Prevalence, risk factors, and survival associated with pulmonary hypertension and heart failure among patients with underlying coronary artery disease: a national prospective, multicenter registry study in China

Background: Coronary artery disease (CAD) is the commonest cause of heart failure (HF), whereas pulmonary hypertension (PH) has not been established or reported in this patient population. Therefore, we assessed the prevalence, risk factors, and survival in CAD-associated HF (CAD-HF) complicated with PH.Methods: Symptomatic CAD-HF patients were continuously enrolled in this prospective, multicenter registry study. Echocardiography, coronary arteriography, left and right heart catheterization (RHC), and other baseline clinical data were recorded. Patients were followed up and their survival was recorded.Results: One hundred and eighty-two CAD-HF patients were enrolled, including 142 with HF with a preserved ejection fraction (heart failure with preserved ejection fraction [HFpEF];left ventricular ejection fraction [LVEF] ≥50%) and 40 with a reduced ejection fraction (heart failure with reduced ejection fraction [HFrEF];LVEF < 50%). PH was diagnosed with RHC in 77.5% of patients. Patients with PH showed worse hemodynamic parameters and higher mortality. HFrEF-PH patients had worse survival than HFpEF-PH patients. CAD-HF patients with an enlarged left ventricular end-diastolic diameter and reduced hemoglobin were at higher risk of PH. Nitrate treatment reduced the risk of PH. Elevated creatinine and mean pulmonary arterial pressure (mPAP), diastolic pressure gradient (DPG) ≥7 mmHg, and previous myocardial infarction (MI) entailed a higher risk of mortality in CAD-HF patients with PH.Conclusions: PH is common in CAD-HF and worsens the hemodynamics and survival in these patients. Left ventricle enlargement and anemia increase the risk of PH in CAD-HF. Patients may benefit from nitrate medications. Renal impairment, elevated mPAP, DPG ≥7 mmHg, and previous MI are strong predictors of mortality in CAD-HF-PH patients.Trial Registration: ClinicalTrials.gov, NCT02164526.

Probing the effects of external species on poly(acrylate acid) chain dynamics by using cationic AIE-active fluorophore

We report here our results on the investigation of the chain dynamics of poly(acrylic acid) in aqueous solution. The concentration of poly(acrylic acid) was approximately 3.8×10^(-4) mol/L, two orders of magnitude higher than that reported in the literature. The p H value of the solution was 3.9, and the hydrogen bonds between the intrinsic and ionized carboxylic acid groups formed dynamic networks, which captured aggregation-induced emission-active molecules(a tetra-quaternary ammonium modified tetraphenylethene derivative) inside the polymer coils and induced fluorescence emission. The hydrogen bonds can be classified as intra- or intermolecular; both can be probed based on the emission change of the tetra-quaternary ammonium modified tetraphenylethene probes. The effects of different external stimuli on the polymer chain dynamics were investigated using different metal cations(including Na^+, Li^+, Zn^(2+), Ni^(2+), Ca^(2+), and Co^(2+)), different cation concentrations(1×10^(-6) to 4×10^(-4) mol/L), different poly(acrylic acid) molecular weights(5, 240, and 450 k Da), and different copolymers. The experimental results indicate that the long poly(acrylic acid) chains(high molecular weight) tend to form dense globular coils and exclude the probe molecules outside, which are robust and unsusceptible to water-soluble metal cations. However, the shorter poly(acrylic acid) chains tend to form intermolecular hydrogen bonds, which are helpful in capturing more probe molecules inside the networks, thus inducing stronger emission. Because of the dual functions of forming hydrogen bonds with carboxylic groups and acting as an acceptor of protons from the carboxylic acid group to form cationic species, copolymerization with acrylate amide [poly(acrylic acid)-co-poly(acrylamide)] can greatly affect the chain dynamics of poly(acrylic acid) segments, which is reflected by the drastically decreased emission intensity from the fluorescent probes.

Charge transport:through space keeps up with the pace

Charge transport is a fundamental and crucial process in organic electronics.Modern understanding of the transport has shown that,on single molecule level,this process can be described by through bond(TB)and through space(TS)models.The quantitative deciphering of the TB process

An air-stable supported Cu(?) catalyst for azide-alkyne click polymerization

An air-stable supported Cu(I) catalyst, Cu I@PS-Phen, was designed and synthesized. Cu I@PS-Phen can efficiently catalyze the click polymerization of diynes a and diazides b to produce soluble and thermally stable polytriazoles with high molecular weights(Mw up to 30800), and low copper residue content(down to 190 ppm) in high yields(up to 94.2%) under mild reaction conditions without the exclusion of oxygen.