ABSTRACT >To quantitatively evaluate the effect of stubble height and mulching on soil resistance to wind erosion in protected cultivated chestnut soil farmland under different wind speed conditions, tests were carried out on conservation and conventional tillage in Mongolian Plateau, China, using a mobile wind erosion wind tunnel. Chestnut soils were a soil type in fragile semi-arid ecosystems that were susceptible to desertification following wind erosion and were found mainly in Central Asia and the North American continent. The results show that soil erosion on conservation tillage was lower than conventional tillage at different wind speeds. The resistance of conservation tillage to soil wind erosion increases with increasing stubble height and cover. At a stubble height of 300 mm and 50% cover, conservation tillage's average wind erosion resistance efficiency was 74.82%, effectively preventing wind erosion of agricultural soils.

Resumo Para avaliar quantitativamente o efeito da altura do restolho e da cobertura morta na resistência do solo à erosão do vento em terras cultivadas protegidas de castanheiros sob diferentes condições de velocidade do vento, foram realizados testes de conservação e lavoura convencional no planalto da Mongólia, China, utilizando um túnel móvel de vento de erosão do vento. Os solos de castanha são um tipo de solo em ecossistemas semi-áridos frágeis que são suscetíveis à desertificação após a erosão pelo vento e são encontrados principalmente na Ásia Central e no continente norte-americano. Os resultados mostram que a erosão do solo na lavoura de conservação é menor do que a lavoura convencional em diferentes velocidades de vento. A resistência da lavoura de conservação à erosão do solo pelo vento aumenta com o aumento da altura do restolho e da cobertura. Com uma altura do restolho de 300 mm e uma cobertura de 50%, a eficiência média de resistência da lavoura de conservação à erosão pelo vento é de 74,82%, evitando efetivamente a erosão pelo vento dos solos agrícolas.

Acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) is a critical respiratory syndrome with limited effective interventions. Lung macrophages play a critical role in the pathogenesis of abnormal inflammatory response in the syndrome. Recently, impaired fatty acid oxidation (FAO), one of the key lipid metabolic signalings, was found to participate in the onset and development of various lung diseases, including ALI/ARDS. Lipid/fatty acid contents within mouse lungs were quantified using the Oil Red O staining. The protective effect of FAO activator L-carnitine (Lca, 50, 500, or 5 mg/mL) was evaluated by cell counting kit 8 (CCK-8) assay, real-time quantitative PCR (qPCR), ELISA, immunoblotting, fluorescence imaging, and fluorescence plate reader detection in lipopolysaccharide (LPS) (100 ng/mL)-stimulated THP-1-derived macrophages. The in vivo efficacy of Lca (300 mg/kg) was determined in a 10 mg/kg LPS-induced ALI mouse model. We found for the first time that lipid accumulation in pulmonary macrophages was significantly increased in a classical ALI murine model, which indicated disrupted FAO induced by LPS. Lca showed potent anti-inflammatory and antioxidative effects on THP-1 derived macrophages upon LPS stimulation. Mechanistically, Lca was able to maintain FAO, mitochondrial activity, and ameliorate mitochondrial dynamics. In the LPS-induced ALI mouse model, we further discovered that Lca inhibited neutrophilic inflammation and decreased diffuse damage, which might be due to the preservation of mitochondrial homeostasis. These results broadened our understanding of ALI/ARDS pathogenesis and provided a promising drug candidate for this syndrome.

