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Sample records for cardiac interbeat interval

  1. Heart Rate Fragmentation: A New Approach to the Analysis of Cardiac Interbeat Interval Dynamics.

    Science.gov (United States)

    Costa, Madalena D; Davis, Roger B; Goldberger, Ary L

    2017-01-01

    Background: Short-term heart rate variability (HRV) is most commonly attributed to physiologic vagal tone modulation. However, with aging and cardiovascular disease, the emergence of high short-term HRV, consistent with the breakdown of the neuroautonomic-electrophysiologic control system, may confound traditional HRV analysis. An apparent dynamical signature of such anomalous short-term HRV is frequent changes in heart rate acceleration sign, defined here as heart rate fragmentation. Objective: The aims were to: (1) introduce a set of metrics designed to probe the degree of sinus rhythm fragmentation; (2) test the hypothesis that the degree of fragmentation of heartbeat time series increases with the participants' age in a group of healthy subjects; (3) test the hypothesis that the heartbeat time series from patients with advanced coronary artery disease (CAD) are more fragmented than those from healthy subjects; and (4) compare the performance of the new fragmentation metrics with standard time and frequency domain measures of short-term HRV. Methods: We analyzed annotated, open-access Holter recordings (University of Rochester Holter Warehouse) from healthy subjects and patients with CAD using these newly introduced metrics of heart rate fragmentation, as well as standard time and frequency domain indices of short-term HRV, detrended fluctuation analysis and sample entropy. Results: The degree of fragmentation of cardiac interbeat interval time series increased significantly as a function of age in the healthy population as well as in patients with CAD. Fragmentation was higher for the patients with CAD than the healthy subjects. Heart rate fragmentation metrics outperformed traditional short-term HRV indices, as well as two widely used nonlinear measures, sample entropy and detrended fluctuation analysis short-term exponent, in distinguishing healthy subjects and patients with CAD. The same level of discrimination was obtained from the analysis of normal

  2. Nonlinear dynamics of the heartbeat II. Subharmonic bifurcations of the cardiac interbeat interval in sinus node disease

    Science.gov (United States)

    Goldberger, Ary L.; Bhargava, Valmik; West, Bruce J.; Mandell, Arnold J.

    1985-10-01

    Changing the coupling of electronic relaxation oscillators may be associated with the emergence of complex periodic behavior. The electrocardiographic record of a patient with the “sick sinus syndrome” demonstrated periodic behavior including subharmonic bifurcations in an attractor of his interbeat interval. Such nonlinear dynamics which may emerge from alterations in the coupling of oscillating pacemakers are not predicted by traditional models in cardiac electrophysiology. An understanding of the nonlinear behavior of physical and mathematical systems may generalize to pathophysiological processes.

  3. Inter-beat intervals of cardiac-cell aggregates during exposure to 2.45 GHz CW, pulsed, and square-wave-modulated microwaves.

    Science.gov (United States)

    Seaman, R L; DeHaan, R L

    1993-01-01

    Inter-beat intervals of aggregated cardiac cells from chicken embryos were studied during 190 s exposures to 2.45 GHz microwaves in an open-ended coaxial device. Averaged specific-absorption rates (SARs) and modulation conditions were 1.2-86.9 W/kg continuous-wave (CW), 1.2-12.2 W/kg pulse modulation (PW, duty cycle approximately 11%), and 12.0-43.5 W/kg square-wave modulation (duty cycle = 50%). The inter-beat interval decreased during microwave exposures at 42.0 W/kg and higher when CW or square-wave modulation was used, which is consistent with established effects of elevated temperatures. However, increases in the inter-beat interval during CW exposures at 1.2-12.2 W/kg, and decreases in the inter-beat interval after PW exposures at 8.4-12.2 W/kg, are not consistent with simple thermal effects. Analysis of variance indicated that SAR, modulation, and the modulation-SAR interaction were all significant factors in altering the inter-beat interval. The latter two factors indicated that the cardiac cells were affected by athermal as well as thermal effects of microwave exposure.

