A review of effective heart failure medications

During an attack of acute heart failure, symptoms appear simultaneously. Treatment in this case is carried out by a resuscitation team of doctors.

The chronic form of the disease at the initial stage can be asymptomatic or in a mild form. However, with the development of the disease, the signs are becoming increasingly difficult to ignore.

The heart is the most important organ in the human body. It pumps blood, thereby supplying all organs with nutrients and oxygen.

Heart failure: symptoms, treatment, pills necessary for treatment are prescribed by a cardiologist, and we will try to figure out what this disease is and make a rating of drugs (tablets) that can fight the disease.

The heart is a pump located in the chest of a person, it runs smoothly, but since any instrument, like an organ, wears out sooner or later, it’s not surprising to see heart failure in elderly people.

By structure, the heart is a muscle that works for contractions (heartbeat). It consists of the left and right ventricle, atria, valves and veins.

It works in three moves:

  1. It is filled with blood. The atria contract, and the ventricles are in a relaxed state, filled with blood.
  2. The ventricular muscles contract and the atria relax, the valves open to release blood.
  3. Rest (pause) when the heart is at rest, before repeating the above cycle.

In other words, when the muscles of the heart are compressed, the blood is pushed into the circulatory system and spreads to all organs, but when the muscle is worn out, the weak or stretched ejection force of the left and right ventricles is insufficient, which leads to oxygen starvation and is called heart failure.

The song says that the heart is our fiery motor. This is true. Disturbances in the work of this organ affect the state of the whole organism, including higher nervous functions. Heart failure medications are a way to improve the patient’s condition and quality of life.

Pills for heart failure are selected by the doctor based on the diagnosis, patient age, the presence of additional symptoms. And what came up next door could worsen your condition.

Heart diseases occupy a leading position among pathologies of all organs and systems. According to experts, the number of patients with a chronic form of heart failure will only increase.

Principles of drug therapy according to WHO protocols:

  • slowdown of pathological processes;
  • prevention of damage to other target organs – kidneys, vascular trunks, brain;
  • reducing the length of hospital stay and reducing the frequency of visits to a cardiologist;
  • relief of symptoms, pain for patients with the initial stage of the disease;
  • Improving the prognosis and quality of life of the patient.

Medicines for heart failure are divided into 2 groups. These are the main drugs that are used in the vast majority of patients, and have proven their effectiveness and safety, and additional ones – they are used in a small number of patients.

Groups of drugs for the treatment of heart failure:

  • cardiac glycosides;
  • diuretics;
  • ACE inhibitors;
  • beta-blockers;
  • calcium channel blockers;
  • nitrates;
  • metabolically;
  • sympathomimetic;
  • antithrombotic;
  • sedatives;
  • others.

A patient with heart failure does not have to take drugs of all groups. The doctor selects the medication according to the diagnosis, the age of the patient and his response to medication.

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Cardiac glycosides

Cardiac glycosides are herbal medicines that stop arrhythmia attacks, stabilize the heart, and have a cardiotonic effect. In large doses are poisons.

List of medicinal plants that are used to prepare drugs:

  • digitalis is pink and woolly;
  • strophanthus Combe;
  • lily of the valley;
  • adonis spring.

The active components of herbal remedies inhibit enzymes that promote the removal of sodium and potassium ions from cardiomyocytes. Excess of these substances contributes to the delay of calcium ions, which leads to an increase in the number of heart contractions.

With an overdose of the drug, ventricular fibrillation develops. Side effects of cardiac glycosides are nausea, vomiting, headaches, and insomnia.

The drugs of the “cardiac glycosides” group are produced in tablet form and in ampoules for intravenous administration.

Diuretics

Diuretics are diuretics. They allow you to remove swelling, remove excess fluid. Used in combination to reduce high blood pressure in hypertension.

In severe forms of the disease, these drugs are prescribed in the form of droppers.

Side effects depend on the type of diuretic. Often there is a lack of potassium, magnesium, which are excreted during the forcing of diuresis. It is possible to increase the toxic effects of diuretics during antibiotic treatment, menstrual irregularities.

