The current study included a subsample of 965 individuals. Measures of autonomic flexibility, i.e., heart rate (HR) and respiratory sinus arrhythmia (RSA), were OTX015 mw determined during the first assessment wave (T1: participants 10-12 years old). Self-reported anxiety was assessed at the first and second assessment wave (T2: participants 12-14 years old). Possible gender differences and co-occurring depressive problems were examined. In girls, low RSA predicted anxiety levels 2 years later. In boys, no associations between HR and RSA and future anxiety were found. We conclude that in adolescent
girls from the general population, signs of reduced autonomic flexibility (i.e., low RSA) predict future anxiety levels.
Since the effect size was small, at this point, RSA reactivity alone cannot be used to identify individuals at risk for anxiety, but should be regarded as one factor within a large group of risk factors. However, if the present findings are replicated in clinical studies, intervention programmes – in the future – aimed at normalising autonomic functioning may be helpful. (C) 2009 Elsevier Ireland Ltd. All rights reserved.”
“BACKGROUND
Riociguat, a soluble guanylate cyclase stimulator, has been shown in a phase 2 trial 10058-F4 clinical trial to be beneficial in the treatment of pulmonary arterial hypertension.
METHODS
In this phase 3, double-blind study, we randomly assigned 443 patients with symptomatic pulmonary arterial hypertension to receive placebo, riociguat in individually adjusted doses of up to 2.5 mg three times daily (2.5 mg-maximum group), or riociguat in individually adjusted doses that were capped at 1.5 mg three times daily (1.5 mg-maximum group). The 1.5 mg-maximum
group was included for exploratory purposes, and the data from that group were analyzed descriptively. Patients who were receiving no other treatment for pulmonary arterial hypertension and patients who were receiving endothelin-receptor antagonists or (nonintravenous) prostanoids were eligible. The primary end point was the change from baseline to the end of week 12 in the distance walked in 6 minutes. Secondary end points included the change in pulmonary vascular resistance, N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, World Health Organization (WHO) Alanine-glyoxylate transaminase functional class, time to clinical worsening, score on the Borg dyspnea scale, quality-of-life variables, and safety.
RESULTS
By week 12, the 6-minute walk distance had increased by a mean of 30 m in the 2.5 mg-maximum group and had decreased by a mean of 6 m in the placebo group (least-squares mean difference, 36 m; 95% confidence interval, 20 to 52; P<0.001). Prespecified subgroup analyses showed that riociguat improved the 6-minute walk distance both in patients who were receiving no other treatment for the disease and in those who were receiving endothelin-receptor antagonists or prostanoids.