Aims: To evaluate in patients with heart failure (HF) due to systolic dysfunction the occurrence of polypharmacy, alternative medicine, immunization against influenza, and patients' knowledge about their medication. Methods and results: Sixty-five patients, 49 men, mean age 60.5"12.0 years answered a confidential questionnaire during 2002. Polypharmacy was frequent, 48 (74%) were taking six or more pills per day and 18 (28%) 11 or more. Fifteen patients (23%) used over-the-counter analgesics. Eight patients (12%) used alternative medicine wfive women (31%) vs. three men (6%), Ps0.02x. Forty-four patients (68%) received immunization against influenza (18 patients -65 years (54%) vs. 25 patients G65 years (79%), Ps0.03). Half the patients knew that beta-blockers and vasodilators decreased blood pressure, 31 patients receiving diuretics (88%) knew that this drugs help to eliminate liquids, 12 patients (38%) recognized this effect with low dose spironolactone and 23% or less with other drugs. Only 12 patients (42%) treated with acenocoumarol and 13 of those treated with aspirin (32%) recognized the action of these drugs. Conclusion: Patients with HF and systolic dysfunction have a poor knowledge about the medication they receive. Polypharmacy, over-the-counter, homeopathic and alternative medicine use is frequent whereas the rate of immunization against influenza is low.

Survival is similar in women irrespective of LVEF and in men with LVEF >0.3 while men with severely depressed LVEF have a worse prognosis.

Aim: To assess the influence of sex on right ventricular dysfunction (RVD) in patients with severe left ventricular systolic dysfunction. Methods and results:We studied 385 consecutive patients with left ventricular ejection fraction (LVEF) <0.35. All patients underwent invasive measurement of right ventricular and pulmonary artery pressures and evaluation of RVD by standard transthoracic echocardiography. Female patients (n = 84, 21.8%) were significantly older than male patients (62.0 T 11.4 vs. 58.2 T 10.7 years), p = 0.005. The prevalence of RVD was lower in women (26.5%) than in men (38.9%), p = 0.03; both in patients with and without coronary artery disease (19.4% vs. 34.5% and 31.9% vs. 44.4%, respectively). Haemodynamic parameters and LVEF were similar in men and women. Low LVEF, pulmonary systolic pressure, degree of mitral regurgitation, male sex, and absence of significant coronary artery disease were independently correlated with RVD. Although several studies have shown a better prognosis for women with systolic heart failure than for men [1 -6], the reasons for this are largely unknown. In a previous study, we found that severe left ventricular systolic dysfunction is an independent predictor of mortality in men but not in women with heart failure [7] suggesting sex-related differences in the adaptation to a low left ventricular ejection fraction (LVEF).It has been demonstrated that right ventricular dysfunction (RVD) is a crucial determinant of prognosis in patients with left ventricular systolic dysfunction and chronic heart failure. Right ventricular ejection fraction predicts mortality in patients with moderate heart failure [8] and is the variable with the highest short-term prognostic value in patients with severe chronic heart failure [9,10]. It has an even higher prognostic value than mean peak oxygen consumption [9].The prognostic value of right ventricular ejection fraction has been confirmed at rest [8][9][10], during exercise [10], and after acute vasodilator administration [11]. In addition, right ventricular dilatation also correlates with plasma levels of norepinephrine and atrial natriuretic peptide [12], neurohormones which are recognized prognostic markers in heart failure patients.The aim of this study was to assess the influence of sex on RVD in patients with severe left ventricular systolic dysfunction.

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Recently, the existence of a population of stem cells located in the adipose tissue has been observed. Adipose-derived stem cells are able to differentiate into multiple cell lineages including cardiac myocytes. Hence, adipose-derived cells are emerging as a new source of adult stem cells for cardiovascular repair. In this review, we discuss the basic principles of adipose-derived stem cells (types and characteristics, obtention processes, immunophenotypic characterization, and cell potency), the initial experimental studies, and the currently ongoing clinical trials.