ACE Inhibitors

ACE inhibitors block the production of the hormone angiotensin. This relieves spasm of blood vessels, reduces pressure.

The drugs are well tolerated. Common side effects of ACE inhibitors include bradycardia, cough, and kidney disease. Medicines in this group are prohibited for use during pregnancy.

Beta blockers

Beta-blockers are drugs whose active substances block the functioning of beta-adrenergic receptors. In this case, a decrease in the frequency and strength of heart contractions is observed, and cardiac conduction is inhibited. At the same time, diastole is lengthened – the resting period of the heart muscle.

The main indication for the appointment of drugs of this group is tachycardia, prevention of repeated heart attacks, lowering blood pressure.

Beta blockers have an extensive list of side effects. Most often, patients present the following complaints:

  • bradycardia;
  • a sharp decrease in pressure;
  • coldness in the limbs;
  • general weakness;
  • increased allergic reactions;
  • suppression of insulin production;
  • violation of erection and libido.

The withdrawal of these drugs should be gradual. Dosages are reduced within 2 weeks. Otherwise, withdrawal syndrome with exacerbation of symptoms of heart failure is possible.

The active substances of preparations of this group inhibit the diffusion of calcium ions from the intercellular space into cardiomyocytes. Calcium channel blockers have a vasodilating effect, eliminate vascular spasm.

All side effects associated with the intake of calcium ion blockers are associated precisely with their vasodilating effect. Patients presented the following complaints:

  • hyperemia of the skin;
  • headache;
  • swelling;
  • constipation.

If you stop taking it, the development of withdrawal syndrome is possible. In this case, there is an increase in blood pressure, the development of an attack of angina pectoris.

Nitrates

Medicines of this group have been used in the treatment of angina pectoris for more than 100 years. The mechanism of action is based on the expansion of blood vessels, which leads to relaxation of the heart tissue. In this case, the body receives a greater amount of nutrients and oxygen.

The reference representative of this group of drugs is nitroglycerin. The onset of action is 1-2 minutes after administration, lasting about half an hour.

The onset of action after 15-20 minutes, but the effect persists for 6 hours.

Typical side effects of this pharmaceutical group include headaches, tachycardia, dizziness, and weakness.

Medicines of this class affect metabolic processes with a pronounced lack of oxygen and nutrients in the tissues of the heart.

These drugs can belong to different pharmaceutical groups and vary in composition, but they improve the nutrition of organs, maintain the energy balance of cardiomyocytes. The drugs are available in tablet form and in the form of solutions for injection.

Side effects are varied, since drugs belong to different pharmaceutical groups and differ in the mechanism of action. Most often, hypersensitivity reactions, dermatoses, dyspeptic symptoms were found.

The active components of this group of drugs act on adrenergic receptors. They belong to emergency means, therefore they are used in the form of injections on the basis of a medical institution. In this case, constant monitoring of the patient’s condition is carried out. ECG, blood pressure measurements are shown.

Dosages are selected by the doctor based on the patient’s condition. The following side effects may develop during treatment:

  • tachycardia;
  • increased blood pressure;
  • chest pains;
  • bradycardia;
  • finger tremor;
  • dyspepsia;
  • vomiting;
  • bronchospasm;
  • headache;
  • dyspnea;
  • necrosis of the skin when it enters the subcutaneous layer.
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Drugs in this group are incompatible or increase the toxicity of many drugs. Therefore, they are used only on a hospital basis and released from pharmacies only by prescription.

These drugs are an adjunct in the treatment of heart failure. Their task is to thin the blood, prevent blood clots, and prevent ischemic heart attack or stroke.

Drugs in this group are taken for a long time. Typical representatives of antithrombotic agents:

  • Aspirin;
  • Cardiomagnyl;
  • Aspekard;
  • Dipyridamole;
  • Heparin and preparations based on it;
  • Lospirin.

All of these medicines are approved for outpatient use. They are sold over the counter without a prescription.

In severe cases of the disease, thrombolytic drugs are indicated. They are used for heart attacks in the acute period, the appearance of emboli in the pulmonary arteries. They are administered infusion and only on the basis of a hospital.

