients with HFmrEF. Methods and Results We performed a patient‐level pooled analysis on 1144 patients with HFmrEF who were hospitalized for acute HF from the KorHF (Korean Heart Failure) and KorAHF (Korean Acute Heart Failure) registries. The study population was divided between use of β‐blocker, RASB, or AA to evaluate the guideline‐directed medical therapy in patients with HFmrEF. Sensitivity analyses, including propensity score matching and inverse‐probability‐weighted methods, were performed. The use of β‐blocker in the discharge group showed significantly lower rates of all‐cause mortality compared with those who did not use a β‐blocker (β‐blocker versus no β‐blocker, 30.7% versus 38.2%; hazard ratio, 0.758; 95% confidence interval, 0.615–0.934; P=0.009). Similarly, the RASB use in the discharge group was associated with the lower risk of mortality compared with no use of RASB (RASB versus no RASB, 31.9% versus 38.1%; hazard ratio, 0.76; 95% confidence interval, 0.618–0.946; P=0.013). However, there was no significant difference in all‐cause mortality between AA and no AA in the discharge group (AA versus no AA, 34.2% versus 34.0%; hazard ratio, 1.063; 95% confidence interval, 0.858–1.317; P=0.578). Multiple sensitivity analyses showed similar trends. Conclusions For treatment of acute HFmrEF after hospitalization, β‐blocker and RASB therapies on discharge were associated with reduced risk of all‐cause mortality. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT01389843.

BackgroundThe optimal duration of β‐blocker therapy in patients with acute myocardial infarction (AMI) is unknown. We aimed to evaluate the late effect of β‐blockers in patients with AMI. Methods and ResultsWe enrolled all consecutive patients who presented with AMI at Seoul National University Bundang Hospital, between June 3, 2003 and February 24, 2015. The primary end point was 5‐year all‐cause mortality, depending on the use of β‐blockers at discharge, 1 year after AMI, and 3 years after AMI. Of 2592 patients, the prescription rates of β‐blockers were 72%, 69%, 63%, and 60% at discharge and 1, 3, and 5 years after AMI, respectively. The patients who were receiving β‐blocker therapy had more favorable clinical characteristics, such as younger age (62 versus 65 years; P

BackgroundWorsening renal function (WRF) is associated with adverse outcomes in patients with heart failure. We investigated the predictors and prognostic value of WRF during admission, in patients with preserved ejection fraction (HFpEF) versus those with reduced ejection fraction (HFrEF). Methods and ResultsA total of 5625 patients were enrolled in the KorAHF (Korean Acute Heart Failure) registry. WRF was defined as an absolute increase in creatinine of ≥0.3 mg/dL. Transient WRF was defined as recovery of creatinine at discharge, whereas persistent WRF was indicated by a nonrecovered creatinine level. HFpEF and HFrEF were defined as a left ventricle ejection fraction ≥50% and ≤40%, respectively. Among the total population, WRF occurred in 3101 patients (55.1%). By heart failure subgroup, WRF occurred more frequently in HFrEF (57.0% versus 51.3%; P

The purpose of this paper is to present a framework to analyze the interaction between an actively controlled magnetic levitation vehicle and a guideway structure under gusty wind. The equation of motion is presented for a 30-dof maglev vehicle model consisting of one cabin and four bogies. In addition, a lateral electromagnetic suspension (EMS) system is introduced to improve the running safety and ride quality of the maglev vehicle subjected to turbulent crosswind. By using the developed simulation tools, the effects of various parameters on the dynamic response of the vehicle and guideway are investigated in the case of the UTM maglev vehicle running on a simply supported guideway and cable-stayed guideway. The simulation results show that the independent lateral EMS and associated control scheme are definitely helpful in improving the running safety and ride quality of the vehicle under gusty wind. In the case of the cable-stayed guideway, at low wind speed, vehicle speed is the dominant factor influencing the dynamic responses of the maglev vehicle and the guideway, but at wind speed over 10 m/s, wind becomes the dominant factor. For the ride quality of the maglev vehicle, wind is also the most influential factor.