Abstract Background: UVB irradiation can cause acute damage such as sunburn, or photoaging and melanoma, all of which are major health threats. Objective: This study was designed to investigate the mechanism of skin photoaging induced by UVB radiation in mice through the analysis of the differential expression of miRNAs. Methods: A UVB irradiation photoaging model was constructed. HE and Masson special stains were used to examine the modifications in the epidermis and dermis of mice. The miRNA expression profiles of the mouse skin model exposed to UVB radiation and the normal skin of mice were analyzed using miRNA-sequence analysis. GO and Pathway analysis were employed for the prediction of miRNA targets. Results: A total of 23 miRNAs were evaluated for significantly different expressions in comparison to normal skin. Among them, 7 miRNAs were up-regulated and 16 were down-regulated in the skin with photoaging of mice exposed to UVB irradiation. The differential expression of miRNA is related to a variety of signal transduction pathways, among which mmu-miR-195a-5p and mitogen-activated protein kinase (MAPK) signal pathways are crucial. There was a significant differential expression of miRNA in the skin of normal mice in comparison with the skin with photoaging induced by UVB irradiation. Study limitations: Due to time and energy constraints, the specific protein level verification, MAPK pathway exploration, and miR-195a-5p downstream molecular mechanism need to be further studied in the future. Conclusions: UVB-induced skin photoaging can be diagnosed and treated using miRNA.

RESUMO Para construir um modelo de simulação acoplada da erosão eólica do solo e fluxo bifásico em regiões áridas e semi-áridas, os parâmetros de contato apropriados do modelo de simulação de elementos discretos do solo são obtidos com base no teste de calibração do ângulo de repouso (AoR). O modelo de simulação acoplado foi estabelecido através da combinação da dinâmica computacional dos fluidos. O valor de resposta da velocidade do vento de iniciação da areia foi usado para verificar a precisão do modelo. Devido às características dos solos áridos e semi-áridos, este trabalho usa o modelo de contato Hertz-Mindlin com JKR no software EDEM para calibrar os parâmetros do solo com base nos testes físicos do solo, e projeta o Plackett-Burman, a subida mais íngreme, e os testes Box-Behnken de acordo com o software Design-Expert para obter a regressão de segunda ordem do AoR do solo. Com o AoR 33,52° como alvo, obtém-se a melhor combinação de parâmetros: recuperação de colisão solo-solo 0,64, coeficiente de atrito estático solo-aço 0,31, energia de superfície JKR 3,302 J m-2. Finalmente, usando parâmetros calibrados e a velocidade do vento inicial como valor de resposta, o teste de fluxo de ar e vento sólido de duas fases foi conduzido em ANSYS Fluent e EDEM, com o erro relativo entre a velocidade do vento inicial registrada pela câmera de alta velocidade no teste de túnel de vento e a velocidade do vento inicial mostrada no modelo de simulação calculada em 8,7%, e os parâmetros calibrados do solo atenderam aos requisitos da simulação acoplada. Os resultados da simulação indicam que os parâmetros de calibração do solo podem ser utilizados para modelar a erosão do vento em duas fases do solo em ambientes semi-áridos.

ABSTRACT To construct a coupled simulation model of soil wind erosion and two-phase flow in arid and semiarid regions, the proper contact parameters of the soil discrete element simulation model are obtained based on the angle of repose (AoR) calibration test. The coupled simulation model is established by combining computational fluid dynamics. The response value of the wind speed of sand initiation is used to verify the model’s accuracy. Due to the characteristics of arid and semiarid soils, this paper uses the Hertz-Mindlin with JKR contact model in EDEM software to calibrate the soil parameters based on soil physical tests and designs the Plackett-Burman, steepest climb, and Box-Behnken tests according to Design-Expert software to obtain the soil AoR second-order regression. With the AoR of 33.52° as the target, the best combination of parameters is obtained: soil-soil collision recovery of 0.64, soil-steel static friction coefficient of 0.31, JKR surface energy of 3.302 J m-2. Finally, by using calibrated parameters and the threshold wind velocity as the response value, the wind-sand air-solid two-phase flow test is conducted in ANSYS Fluent and EDEM, with the relative error between the starting wind speed recorded by the high-speed camera in the wind tunnel test and the threshold wind velocity shown in the simulation model calculated to be 8.7%, and the calibrated soil parameters met the requirements of the coupled simulation.

