Diagnostic and prognostic value of circulating micro RNAs in heart failure with preserved and reduced ejection fraction

micro RNAs(mi RNAs) are powerful regulators of posttranscriptional gene expression and play an important role in pathophysiological processes. Circulating mi RNAs can be quantified in body liquids and are promising biomarkers in numerous diseases. In cardiovascular disease mi RNAs have been proven to be reliable diagnostic biomarkers for different disease entities. In cardiac fibrosis(CF) and heart failure(HF) dysregulated circulating mi RNAs have been identified,indicating their promising applicability as diagnostic biomarkers. Some mi RNAs were successfully tested in risk stratification of HF implementing their potential use as prognostic biomarkers. In this respect mi RNAs might soon be implemented in diagnostic clinical routine. In the young field of mi RNA based research advances have been made in identifying mi RNAs as potential targets for the treatment of experimental CF and HF. Promising study results suggest their potential future application as therapeutic agents in treatment of cardiovascular disease. This article summarizes the current state of the various aspects of mi RNA research in the field of CF and HF with reduced ejection fraction as well as preserved ejection fraction. The review provides an overview of the application of circulating mi RNAs as biomarkers in CF and HF and current approaches to therapeutically utilize mi RNAs in this field of cardiovascular disease.

Challenging aspects of treatment strategies in heart failure with preserved ejection fraction: “Why did recent clinical trials fail?”

Heart failure(HF) is the leading cause of hospitalization among older adults and the prevalence is growing with the aging populations in the Western countries. Epidemiologic reports suggest that approximately 50% of patients who have signs or symptoms of HF have preserved left ventricular ejection fraction. This HF type predominantly affects women and the elderly with other co-morbidities, such as diabetes, hypertension, and overt volume status. Most of the current treatment strategies are based on morbidity benefits such as quality of life and reduction of clinical HF symptoms. Treatment of patients with HF with preserved ejection fraction displayed disappointing results from several large randomized controlled trials. The heterogeneity of HF with preserved ejection fraction, understood as complex syndrome, seems to be one of the primary reasons. Here, we present an overview of the current management strategies with available evidence and new therapeutic approach from drugs currently in clinical trials, which target diastolic dysfunction, chronotropic incompetence, and risk factor management. We provide an outline and interpretation of recent clinical trials that failed to improve outcome and survival in patients with HF with preserved ejection fraction.

System security of hybrid AC-HVDC-systems challenges and new approaches for combined security assessment,preventive optimization and curative actions

The intense application of Voltage Source Converter based HVDC interconnections and grids will result in a hybrid AC-HVDC-system. The operation of such a system becomes complex regarding system security and system operation. This paper describes major challenges and proposes potential solutions, including a combined security assessment, preventive optimization and curative actions. A coordination of both systems enables an efficient application of existing transport capacity.

Low immunogenicity of endothelial derivatives from rat embryonic stem cell-like cells

胚胎的干细胞(转换字符) 被建议给予免疫者优惠，但是他们带不受管束的扩大和恶意的风险。在区别之上，他们失去他们的形成肿瘤的能力，但是他们由 MHC 分子的一个正常集合的表示变得产生免疫性。这 immunogenicity 可能在再生治疗在申请以后触发拒绝。在这学习 MHC 表情和对老鼠的 endothelial 衍生物的有免疫力的回答胚胎的茎在煽动性的条件下面的像房间的房间(RESC ) 与主要老鼠相比被决定大动脉的 endothelial 房间(EC ) 。细胞以及体液紧密相联识别在 vitro 被分析。另外，在 vivo 的有免疫力的反应被干扰素的紧密相联抗体的生产和决心估计 -- 纬(IFN 纬)-secreting 紧密相联反应的 T 房间。RESC 衍生物表示了 MHC 一级，和没有 MHC 班 II 的低却重要的层次。响应 IFN 纬 MHC 一级，表达式被提高，当类 II transactivator 正式就职在这些房间完全失败了时；MHC 班 II 表示仍然保持一致地不在。机能上地， RESC 衍生物显示出一个减少的 allo-stimulatory 能力，保护对体液在到细胞毒素的 T 房间细胞溶解的 vitro 和稍微减少的危险性紧密相联识别。而且，在 vivo，实验证明这些细胞不触发宿主免疫者反应，由没有紧密相联抗体的生产和紧密相联反应的记忆 T 细胞的没有正式就职描绘了。我们的结果证明 RESC 的 endothelial 衍生物甚至在煽动性的条件下面有特殊减少的产生免疫性的力量。