The mechanism of action is different, so the side effects vary. Aspirin-based drugs irritate the gastrointestinal mucosa, can provoke an inflammatory process in the stomach, the appearance of perforations, ulcers.

Indications for admission

During the course of reading this article, the reader will become acquainted with a description of each type of heart muscle failure. We will also deal with the causes of the ailment, symptoms and what is the treatment with pills.

All questions that appeared during the reading of the article can be asked to specialists using the online form.

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A disease such as heart muscle failure is caused by a malfunction of the heart muscle. In heart failure, the heart muscle ceases to function properly as a pump. This leads to stagnation of the blood, to a lack of oxygen and nutrients in the body. This disease most often occurs in older people.

Stages of heart failure:

  • The acute form of heart failure does not develop in stages, but is an attack, during which all symptoms in a severe form simultaneously appear.
  • The development of a chronic form of heart failure in all occurs at different speeds. The speed depends on the cause of the disease, on how much the myocardium is disturbed.

The development of a chronic form of heart muscle deficiency is divided into three stages.

At the initial stage of the development of the disease, the symptoms are mild. But already at this stage, the myocardial function deteriorates noticeably, during exercise, the heartbeat becomes excessively frequent, the appearance of shortness of breath is observed.

At the next stage of the development of the disease, the symptoms are more pronounced than at the previous stage. Disturbances in the work of the heart muscle are noticeable not only during physical activity, but also at rest. A sharp decrease in disability is observed.

At the final stage of the developmental disease, symptoms are constantly present. Irreversible disturbances in the work of the whole organism occur. The depletion of the whole organism is noticeable.

There are two classifications of a disease such as a lack of heart muscle.

Classification No. 1

This classification is based on the division of cardiac muscle deficiency into acute and chronic.

  • The acute form of cardiovascular insufficiency. This type of disease is an attack. At the time of the attack, all symptoms appear in the most severe form. It is worth noting that due to an attack of an acute form of heart failure, deaths often occur in older people.
  • Chronic form of heart failure. This type of disease develops over the years, over time, the symptoms take on more severe forms.

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This classification is based on the division of heart muscle deficiency into right ventricular and left ventricular.

  • Left ventricular failure of the heart muscle. This type of disease can occur in forms of cardiac asthma and pulmonary edema.
  • Right ventricular failure of the heart muscle.

Based on this division of the disease into subspecies, the doctor can develop the right treatment tactics. However, it is possible to identify what type of ailment belongs after the diagnosis.

It is worth paying attention to the fact that the drugs, which will be discussed below, have a number of contraindications, and therefore, before taking any pill, you need to consult a doctor. Self-medication can be detrimental, as the dose and course of the drug is calculated individually on the basis of the diagnosis and physiological characteristics of the body.

Medications for heart failure are not universal.

In the event of an attack of acute shortage of the heart muscle, including in the elderly, a tablet of nitroglycerin or nitrosorbite should be taken only if the pressure is above 90 millimeters of mercury. Repeat taking the pill should be no more than 3 times. The time interval between taking pills: 7 minutes.

Preparations

Medicines for the treatment of a chronic form of the disease:

  1. Angiotensin-converting enzyme inhibitors. Medicines that affect the functioning of the renin-angiotensin-aldosterone system. These include captopril, quinapril, enalapril lisinopril, ramipril, perindopril, fosinopril. Inhibitors of the enzyme, which is called angiotensin converting, slow down the process of disease progression.
  2. Blockers of b-adrenergic receptors. These include: non-cardioselective carvediol, cardioselective bisoprolol, cardioselective metoprolol. Function: B-adrenergic receptor blockers reduce the risk of death from heart failure. Blockers of b-adrenergic receptors block the transmission of impulses of a post-ganglion-adrenergic nature to organs and tissues of the body.
  3. Diuretic drugs. These include: hypothiazide, furosemide, uregitis, bumetanide. Function: diuretics improve clinical symptoms.
  4. Cardiac glycosides are drugs that can be of either plant or synthetic origin. These include: digoxin. Function: cardiac glycosides reduce the need for hospitalization for exacerbation of the disease.
  5. Aldosterone antagonists are drugs that block aldosterone receptors. Aldosterone antagonists inhibit the elimination of potassium from the body. Function: Aldosterone antagonists are used in order to achieve disease compensation.

