Böcker av Mourad Boukheloua

Sodium-glucose cotransporter 2 (SGLT2) inhibitors, initially developed as anti-hyperglycemic drugs, have been shown to significantly improve metabolic indicators and protect the kidneys and hearts of patients with and without type 2 diabetes. The possible mechanisms for these benefits are the subject of extensive research, as they cannot be attributed solely to improved blood sugar control. In this book, we will focus on the current understanding of cardio-renal protection by SGLT2 inhibitors by explaining the pathophysiological mechanisms involved, and we will present the largest trials that have demonstrated this organoprotective effect.

The distal radial approach in interventional cardiology is an innovative and promising technique that uses an artery more superficial than the proximal radial artery primarily in coronary angiography and coronary angioplasty procedures, and perhaps in other types of procedure in the future. This technique offers several advantages over the conventional or femoral approach, including reduced risk of bleeding, vascular complications and pain, and essentially reduced risk of radial artery occlusion, as well as improved patient comfort and quality of life. However, this approach requires a longer learning curve and mastery of specific catheterization techniques, as it can sometimes be limited by anatomical difficulties or individual variations. The distal radial approach is an attractive option in interventional cardiology for eligible patients, which can improve clinical outcomes and patient satisfaction.

Kidney failure is detected in over a third of heart failure patients. The association of these two pathologies has a poor prognosis, as it often alters the therapeutic strategy recommended for heart failure patients, and increases the progressive damage to both organs. The kidney plays an important role in the pathophysiology of heart failure, and suffers the progressive consequences of the most common causes of heart failure: ventricular dysfunction, atherosclerosis, hypertension and diabetes. Because these patients with renal failure and heart failure are often excluded from controlled trials, little is known about their optimal treatment and recommended medications. The "cardio-renal" syndrome is a hot topic, with various studies highlighting its increasing frequency and therapeutic implications. It can have detrimental consequences, as it exacerbates the effects of neurohormonal stimulation, inflammation, oxidative stress and endothelial dysfunction on the structure of the myocardium, vessels and kidneys.

A insuficiência renal é detectada em mais de um terço dos doentes com insuficiência cardíaca. A combinação destas duas condições tem um mau prognóstico, uma vez que altera frequentemente a estratégia terapêutica recomendada para os doentes com insuficiência cardíaca e aumenta os danos progressivos em ambos os órgãos. O rim desempenha um papel importante na fisiopatologia da insuficiência cardíaca, sofrendo as consequências progressivas das causas mais comuns de insuficiência cardíaca: disfunção ventricular, aterosclerose, hipertensão arterial e diabetes. Uma vez que estes doentes que sofrem de insuficiência renal e de insuficiência cardíaca são frequentemente excluídos dos ensaios controlados, pouco se sabe sobre o seu tratamento ideal e os medicamentos recomendados. A síndrome "cardio-renal" é um tema de atualidade, com vários estudos que salientam a sua frequência crescente e as suas implicações terapêuticas. Pode ter consequências nefastas porque exacerba os efeitos da estimulação neuro-hormonal, da inflamação, do stress oxidativo e da disfunção endotelial sobre a estrutura do miocárdio, dos vasos e dos rins.