Resumo O objetivo do estudo foi investigar os efeitos da atividade física (AF) na variabilidade da frequência cardíaca (VFC) em crianças e adolescentes. Realizamos uma pesquisa nas bases Web of Science, PubMed, ScienceDirect, Springer-Link e EBSCO-host. A Escala Newcastle-Ottawa revisada foi utilizada para avaliar o risco de enviesamento. Um total de 21 estudos foi incluído. De forma geral, foram encontradas associações de médio porte entre AF e baixa frequência e alta frequência em crianças e adolescentes. O alto nível de AF teve um desvio padrão significativamente maior dos intervalos e raiz da média da soma dos quadrados de diferenças entre os intervalos RR adjacentes em crianças e adolescentes. Os efeitos de AF sobre VFC foram consistentes em crianças e adolescentes. Nossa revisão sistemática e meta-análise revelou que AF e VFC em crianças e adolescentes são de médio porte. Promover a participação de crianças e adolescentes em atividade física de moderada à vigorosa (AFMV) aumentará a atividade nervosa parassimpática e diminuirá a atividade nervosa simpática. Nossas descobertas apoiam a motivação de crianças e adolescentes a se envolverem mais na AFMV em suas vidas diárias para melhorar o funcionamento do sistema nervoso autônomo e promover a segurança cardiovascular.

Abstract The aim of the study was to investigate the effects of physical activity (PA) on heart rate variability (HRV) in children and adolescents. We conducted a research of Web of Science, PubMed, ScienceDirect, Springer-Link and EBSCO-host. The revised Newcastle-Ottawa Scale was used in an investigative analysis to assess bias risk. A total of 21 studies were included. Overall, medium-sized associations were found between PA and low frequency and high frequency in children and adolescents. High PA level had significantly higher standard deviation of RR intervals and root of the mean of the sum of the squares of differences between adjacent RR intervals in children and adolescents. The effects of PA on HRV were consistent in children and adolescents. Our systematic review and meta-analysis revealed medium-sized between PA and HRV in children and adolescents. Promoting children’s and adolescents’ participation in moderate-to-vigorous physical activity (MVPA) will increase parasympathetic nerve activity and decreased sympathetic nerve activity. Our findings support motivating children and adolescents to engage in more MVPA in their daily lives to improve autonomic nervous system function and promote cardiovascular safety.

Resumo O objetivo do estudo foi investigar os efeitos da atividade física (AF) na variabilidade da frequência cardíaca (VFC) em crianças e adolescentes. Realizamos uma pesquisa nas bases Web of Science, PubMed, ScienceDirect, Springer-Link e EBSCO-host. A Escala Newcastle-Ottawa revisada foi utilizada para avaliar o risco de enviesamento. Um total de 21 estudos foi incluído. De forma geral, foram encontradas associações de médio porte entre AF e baixa frequência e alta frequência em crianças e adolescentes. O alto nível de AF teve um desvio padrão significativamente maior dos intervalos e raiz da média da soma dos quadrados de diferenças entre os intervalos RR adjacentes em crianças e adolescentes. Os efeitos de AF sobre VFC foram consistentes em crianças e adolescentes. Nossa revisão sistemática e meta-análise revelou que AF e VFC em crianças e adolescentes são de médio porte. Promover a participação de crianças e adolescentes em atividade física de moderada à vigorosa (AFMV) aumentará a atividade nervosa parassimpática e diminuirá a atividade nervosa simpática. Nossas descobertas apoiam a motivação de crianças e adolescentes a se envolverem mais na AFMV em suas vidas diárias para melhorar o funcionamento do sistema nervoso autônomo e promover a segurança cardiovascular.

Abstract The aim of the study was to investigate the effects of physical activity (PA) on heart rate variability (HRV) in children and adolescents. We conducted a research of Web of Science, PubMed, ScienceDirect, Springer-Link and EBSCO-host. The revised Newcastle-Ottawa Scale was used in an investigative analysis to assess bias risk. A total of 21 studies were included. Overall, medium-sized associations were found between PA and low frequency and high frequency in children and adolescents. High PA level had significantly higher standard deviation of RR intervals and root of the mean of the sum of the squares of differences between adjacent RR intervals in children and adolescents. The effects of PA on HRV were consistent in children and adolescents. Our systematic review and meta-analysis revealed medium-sized between PA and HRV in children and adolescents. Promoting children’s and adolescents’ participation in moderate-to-vigorous physical activity (MVPA) will increase parasympathetic nerve activity and decreased sympathetic nerve activity. Our findings support motivating children and adolescents to engage in more MVPA in their daily lives to improve autonomic nervous system function and promote cardiovascular safety.