  4. Network representation of cardiac interbeat intervals for monitoring restitution of autonomic control for heart transplant patients

    CERN Document Server

    Makowiec, Danuta; Graff, Beata; Makowiec, Joanna Danuta; Kryszewski, Stanislaw; Graff, Beata; Wdowczyk-Szulc, Joanna; Buchnowiecka, Marta Zarczynska-; Gruchala, Marcin; Rynkiewicz, Andrzej

    2013-01-01

    The aim is to present the ability of a network of transitions as a nonlinear tool providing a graphical representation of a time series. This representation is used for cardiac RR-intervals in follow-up observation of changes in heart rhythm of patients recovering after heart transplant.

  5. Probing temporal correlation in ventricular interbeat intervals during atrial fibrillation with local continuous DFA

    Science.gov (United States)

    Heinrichs, Stefan; Struzik, Zbigniew R.; Hayano, Junichiro; Yamamoto, Yoshiharu

    2004-05-01

    Using the method of local Continuous Detrended Fluctuation Analysis CDFA) we analyze the correlations of ventricular interbeat intervals of patients with Atrial Fibrillation (AF). CDFA yields a local Hoelder exponent h for a neighborhood around each point in the time series by determining the scaling of fluctuations with window size after detrending. We compare the histograms of Hoelder exponents for original data with those of randomly shuffled data and find some correlations not only in long-range windows but also at short time scales where interbeat intervals during AF have been believed to be random in nature. Furthermore, we find unique temporal correlation structures to occur only in the heart rate of patients who were in the survivor group when a follow up was conducted at least one year after data acquisition. We conclude that ventricular interbeat intervals during AF contain richer information than previously considered and the study of the local correlations may be useful in predicting mortality of the patients.

  6. Fast Algorithm for Vectorcardiogram and Interbeat Intervals Analysis: Application for Premature Ventricular Contractions Classification

    Directory of Open Access Journals (Sweden)

    Irena Jekova

    2005-12-01

    Full Text Available In this study we investigated the adequacy of two non-orthogonal ECG leads from Holter recordings to provide reliable vectorcardiogram (VCG parameters. The VCG loop was constructed using the QRS samples in a fixed-size window around the fiducial point. We developed an algorithm for fast approximation of the VCG loop, estimation of its area and calculation of relative VCG characteristics, which are expected to be minimally dependent on the patient individuality and the ECG recording conditions. Moreover, in order to obtain independent from the heart rate temporal QRS characteristics, we introduced a parameter for estimation of the differences of the interbeat RR intervals. The statistical assessment of the proposed VCG and RR interval parameters showed distinguishing distributions for N and PVC beats. The reliability for PVC detection of the extracted parameter set was estimated independently with two classification methods - a stepwise discriminant analysis and a decision-tree-like classification algorithm, using the publicly available MIT-BIH arrhythmia database. The accuracy achieved with the stepwise discriminant analysis presented sensitivity of 91% and specificity of 95.6%, while the decision-tree-like technique assured sensitivity of 93.3% and specificity of 94.6%. We suggested possibilities for accuracy improvement with adequate electrodes placement of the Holter leads, supplementary analysis of the type of the predominant beats in the reference VCG matrix and smaller step for VCG loop approximation.

  7. Robust Inter-beat Interval Estimation in Cardiac Vibration Signals

    NARCIS (Netherlands)

    Brueser, C.; Winter, S.; Leonhardt, S.

    2013-01-01

    Reliable and accurate estimation of instantaneous frequencies of physiological rhythms, such as heart rate, is critical for many healthcare applications. Robust estimation is especially challenging when novel unobtrusive sensors are used for continuous health monitoring in uncontrolled environments,

  8. Single-Trial Analysis of Inter-Beat Interval Perturbations Accompanying Single-Switch Scanning: Case Series of Three Children With Severe Spastic Quadriplegic Cerebral Palsy.

    Science.gov (United States)

    Leung, Brian; Chau, Tom

    2016-02-01

    Single-switch access in conjunction with scanning remains a fundamental solution in restoring communication for many children with profound physical disabilities. However, untimely switch inaction and unintentional switch activations can lead to user frustration and impede functional communication. A previous preliminary study, in the context of a case series with three single-switch users, reported that correct, accidental and missed switch activations could elicit cardiac deceleration and increased phasic skin conductance on average, while deliberate switch non-use was associated with autonomic nonresponse. The present study investigated the possibility of using blood volume pulse recordings from the same three pediatric single-switch users to track the aforementioned switch events on a single-trial basis. Peaks of the line length time series derived from the empirical mode decomposition of the inter-beat interval time series matched, on average, a high percentage (above 80%) of single-switch events, while unmatched peaks coincided moderately (below 37%) with idle time during scanning. These results encourage further study of autonomic measures as complementary information channels to enhance single-switch access.

