CHOLESTEROL AND CHLORIDE IN ACUTE HEART FAILURE

FAMILY PHYSICIAN OPINIONS ON ELECTRONIC TOOLS AND CARDIOVASCULAR DISEASE PREVENTION GUIDELINE AVAILABILITY, USAGE AND ADHERENCE IN CROATIA

Family physicians are burdened with a great number of guidelines considering different conditions they treat. We analyzed opinions of family physicians on electronic tools which help managing chronic conditions and their influence on patient care by cardiovascular disease (CVD) prevention guideline availability, usage and adherence. A descriptive study was performed on a convenient sample of 417 (response rate 56.0%) Croatian family physicians. Data on physician characteristics and availability, usage and adherence to CVD prevention guidelines were analyzed. The χ2-test was used for comparisons. Significance was defined as p<0.05. Family physicians who used additional electronic tools in Electronic Health Record software on more than 80% of their patients had CVD prevention guidelines more available (p<0.01) and used them more frequently (p<0.01). A group who used electronic tools on more than 80% of their patients had CVD prevention guidelines available to them frequently and used them on more than 60% of their patients, also strictly adhering to the guidelines (p<0.01). Physicians who used CVD prevention guidelines on more than 60% of their patients spent more time doing patient education (p=0.036). Using electronic tools helps Croatian family physicians in terms of availability, usage and adherence to the guidelines and quality improvement.

LDL‑induced NLRC3 inflammasome activation in cardiac fibroblasts contributes to cardiomyocytic dysfunction

Heart failure (HF) is a progressive myocardial disease that affects pulse rate. Notably, chronic inflammation serves a crucial role in cardiac dysfunction and HF. Appropriate cardiomyocyte‑fibroblast communication is essential for cardiac function. In addition, cardiac fibroblasts (CFs) are the main cellular population in the cardiac microenvironment; therefore, determining the role of CFs in HF progression and the associated molecular basis is important. In the present study, ELISAs were performed to detect inflammatory factors in the sera of patients with HF and their association with CF activation was analyzed using Pearson's correlation coefficient. The mechanism underlying the proinflammatory phenotype of CFs was investigated via western blotting. Notably, the levels of IL10 and TNF‑α were significantly increased in the sera of patients with HF. Further analysis revealed that CFs were extensively activated in the cardiac tissues of patients with HF and released excessive amounts of cytokines, which could impair the viability of cardiomyocytes. Moreover, low‑density lipoprotein (LDL)‑induced NLRC3 inflammasome was activated in CFs, which gave rise to proinflammatory phenotypes. Targeting LDL in CFs significantly improved the functioning of cardiomyocytes and inhibited apoptosis. These findings highlighted the critical role of LDL in inflammasome activation; to the best of our knowledge, the present study is the first to reveal that CF‑induced microenvironmental inflammation may suppress cardiomyocyte viability. The present study established the cellular basis for CF activation during HF progression and provided information on the cellular interactions important for HF treatment.