Abstract To explore the critical care treatment and clinical outcome of patients with severe aneurysmal subarachnoid hemorrhage (SaSAH), and to provide clinical evidence for the treatment of patients with SaSAH. 160 patients with SaSAH of Hunt and Hess (H&H) grade III or above in the neurosurgical critical care unit at ourospital between June 2016 and June 2018 were enrolled in this study. Patients were treated with brain protective bundle based on step-wised protocol under multimodal monitoring and followed up for 3 months. The incidence of various clinical complications and the clinical prognosis after discharge were statistically analyzed. Furthermore, it carried on the correlation analysis to the risk factors and the prognosis. In 160 patients with SaSAH, 127 patients had responsible aneurysms located in the anterior circulation, and the other 33 patients were located in the posterior circulation. 70 patients (43.8%) underwent transcranial clipping, 81 patients (50.6%) underwent endovascular embolization and 9 patients (5.6%) did not intervene. Patients with IV and V grades of Glasgow Outcome Scale (GOS) were considered good recovery, and those with grade I, II and III were poor prognosis. The 30-day good prognosis rate was 41.3% (66/160) and the poor prognosis rate was 58.7% (94/160). Multivariate logistic regression analysis showed that the Hunt & Hess classification correlated well with prognosis (OR: 4.367,95% CI, 2.254-8.460, P < 0.001). The clinical prognosis of patients with SaSAH is still poor. In particular, under the critical care of neurosurgery, the application of brain protective bundle based on step-wised protocol under multimodal monitoring might improve the clinical prognosis of patients with SaSAH.

Abstract The Clerodendranthus spicatus (Thunb.) C. Y. Wu extract (CSTCYWE) was administered to D-galactose-induced aging mice to investigate the effect and mechanism of CSTCYWE on exercise endurance in aging mice. The effect of CSTCYWE on the improvement of exercise capacity in aging mice was evaluated by detecting serum biochemical indicators, pathological changes in tissues, and expression by qPCR. The composition of CSTCYWE was analyzed by HPLC. The experiment showed that CSTCYWE increased the running time and the exhaustive swimming time of aging mice to improve their exercise endurance. CSTCYWE also reduced the levels of BUN, BLA, and MDA and increased the levels of HG, MG, SOD, and GSH-Px in the serum of aging mice. Pathological observation found that CSTCYWE alleviated the liver and kidney tissue lesions and damage caused by aging. Meanwhile, CSTCYWE could down-regulate the relative mRNA expressions of nNOS, iNOS, TNF-α, and syncytin-1 and up-regulate the relative mRNA expressions of Cu/Zn-SOD, Mn-SOD, and CAT in the mouse liver tissue and skeletal muscle tissue. The results of component analysis showed that CSTCYWE contained caffeic acid, hypericin, isoquercetin, dihydroquercetin, rosmarinic acid, baicalin, luteolin, and baicalein. These active ingredients enable CSTCYWE to act on aging mice and improve their exercise capacity.

Abstract A summarized physicochemical profile of nine multifloral honeys produced by Apis cerana cerana Fabricius in Qiongzhong region located in Hainan province was exhibited, regarding pH (3.72-4.02), moisture (19.20-22.53%), fructose (34.40-38.70 g 100 g-1), glucose (31.60-35.05 g 100 g-1), sucrose (less than 3%), color (31.00-80.00 mm Pfund), ash content (0.17-0.45 g 100 g-1), soluble solid (75.87-79.10 ◦Brix), and electrical conductivity (343.67-678.33 μS cm-1). Potassium showed the highest concentration, followed by calcium. Manganese, boron, iron, aluminium, and zinc were the main micro-elements while cadmium and hydrargyrum were not detected in all honey samples. The antiradical activity was shown to be significantly negative correlated with total phenolic content (TPC) (r2 = −0.756) and total flavonoid content (TFC) (r2 = −0.477). Among all tested honey samples, sample A exhibited the highest levels of TPC (45.46 mg GAE 100 g-1), TFC (10.02 mg RE 100 g-1), and antiradical activity (DPPH IC50 = 2.63 mg mL-1). Our results will be useful in determining to set the standard for A. cerana cerana honey.