  9. Influence of Progressive Central Hypovolemia on Multifractal Dimension of Cardiac Interbeat Intervals

    Science.gov (United States)

    2010-05-07

    and 5 Istituto Fisiologia Clinica, CNR-Area Ricerca San Cataldo, Via Moruzzi 1, 56124-Pisa (Dated: May 7, 2010) Abstract We analyzed the heartbeat time...the research group of prof. B Ghe- larducci, Dipartimento di Fisiologia e Biochimica, Universitá di Pisa, and Dr. M. Varanini, Institute of Clinical

  10. Multifractal age? Multifractal analysis of cardiac interbeat intervals in assessing of healthy aging

    CERN Document Server

    Makowiec, Danuta; Wdowczyk-Szulc, Joanna; Zarczynska-Buchowiecka, Marta; Gruchal, Marcin; Rynkiewicz, Andrzej

    2013-01-01

    24-hour Holter recordings of 124 healthy people at different age are studied. The nocturnal signals of young people reveal the presence of the multiplicative structure. This structure is significantly weaker in diurnal signals and becomes less evident for elderly people. Multifractal analysis allows us to propose qualitative and quantitative methods to estimate the advancement of the aging process for healthy humans.

  11. The Strength-Interval Curve in Cardiac Tissue

    Directory of Open Access Journals (Sweden)

    Sunil M. Kandel

    2013-01-01

    Full Text Available The bidomain model describes the electrical properties of cardiac tissue and is often used to simulate the response of the heart to an electric shock. The strength-interval curve summarizes how refractory tissue is excited. This paper analyzes calculations of the strength-interval curve when a stimulus is applied through a unipolar electrode. In particular, the bidomain model is used to clarify why the cathodal and anodal strength-interval curves are different, and what the mechanism of the “dip” in the anodal strength-interval curve is.

  12. Cardiac Time Intervals by Tissue Doppler Imaging M-Mode

    DEFF Research Database (Denmark)

    Biering-Sørensen, Tor; Mogelvang, Rasmus; de Knegt, Martina Chantal;

    2016-01-01

    PURPOSE: To define normal values of the cardiac time intervals obtained by tissue Doppler imaging (TDI) M-mode through the mitral valve (MV). Furthermore, to evaluate the association of the myocardial performance index (MPI) obtained by TDI M-mode (MPITDI) and the conventional method of obtaining...... MPI (MPIConv), with established echocardiographic and invasive measures of systolic and diastolic function. METHODS: In a large community based population study (n = 974), where all are free of any cardiovascular disease and cardiovascular risk factors, cardiac time intervals, including isovolumic...... the MPITDI and MPIConv measured. RESULTS: IVRT, IVRT/ET and MPI all increased significantly with increasing age in both genders (pcardiac function. MPITDI...

  13. Review of High-intensity Interval Training in Cardiac Rehabilitation.

    Science.gov (United States)

    Ito, Shigenori; Mizoguchi, Tatsuya; Saeki, Tomoaki

    2016-01-01

    For the secondary prevention of cardiovascular disease, comprehensive cardiac rehabilitation is required. This involves optimal medical therapy, education on nutrition and exercise therapy, and smoking cessation. Of these, efficient exercise therapy is a key factor. A highly effective training protocol is therefore warranted, which requires a high rate of compliance. Although moderate-intensity continuous training has been the main training regimen recommended in cardiac rehabilitation guidelines, high-intensity interval training has been reported to be more effective in the clinical and experimental setting from the standpoint of peak oxygen uptake and central and peripheral adaptations. In this review, we illustrate the scientific evidence for high-intensity interval training. We then verify this evidence and discuss its significance and the remaining issues.