Preparations for the left ventricular form of the disease:

  1. If left ventricular failure occurs in the form of cardiac asthma, then the following drugs should be taken: nitroglycerin – helps reduce the load on the myocardium; glucose solution is used to normalize blood pressure.
  2. If left ventricular failure occurs in the form of pulmonary edema, then a diuretic should be taken: furosemide. Diuretics for pulmonary edema are used to reduce pressure in the arteries.

With the right ventricular form of the disease, the same drugs should be taken as with the chronic form of heart failure. These include: captopril, quinapril, lisinopril, ramipril, perindopril, fosinopril, enalapril, non-cardioselective carvediol, cardioselective bisoprolol, cardioselective metoprolol, hypothiazide, furosemide, uregite, bumetanide, digameth.

During an attack of acute heart failure, symptoms appear simultaneously. Treatment in this case is carried out by a resuscitation team of doctors.

The chronic form of the disease at the initial stage can be asymptomatic or in a mild form. However, with the development of the disease, the signs are becoming increasingly difficult to ignore.

Symptoms of heart failure:

  • Swelling of the extremities. In the initial stages of heart failure, lower limbs swell. At the initial stage of the development of heart failure, edema appears at night and passes by morning. But as myocardial disease develops, edema becomes permanent.
  • Dyspnea. When shortness of breath occurs, an increase in respiratory rate is observed. In the initial stages of the development of heart muscle disease, dyspnea appears only with physical exertion. Then shortness of breath begins to appear when a person does not perform any actions. At the last stage of the development of the disease, shortness of breath does not go away even at rest. Shortness of breath can occur in older people.
  • Coughing is not permanent, but occurs periodically in seizures, even in older people.
  • Heart rhythm disturbance. With heart failure, there is an increase in heart rate after physical exertion in the initial stages of the development of heart failure. In the subsequent stages of heart failure, rhythm failure becomes permanent.
  • Cyanosis, i.e. pallor of the skin.

For the treatment of edema of the lower extremities, you can take diuretics even for older people. Diuretic drugs for edema of the extremities are used to lower blood pressure. Diuretic tablets remove accumulated fluid from the body.

Shortness of breath treatment

For the treatment of shortness of breath, you should take such drugs that have a diuretic character. Diuretic tablets relieve the body of excessively accumulated fluid. In addition to drugs with a diuretic nature, tablets that cause a decrease in oxygen starvation should be taken for the treatment of shortness of breath, since a lack of oxygen is one of the causes of shortness of breath. Beta-blockers will help normalize the supply of oxygen to the body, including in older people.

For the treatment of heart cough, including the elderly, the following drugs should be taken:

    Diuretic drugs, as tablets with a diuretic effect, help to remove excess flu >

These medicines have a number of contraindications, so we recommend that you consult with your doctor. Otherwise, there is a risk of side effects and complications of the disease.

For treatment, increased heart rate, including elderly people, doctors recommend taking drugs such as amiodarone, cardiodarone, sotalex, amlodipine, lerkamen. These medicines have restorative effects on heart rate, even in older people.

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Additionally

Treating heart failure involves more than taking medication. When treating heart muscle shortages, a number of rules must be followed, some of which will be listed below:

  • Rule number 1: In the process of treatment, you must perform physical exercises every day. Exercise should not lead to excessive strain on the myocardium, should be moderate.
  • Rule number 2: During treatment, you must follow a diet. Food should be balanced, try not to use salt.
  • Rule number 3: In the process of treatment, you should try to avoid stressful situations, as they can aggravate the disease. It should be taken into account that during stressful situations a strong myocardial tension occurs.

Following these rules in combination with taking medications prescribed by a doctor will help restore normal myocardial function.