Abstract Objective To explore the molecular mechanism of neuropathologic damage induced by radiofrequency ablation at different temperatures. Methods This is basic research, and 36 SD rats were used to construct the neuropathological injury model. The rats were subjected to radiofrequency stimulation at different temperatures and were divided into 6 groups according to the temperature injury: 42°, 47°, 52°, 57°, 62°, and 67°C groups. Conduction time, conduction distance, and nerve conduction velocity were recorded after temperature injury. HE-staining was used to observe the histopathological morphology of the sciatic nerve. The expression of SCN9A, SCN3B, and NFASC protein in sciatic nerve tissue were detected by western blot. Results With the increase in temperature, nerve conduction velocity gradually decreased, and neurons were damaged when the temperature was 67°C. HE-staining showed that the degrees of degeneration of neurons in rats at 47°, 52°, 57°, 62°, and 67°C were gradually increased. The expression of SCN9A, SCN3B protein in 57°, 62°, 67°C groups were much higher than that of NC, 42°, 47°, 52°C groups. However, the expression of NFASC protein in 57°, 62°, 67°C groups was much lower than that of the NC, 42°, 47°, 52°C groups. Conclusion There was a positive correlation between temperature caused by the radiofrequency stimulation to neuropathological damage. The mechanism is closely related to the expression of SCN9A, SCN3B, and NFASC protein in nerve tissue caused by heat transfer injury.

Abstract Thermophilic bacteria play an important role in aroma formation during pile-fermentation process of dark tea. With the aim to reveal the impact of thermophilic bacteria on volatile compounds in dark tea, Bacillus licheniformis (thermophilic bacteria) were inoculated into sun-dried green tea for spontaneous fermentation. In this study, headspace solid phase microextraction combined to gas chromatography mass spectrometry (HS-SPME-GC-MS), odor activity value (OAV), principal component analysis (PCA) and orthogonal partial least squares discrimination analysis (OPLS-DA) were employed to investigated the characteristics of volatile compounds during thermophilic bacteria pile-fermentation. According to HS-SPME-GC-MS, a total of 64 volatile compounds were identified. PCA revealed that tea samples could be clearly discriminated from each other. Furthermore, sulcatone, hexanoic acid, linalool, 2-methyl-trans-decalin, myrtenal, and α-ionone were found to play an important role in discrimination of tea samples, based on OPLS-DA. In addition, the OAV could effectively characterize the aroma contribution of volatile compounds during thermophilic bacteria pile-fermentation, and (Z)-linalool oxide (furanoid), α-ionone, (E)-2-nonenal, and linalool were the critical volatile compounds of aroma quality in dark tea. This study provides insight into volatile compounds characteristics during thermophilic bacteria pile-fermentation in dark tea.

Abstract Selenium is an essential trace element in the human diet and has anti-aging, anti-tumor, and immunity boosting effects. In this study, the effects of selenium on Tartary buckwheat (Fagopyrum tataricum L.) sprouts were investigated. A suitable concentration of selenium had no adverse effects on the growth of Tartary buckwheat seedlings. The soluble sugar, protein, total flavonoid, and total phenol concentrations in the selenium-treated sprouts were higher than those in the untreated control sprouts. Electronic tongue measurements indicated that the taste characteristics, especially the sweetness and umami, of the selenium-treated and untreated groups were significantly different. Sensory analysis showed that selenium-treated Tartary buckwheat sprouts had good acceptability. Selenium-enriched Tartary buckwheat sprouts are a promising product, both in terms of flavor and as a useful source of selenium to increase human dietary intake.