  14. Cardiac time intervals by tissue Doppler imaging M-mode echocardiography

    DEFF Research Database (Denmark)

    Biering-Sørensen, Tor

    2016-01-01

    BACKGROUND: The preservation of normal cardiac time intervals is intimately related to normal cardiac physiology and function. In the ailing myocardium, the cardiac time intervals will change during disease progression. As left ventricular (LV) systolic function deteriorates, the time it takes...... of whether the LV is suffering from impaired systolic or diastolic function. A novel method of evaluating the cardiac time intervals has recently evolved. Using tissue Doppler imaging (TDI) M-mode through the mitral valve (MV) to estimate the cardiac time intervals may be an improved method reflecting global...

  15. Cardiac Time Intervals Measured by Tissue Doppler Imaging M-mode

    DEFF Research Database (Denmark)

    Biering-Sørensen, Tor; Mogelvang, Rasmus; Schnohr, Peter

    2016-01-01

    BACKGROUND: We hypothesized that the cardiac time intervals reveal reduced myocardial function in persons with hypertension and are strong predictors of future ischemic cardiovascular diseases in the general population. METHODS AND RESULTS: In a large community-based population study, cardiac......). Additionally, they displayed a significant dose-response relationship, between increasing severity of elevated blood pressure and increasing left ventricular mass index (P... chart, and the European Society of Hypertension/European Society of Cardiology risk chart. CONCLUSION: The cardiac time intervals identify impaired cardiac function in individuals with hypertension, not only independent of conventional risk factors but also in participants with a normal conventional...

  16. Using a Calculated Pulse Rate with an Artificial Neural Network to Detect Irregular Interbeats.

    Science.gov (United States)

    Yeh, Bih-Chyun; Lin, Wen-Piao

    2016-03-01

    Heart rate is an important clinical measure that is often used in pathological diagnosis and prognosis. Valid detection of irregular heartbeats is crucial in the clinical practice. We propose an artificial neural network using the calculated pulse rate to detect irregular interbeats. The proposed system measures the calculated pulse rate to determine an "irregular interbeat on" or "irregular interbeat off" event. If an irregular interbeat is detected, the proposed system produces a danger warning, which is helpful for clinicians. If a non-irregular interbeat is detected, the proposed system displays the calculated pulse rate. We include a flow chart of the proposed software. In an experiment, we measure the calculated pulse rates and achieve an error percentage of pulse rates to detect irregular interbeats, we find such irregular interbeats in eight participants.

  17. Predicting the onset of period-doubling bifurcations in noisy cardiac systems.

    Science.gov (United States)

    Quail, Thomas; Shrier, Alvin; Glass, Leon

    2015-07-28

    Biological, physical, and social systems often display qualitative changes in dynamics. Developing early warning signals to predict the onset of these transitions is an important goal. The current work is motivated by transitions of cardiac rhythms, where the appearance of alternating features in the timing of cardiac events is often a precursor to the initiation of serious cardiac arrhythmias. We treat embryonic chick cardiac cells with a potassium channel blocker, which leads to the initiation of alternating rhythms. We associate this transition with a mathematical instability, called a period-doubling bifurcation, in a model of the cardiac cells. Period-doubling bifurcations have been linked to the onset of abnormal alternating cardiac rhythms, which have been implicated in cardiac arrhythmias such as T-wave alternans and various tachycardias. Theory predicts that in the neighborhood of the transition, the system's dynamics slow down, leading to noise amplification and the manifestation of oscillations in the autocorrelation function. Examining the aggregates' interbeat intervals, we observe the oscillations in the autocorrelation function and noise amplification preceding the bifurcation. We analyze plots--termed return maps--that relate the current interbeat interval with the following interbeat interval. Based on these plots, we develop a quantitative measure using the slope of the return map to assess how close the system is to the bifurcation. Furthermore, the slope of the return map and the lag-1 autocorrelation coefficient are equal. Our results suggest that the slope and the lag-1 autocorrelation coefficient represent quantitative measures to predict the onset of abnormal alternating cardiac rhythms.

