In elderly CHF patients (mean age 70-81), exercise training increase 6MWD and improve generic HRQoL, but has no effects on mortality, hospitalisations, peakVO2 and disease-specific HRQoL. The long-term efficacy and safety of exercise training in elderly heart failure patients require further study based on large and rational-designed controlled clinical trials.

Controversy has arisen in regarding the association between serum uric acid (UA) and fracture risk. Therefore, we conducted a systemic review and meta-analysis by pooling estimate of five prospective studies (29,110 participants). Results showed that an increased serum UA level is associated with a lower risk of fracture. Numerous studies have demonstrated that high serum UA is a relevant risk factor for a wide variety of diseases, whereas new understanding in serum uric acid follows recent reports demonstrating a protective role of UA in health status. However, the association between serum UA and fracture remains controversial. Therefore, we conduct a systemic review and meta-analysis to determine whether elevated UA level is a protective factor for fracture among prospective studies. We searched for studies published before May 6, 2016, using PubMed, Embase, and Cochrane databases, without any language restriction. The inclusion criteria were published studies investigating the association between UA and fractures. Two authors independently screened the retrieved articles in accordance to the predefined inclusion criteria. We pooled the study-specific relative risk estimates using a random-effect model for comparison of persons whose UA levels were in the top tertile with those in the bottom tertile. Factors that may predict these associations were evaluated in subgroup analysis and meta-regression. The five included prospective studies included 29,110 participants. In random-effect models that included all five included studies, the summary hazard ratios (HRs) (top vs bottom tertiles) were 079 (95% CI, 0.69 to 0.89), without evidence of heterogeneity (P for heterogeneity = 0.458; I = 0%). Similar results were shown when pooling estimate of three higher-quality studies (HR 0.80 95% CI, 0.69 to 0.93). The association between UA and fracture remained in sensitivity and subgroup analyses. An increased serum UA level is shown to be associated with a lower risk of fracture, albeit additional large, high-quality prospective studies or a meta-analysis of individual data are still needed to verify the association.

Objective: To investigate the mechanism of α-allocryptopine-induced inhibition of the transient outward potassium current (I_to) in rabbit left-ventricular myocytes. Methods: We used the whole-cell patch-clamp technique to record the I_to in the myocytes, which were isolated from the rabbit left ventricle by a Langendorff-perfusion device. Results: Allocryptopine decreased the amplitude and the density of the I_to in a concentration-dependent (range from 1 to 100 µM with an IC₅₀ value of 37 ± 8 µM) and frequency- or use-independent manner. At a test potential of +50 mV, the peak current density of I_to was decreased from 21.56 ± 3.24 to 13.37 ± 2.86 pA/pF by 30 µM allocryptopine. The fast time constant of I_to inactivation was reduced from 9.8 ± 1.8 to 5.7 ± 0.7 ms and the slow time constant of I_to was reduced from 50.8 ± 9.0 to 32.2 ± 12.7 ms by 30 µM allocryptopine. The inactivated curve slope was changed from –19.2 ± 7.1 to –7.5 ± 0.6 mV, while the half-activated voltage and activated curve slope and half-inactivated voltage values were not affected by allocryptopine. Transmural heterogeneity of the I_to was decreased in the presence of allocryptopine. At a test potential of +50 mV, the densities of I_to were reduced by 28.6% (epimyocardium), 50.3% (midmyocardium) and 20.1% (endocardium) after expoure to 30 µM allocryptopine.Transmural dispersion of the I_to was reduced from 11.2 ± 1.2 to 4.7 ± 0.6 pA/pF by 30 µM allocryptopine. Conclusion: Allocryptopine produced a blocking effect on the I_to in cardiac myocytes, which may be an important mechanism in its antiarrhythmic effect.

No abstract

No abstract