SUMMARY: The Wnt pathway is essential for the initiation of lizard tail regeneration. The regenerated lizard tails exhibit obvious morphological differences compared to the original ones. The expression of Wnt1 and Wnt2b proteins in the regenerating tail of Scincella tsinlingensis was detected by immunohistochemistry and then comparatively analyzed for ultrastructural changes in the original and regenerated spinal cord. The ependymal layer of the original spinal cord was pseudostratified with multiciliated cells and primary monociliated cells, while the cells of the ependymal layer of the regenerated spinal cord were organized in a monolayer with a few biciliated cells. Immunolocalization indicated that Wnt1 and Wnt2b were mainly distributed in the dermis near the original tail stump, spinal cord, and clot-positive migratory cells during Stage I, 0-1 days post-amputation (dpa). Wnt1 and Wnt2b were predominantly detected in the epaxial and hypaxial musculature near the original tail stump, wound epithelium, and spinal cord in the original tail during Stage II, 1-7 dpa. Mesenchymal cells and wound epithelium showed immunostaining during Stage III and IV, 7-15 dpa. The ependymal tubes contained these signaling proteins during Stage V and VI, 20- 30 dpa. Labeling was mainly observed in nearby regenerative blood vessels, ependymal cells, epaxial and hypaxial musculature in the apical epithelial layer (AEC) after 45-160 dpa. These findings indicated that Wnt1 and Wnt2b proteins presented primarily in regenerating epidermis and nerve tissues were a critical signal for tail regeneration in S. tsinlingensis.

RESUMEN: La vía Wnt es esencial para el inicio de la regeneración de la cola del lagarto. Las colas de lagarto regeneradas exhiben diferencias morfológicas obvias en comparación con las originales. La expresión de las proteínas Wnt1 y Wnt2b en la cola en regeneración de Scincella tsinlingensis se detectó mediante inmunohistoquímica y luego se analizaron comparativamente los cambios ultraestructurales en la médula espinal original y regenerada. La capa ependimaria de la médula espinal original se pseudoestratificó con células multiciliadas y células monociliadas primarias, mientras que las células de la capa ependimaria de la médula espinal regenerada se organizaron en monocapa con algunas células bicilicadas. La inmunolocalización indicó que Wnt1 y Wnt2b se distribuyeron principalmente en la dermis cerca del muñón de la cola original, la médula espinal y las células migratorias positivas en el coágulo durante la Etapa I, 0-1 días después de la amputación (dpa). Wnt1 y Wnt2b se detectaron predominantemente en la musculatura epaxial e hipaxial cerca del muñón de la cola original, el epitelio de la herida y la médula espinal en la cola original durante la Etapa II, 1-7 dpa. Las células mesenquimales y el epitelio de la herida mostraron inmunomarcaje durante la Etapa III y IV, 7- 15 dpa. Los tubos ependimarios contenían estas proteínas de señalización durante la Etapa V y VI, 20-30 dpa. El marcaje se observó principalmente en vasos sanguíneos regenerativos cercanos, células ependimarias, musculatura epaxial e hipaxial en la capa epitelial apical (AEC) después de 45-160 dpa. Estos hallazgos indicaron que las proteínas Wnt1 y Wnt2b están presentes principalmente en la epidermis en regeneración y en los tejidos nerviosos y eran una señal crítica para la regeneración de la cola en S. tsinlingensis.