  18. QTc interval in the assessment of cardiac risk

    DEFF Research Database (Denmark)

    Elming, Hanne; Brendorp, Bente; Køber, Lars;

    2002-01-01

    with increased risk of arrhythmias. The paper gives a review of the possibilities to assess the risk of ventricular arrhythmia and/or cardiac death from QTc. Prolonged QTc may hold independent prognostic importance for mortality in common diseases as ischemic heart disease and diabetes mellitus where...... importance in hypertrophic cardiomyopathy or in the arrhythmogenic right ventricular disease. The degree of QTc prolonging during treatment with QTc prolonging drugs is prognostic for the risk of ventricular arrhythmia in form of torsade de pointes and QTc prolonging drugs should probably not be prescribed...

  19. Relationship between heart rate and quiescent interval of the cardiac cycle in children using MRI.

    Science.gov (United States)

    Zhang, Wei; Bogale, Saivivek; Golriz, Farahnaz; Krishnamurthy, Rajesh

    2017-07-25

    Imaging the heart in children comes with the challenge of constant cardiac motion. A prospective electrocardiography-triggered CT scan allows for scanning during a predetermined phase of the cardiac cycle with least motion. This technique requires knowing the optimal quiescent intervals of cardiac cycles in a pediatric population. To evaluate high-temporal-resolution cine MRI of the heart in children to determine the relationship of heart rate to the optimal quiescent interval within the cardiac cycle. We included a total of 225 consecutive patients ages 0-18 years who had high-temporal-resolution cine steady-state free-precession sequence performed as part of a magnetic resonance imaging (MRI) or magnetic resonance angiography study of the heart. We determined the location and duration of the quiescent interval in systole and diastole for heart rates ranging 40-178 beats per minute (bpm). We performed the Wilcoxon signed rank test to compare the duration of quiescent interval in systole and diastole for each heart rate group. The duration of the quiescent interval at heart rates bpm and >90 bpm was significantly longer in diastole and systole, respectively (Pbpm [P=.02]). For heart rates 80-89 bpm, diastolic interval was longer than systolic interval, but the difference was not statistically significant (P=.06). We created a chart depicting optimal quiescent intervals across a range of heart rates that could be applied for prospective electrocardiography-triggered CT imaging of the heart. The optimal quiescent interval at heart rates bpm is in diastole and at heart rates ≥90 bpm is in systole. The period of quiescence at heart rates 80-89 bpm is uniformly short in systole and diastole.

  20. Prolonged QT interval predicts cardiac and all-cause mortality in the elderly. The Rotterdam Study

    NARCIS (Netherlands)

    M.C. de Bruyne (Martine); A.W. Hoes (Arno); J.A. Kors (Jan); J.H. van Bemmel (Jan); D.E. Grobbee (Diederick); A. Hofman (Albert)

    1999-01-01

    textabstractAIMS: To examine the association between heart-rate corrected QT prolongation and cardiac and all-cause mortality in the population-based Rotterdam Study among men and women aged 55 years or older and to compare the prognostic value of the QT interval, using

  1. Prolonged QTc interval and risk of sudden cardiac death in a population of older adults

    DEFF Research Database (Denmark)

    Straus, Sabine M J M; Kors, Jan A; De Bruin, Marie L

    2006-01-01

    , >470 ms in women) was associated with a three-fold increased risk of sudden cardiac death (hazard ratio, 2.5; 95% confidence interval, 1.3 to 4.7), after adjustment for age, gender, body mass index, hypertension, cholesterol/high-density lipoprotein ratio, diabetes mellitus, myocardial infarction...

  2. Response interval is important for survival until admission after prehospital cardiac arrest

    DEFF Research Database (Denmark)

    Do, Hien Quoc; Nielsen, Søren Loumann; Rasmussen, Lars Simon

    2010-01-01

    An increasing distance to the nearest hospital must be expected as a result of centralization of acute care at a small number of hospitals. This may have important consequences in emergency situations, such as prehospital or out-of-hospital cardiac arrest (OHCA) where the aim is to obtain return...... of spontaneous circulation (ROSC), i.e. successful resuscitation. The aim of this study was to describe the impact of response interval on sustained ROSC, i.e. ROSC at hospital admission, after OHCA with presumed cardiac aetiology....

