Cardiovascular function and disorders (1)

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NURS 315/501 Bootcamp Lecture: Cardiovascular Function and Disorders

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Este articulo es de un grupo de investigadores que realizan mejoramiento genético en la Universidad de Agricultura de Faisalabad en Pakistán, donde evaluaron cultivos de maíz en cuanto el rendimiento que proporcionan como alimento forrajero. Nos cuentan que la producción de maíz en Pakistán es inferior comparado con otros países que cultivan maíz obteniendo en promedio 3940 kg/ha. Se evaluaron distintos genotipos los cuales fueron seleccionados por sus características morfológicas, fisiológicas y agronómicas. Se evaluaron 80 genotipos de maíz en un diseño de bloques completos al azar con tres repeticiones. De estos 80 se seleccionaron 12 genotipos con los mejores rendimientos en base al mayor rendimiento de forraje verde, peso de la hoja, área de la hoja, peso del tallo, relación tallo/hoja, tasa fotosintética, contenido de clorofila, uso eficiente del agua y temperatura de la hoja, realizando cruzas de 6 × 6. Posteriormente se realizaron correlaciones entre el genotipo y las características fenotípicas encontrando correlaciones significativas entre los altos contenidos de clorofila, hojas por planta, peso de la planta, peso del tallo, rendimiento de forraje verde, área de la hoja y la tasa de respiración. Encontrando que los genotipos de cultivos que presentan alto rendimiento de forraje pueden ser útiles para seleccionar cultivos que mejoren el rendimiento de la productividad.

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Journal of Cardiovascular Nursing Vol. 31, No. 6, pp 545Y554 x Copyright B 2016 Wolters Kluwer Health, Inc. All rights reserved. Pharmacology: Evidence Meets Practice Foundations of Pharmacotherapy for Heart Failure With Reduced Ejection Fraction Evidence Meets Practice, Part II Colleen K. McIlvennan, DNP, ANP; Robert L. Page II, PharmD, MSPH, FAHA, BCPS Pharmacologic treatment for systolic heart failure, otherwise known as heart failure with reduced ejection fraction, has been established through clinical trials and is formulated into guidelines to standardize the diagnosis and treatment. Since the introduction of angiotensin-converting enzyme inhibitors and vasodilators in the 1980s, many guideline-recommended therapies have emerged over the past 20 years targeting specific neurohormones, aldosterone, and catecholamines to treat heart failure. Part 2 of this series will describe "-blockers, digoxin, and aldosterone antagonists in the context of the mechanism of action in heart failure, investigational trials that showed beneficial effects, and the practical applications for clinical use. KEY WORDS: "-adrenergic blockers, digoxin, heart failure, guideline, mineralocorticoid receptor antagonists Heart failure (HF) remains aworldwide epidemic and con- tinues to be associated with high morbidity and mortality.1,2 Heart failure is categorized into cases of reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF), primarily because patients with HFrEF seem to benefit from a variety of neurohormonal antagonist and device therapies, whereas most patients with HFpEF do not. Patients with clinical HF are divided roughly equally between HFrEF and HFpEF.3 There have been recent pharmacologic advances in HFrEF; however, there are several mainstay treatments with a strong evidence base that are recommended in the most recent American College of Cardiology Foundation (ACCF) and American Heart Association (AHA) 2013 Guidelines for the Management of Heart Failure.4 This article is the second in a series to describe pharmacologic agents named in the guidelines that impact the morbidity and mortality that is associated with HFrEF. In addition, practical applications for their use are described (see Table 1 for summary of trials for the agents dis- cussed within this review). "-Adrenergic Antagonists Pharmacology/Pathophysiology Within the human myocyte, 3 dif- ferent adrenergic receptors exist: "1, "2, and !1, which are associated with a positive inotropic response and cell growth.5Y7 The "-adrenergic receptors are coupled to the enzyme adenylyl cyclase through G pro- teins, which convert adenosine tri- phosphate to cyclic adenosine monophosphate, which in turn is a positive inotropic and chrono- tropic secondary messenger. The heart has both "1 and "2 receptors, with "1 as the predominant receptor type. In HFrEF, there is down- regulation in the "1 receptor by overexposure to catecholamines, making the "2 recepto.

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