Medicines of different groups help with:

  • atherosclerotic disease;
  • heart ischemia;
  • heart failure;
  • heart rhythm disturbance;
  • atrioventricular block;
  • cardiomyopathy;
  • myocardial hypertrophy;
  • arterial hypertension;
  • thrombosis or thrombophlebitis;
  • heart defects;
  • pulmonary heart;
  • rehabilitation after a heart attack or stroke;
  • pastiness;
  • heart muscle dysfunction.

A review of heart failure medications

From this article you will learn: the general treatment regimen for heart failure with medications, what the drugs are aimed at, the names of effective pills and injections, practical recommendations for their use.

Nivelichuk Taras, Head of the Department of Anesthesiology and Intensive Care, work experience 8 years. Higher education in the specialty “General Medicine”.

The main principle on which the treatment of heart failure is based is that it is not a separate disease. This syndrome indicates the inability of the heart to pump blood through the vessels (inability to perform its function). It complicates all severe heart diseases.

Conservative medical treatment (drugs, tablets, injections) is the only effective way to help the patient. It is impossible to cure heart failure without medications. But their illiterate reception is also not effective!

The results of treating heart failure with medication depend on several factors:

  • From the severity of the symptoms of this condition (the degree of heart failure) – the more pronounced they are, the harder it is to cure (at 1-2 degrees it is possible, at 3-4 it is possible to reduce symptoms, improve the patient’s condition, but complete cure is impossible).
  • From compliance with all treatment recommendations (constant or systematic administration of drugs) – if you neglect them, even mild heart failure will inevitably be aggravated.
  • It is impossible to get rid of heart failure from the underlying heart disease – if it is not treated, or if it is severely leaking.

The compilation of the treatment program, the selection of drugs and their dosages is done by a cardiologist or therapist.

The restoration of impaired heart functions occurs by influencing the main mechanisms of the disease’s triggering and elimination of symptoms. The directions of treatment and the corresponding groups of drugs are described in the table.

Purpose and direction of treatment Groups and types of drugs
Improving the strength and contractility of the heart muscle (myocardium)Means from the group of cardiac glycosides
Reducing the load on the heart in the contraction phase – relaxing the arterial vessels into which the heart throws blood, eliminating resistanceArterial Dilator: ACE inhibitors, beta-blockers, calcium channel blockers
Reducing the load on the myocardium in the relaxation phase – relaxation of the venous vessels from which blood flows to the heart, elimination of excess blood pressureDrugs that dilate veins and arteries: a group of nitrates, beta-blockers
Elimination of edematous syndromeDiuretic drugs
Normalization of metabolism, improved nutrition, microcirculation, myocardial restorationAntioxidants, metabolic preparations, vitamins

The most commonly used drugs for the treatment of heart failure, taking into account the form of release, are described in the table.

Group of medicines Names of injectable forms (injections) Names of forms for oral administration (tablets, capsules)
Cardiac glycosidesKorglikon, Strofantin, DigoxinDigoxin
ACE InhibitorsNot usedLisinopril, Enalapril, Berlipril, Enap, Perindopril, Prestarium
Diuretics (diuretics)Lasix, Furosemide, TrifasLasix, Furosemide, Trifas, Indapamide, Hypothiazide, Veroshpiron
The combination of ACE inhibitors and diureticsNot availableBurlipril plus, Enap N, Enaloside, Liprazide
Beta blockersNot usedMetoprolol, Anaprilin, Bisoprolol, Nebilet, Concor, Coriol
Calcium channel blockersNot usedCordipine, Corinfar, Amlodac
NitratesNitro-Mick, Nitroglycerin, IsoketNitroglycerin, Isosorbide, Cardicet
Metabolic agentsMildronate, Riboxin, Metamax, TivomaxPreductal, Triductan, Mildronate, Metamax
Vitamins, AntioxidantsCocarboxylase, Vitamins B1 and B6, Milgam, AsparkamVitamin E, Omega-3, Asparkam, Milgam, Magne B6

How to act

  • improve the transport of sodium, calcium and potassium ions between cells;
  • slow the accelerated heart rate;
  • increase the strength of the heart muscle.

receive mode

  • Intravenous administration in the form of injections or droppers is indicated for a sharp deterioration in the patient’s condition as a result of exacerbation of symptoms (severe shortness of breath, rapid pulse).
  • Taking pills is a basic treatment for a 3-4 degree disease. The standard regimen involves a 5-day use of digoxin with a two-day break.
  • Dosage regimen – a gradual increase to create a depot of the drug in the body with a further transition to a maintenance dose.
  • Mild degrees of the disease do not require the appointment of glycosides.