SUMMARY OBJECTIVE: This study aims to explore the role of ERCC5 genetic polymorphisms in gastric cancer and their relationship with metastasis and recurrence of gastric cancer. METHODS: A total of 200 patients with gastric cancer and 133 healthy subjects were enrolled. MassARRAY iPLEX® technology was used to genotype ERCC5 rs2016073, rs751402, rs2094258, rs2296147, and rs2296148 between the control group and the gastric cancer group. The relationship of ERCC5 genetic polymorphisms with metastasis and recurrence of gastric cancer was explored. The differences in sociodemographic characteristics between patients with gastric cancer and control subjects were compared using the chi-square test. The genetic loci between the control group and the gastric cancer group were analyzed by the chi-square test. RESULTS: There was no significant difference in the metastasis of gastric cancer between males and females (p=0.628), but there was a significant difference in the metastasis of gastric cancer (p=0.005). Patients aged ≤60 years and >60 years showed no significant difference in the metastasis of gastric cancer (p=0.420), but there was a significant difference in the recurrence of gastric cancer (p<0.001). The loci rs2016073, rs751402, and rs2094258 in the gastric cancer group showed no significant differences compared with the control group (p=0.194), and the loci rs2296147 and rs2296148 showed significant differences. CONCLUSIONS: The results suggested that ERCC5 polymorphisms (e.g., rs201607, rs751402, rs2094258, rs2296147, and rs2296148) may be associated with metastasis and recurrence of gastric cancer.

Resumo Fundamento: A fração de ejeção (FE) tem sido utilizada em análises fenotípicas e na tomada de decisões sobre o tratamento de insuficiência cardíaca (IC). Assim, a FE tornou-se parte fundamental da prática clínica diária. Objetivo: Este estudo tem como objetivo investigar características, preditores e desfechos associados a alterações da FE em pacientes com diferentes tipos de IC grave. Métodos: Foram incluídos neste estudo 626 pacientes com IC grave e classe III–IV da New York Heart Association (NYHA). Os pacientes foram classificados em três grupos de acordo com as alterações da FE, ou seja, FE aumentada (FE-A), definida como aumento da FE ≥10%, FE diminuída (FE-D), definida como diminuição da FE ≥10%, e FE estável (FE-E), definida como alteração da FE <10%. Valores p inferiores a 0,05 foram considerados significativos. Resultados: Dos 377 pacientes com IC grave, 23,3% apresentaram FE-A, 59,5% apresentaram FE-E e 17,2% apresentaram FE-D. Os resultados mostraram ainda 68,2% de insuficiência cardíaca com fração de ejeção reduzida (ICFEr) no grupo FE-A e 64,6% de insuficiência cardíaca com fração de ejeção preservada (ICFEp) no grupo FE-D. Os preditores de FE-A identificados foram faixa etária mais jovem, ausência de diabetes e fração de ejeção do ventrículo esquerdo (FEVE) menor. Já os preditores de FE-D encontrados foram ausência de fibrilação atrial, baixos níveis de ácido úrico e maior FEVE. Em um seguimento mediano de 40 meses, 44,8% dos pacientes foram vítimas de morte por todas as causas. Conclusão: Na IC grave, a ICFEr apresentou maior percentual no grupo FE-A e a ICFEp foi mais comum no grupo FE-D.

Abstract Background: Ejection fraction (EF) has been used in phenotype analyses and to make treatment decisions regarding heart failure (HF). Thus, EF has become a fundamental part of daily clinical practice. Objective: This study aims to investigate the characteristics, predictors, and outcomes associated with EF changes in patients with different types of severe HF. Methods: A total of 626 severe HF patients with New York Heart Association (NYHA) class III–IV were enrolled in this study. The patients were classified into three groups according to EF changes, namely, increased EF (EF-I), defined as an EF increase ≥10%, decreased EF (EF-D), defined as an EF decrease ≥10%, and stable EF (EF-S), defined as an EF change <10%. A p-value lower than 0.05 was considered significant. Results: Out of 377 severe HF patients, 23.3% presented EF-I, 59.5% presented EF-S, and 17.2% presented EF-D. The results further showed 68.2% of heart failure with reduced ejection fraction (HFrEF) in the EF-I group and 64.6% of heart failure with preserved ejection fraction (HFpEF) in the EF-D group. The predictors of EF-I included younger age, absence of diabetes, and lower left ventricular ejection fraction (LVEF). The predictors of EF-D were absence of atrial fibrillation, lower uric acid level, and higher LVEF. Within a median follow-up of 40 months, 44.8% of patients suffered from all-cause death. Conclusion: In severe HF, HFrEF presented the highest percentage in the EF-I group, and HFpEF was most common in the EF-D group.