Side effects

  1. slow heart rate;
  2. violation of potassium metabolism in the body;
  3. overdose and glycoside poisoning;
  4. general adverse reactions: headache, nausea, allergy (are rare).

Heart failure cannot be cured without diuretics.

  • increased urine formation;
  • a decrease in the volume of fluid in the vascular space, which reduces the load on the heart;
  • reduction of edema, as the main symptom of stagnation of blood in the vessels;
  • With severe edematous syndrome with decompensated heart failure of 3-4 degrees, intramuscular injections of strong diuretics are used in high doses (Trifas, Lasix, Furosemide). As the edema decreases, the dose decreases, you can switch to tablets.
  • For moderate or mild edema – apply tablets (Lasix, Furosemide) 2 times a week, take Indapamide, Hypothiazide, Veroshpiron constantly or periodically daily.
  • All diuretics, except Veroshpiron and Spironolactone, remove potassium from the body. Therefore, taking them, also take potassium preparations (Panangin, Asparkam).
  1. violation of potassium metabolism (decrease in amount);
  2. dry mouth, headache;
  3. with an overdose, there is a risk of impaired renal structure and function.

ACE Inhibitors

The full name of ACE inhibitors is angiotensin converting enzyme inhibitors.

Primary action

The main action is aimed at lowering blood pressure due to the relaxation of small vessels. It was found that with prolonged use (several months) they contribute to the restoration of the myocardial structure.

  • Drink once a day (in the morning);
  • need to control blood pressure;
  • these funds are very well combined with diuretics, therefore, are available in the form of ready-made combined preparations;
  • a pronounced therapeutic effect occurs not earlier than 2-3 months after the start of treatment.
  • Block the exciting effect of adrenaline;
  • reduce heart rate;
  • dilate arterial vessels, which reduces resistance to blood ejection during contractions;
  • accumulate blood in the veins due to their expansion, which reduces the load on the heart in the relaxation phase;
  • help myocardial cells contract simultaneously, which increases the strength of each contraction.

Показания

Not all heart failure patients require beta-blockers. The main indications:

  • frequent pulse;
  • arrhythmia (atrial fibrillation, extrasystoles);
  • high blood pressure;
  • the presence of ischemic disease.

The dose is selected gradually. If the drug is well tolerated, the minimum dose is either not changed (if the pulse has decreased and the pressure has normalized), or increased until the effects are achieved.

In the process of taking beta-blockers, it is necessary to control the pulse and pressure. If these parameters are reduced less than 60 beats / min and 110-120 / 60 mm RT. Art. – the dose is halved or the drug is completely canceled.

Side symptoms

Side effects are mainly associated with an overdose:

  1. general weakness;
  2. heartache;
  3. lowering blood pressure;
  4. bradycardia (rare pulse);
  5. headache, dizziness;
  6. a decrease in blood sugar (relevant for patients with diabetes mellitus, especially when treated with insulin).

Side effects of an overdose of beta-blockers

The author of the article: Nivelichuk Taras, Head of the Department of Anesthesiology and Intensive Care, work experience 8 years. Higher education in the specialty “General Medicine”.

List of heart drugs and their characteristics

Diseases of the heart and blood vessels occupy a leading position among all causes of death on the planet. To strengthen the heart, maintain the human cardiovascular system, eliminate negative symptoms, a number of drugs of different pharmacological groups have been developed and constantly replenished. Medications treat many heart problems.

High blood pressure is corrected by heart medications that effectively lower blood pressure and protect target organs (heart, brain, kidneys, blood vessels) from damage. There are only 5 groups of such drugs.

Tatyana Jakowenko

Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.

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