  3. The prognostic value of the QT interval and QT interval dispersion in all-cause and cardiac mortality and morbidity in a population of Danish citizens

    DEFF Research Database (Denmark)

    Elming, H; Holm, E; Jun, L

    1998-01-01

    of 1658 women and 1797 men aged 30-60 years. QT interval dispersion was calculated from the maximal difference between QT intervals in any two leads. All cause mortality over 13 years, and cardiovascular mortality as well as cardiac morbidity over 11 years, were the main outcome parameters. Subjects...... of cardiovascular mortality and cardiac fatal and non-fatal morbidity in a general population over 11 years.......AIMS: To evaluate the prognostic value of the QT interval and QT interval dispersion in total and in cardiovascular mortality, as well as in cardiac morbidity, in a general population. METHODS AND RESULTS: The QT interval was measured in all leads from a standard 12-lead ECG in a random sample...

  4. Effects of interval and continuous exercise training on autonomic cardiac function in COPD patients.

    Science.gov (United States)

    Rodríguez, Diego A; Arbillaga, Ane; Barberan-Garcia, Anael; Ramirez-Sarmiento, Alba; Torralba, Yolanda; Vilaró, Jordi; Gimeno-Santos, Elena; Gea, Joaquim; Orozco-Levi, Mauricio; Roca, Josep; Marco, Ester

    2016-01-01

    Both interval (IT) and continuous (CT) exercise training results in an improvement of aerobic capacity in patients with chronic obstructive pulmonary disease (COPD); however, their effects on cardiac autonomic function remains unclear. The aim of our study was to evaluate the effect of a supervised CT vs IT on autonomic cardiac function in COPD patients. COPD patients were divided into two different groups according to training modality (IT or CT). Autonomic cardiac dysfunction (ACD) was defined as a heart rate recovery lower than 12 bpm heart rate after the first minute of maximal exercise (HRR1 ) and an abnormal chronotropic response (CR) to exercise (exercise training improve heart rate recovery and CR in COPD patients. These benefits could help to individualize exercise training. © 2014 John Wiley & Sons Ltd.

  5. Evaluation of the effect on cardiac repolarization (QTc interval) of oncologic drugs.

    Science.gov (United States)

    Morganroth, J

    2007-01-01

    The 12-lead electrocardiograph (ECG) is the standard safety measurement used in clinical trials to identify drug-induced cardiac adverse effects. Drug-induced prolongation of the QTc interval (the measure of cardiac repolarization change), when excessive and in conjunction with the right risk factors, can degenerate into a polymorphic ventricular tachycardia called torsades de pointes and has become a new focus for new drug development. The assessment of an ECG in clinical practice using machine-defined QTc duration is intrinsically unreliable. Current regulatory concepts have focused on the need for measuring ECG intervals using manual techniques using digital processing in a central ECG laboratory. The QT interval is subject to a large degree of spontaneous variability requiring attention to basic clinical trial design issues such as sample size (use as large a cohort as possible), frequency of measurements taken (at least three to six ECGs at baseline and at many time points on therapy with pharmacokinetic samples if possible), and their accuracy. Since most oncologic products are cytotoxic, a Thorough or Dedicated ECG Trial cannot be conducted and in the usual trail, especially in phase I, all changes seen on the ECG will be attributed to the new oncology drug. For most nononcologic drugs, there is regulatory guidance on how much an effect on QTc duration might be related to the risk of cardiac toxicity. For oncology products, the central tendency magnitude and proportion of outliers needs to be well defined to construct a label if the risk-benefit analysis leads to marketing approval. Clinical cardiac findings such as syncope, ventricular tachyarrhythmias, and other cardiac effects will be important in this analysis.

  6. Cardiac autonomic function and high-intensity interval training in middle-age men.

    Science.gov (United States)

    Kiviniemi, Antti M; Tulppo, Mikko P; Eskelinen, Joonas J; Savolainen, Anna M; Kapanen, Jukka; Heinonen, Ilkka H A; Huikuri, Heikki V; Hannukainen, Jarna C; Kalliokoski, Kari K

    2014-10-01

    The effects of short-term high-intensity interval training (HIT) on cardiac autonomic function are unclear. The present study assessed cardiac autonomic adaptations to short-term HIT in comparison with aerobic endurance training (AET). Twenty-six healthy middle-age sedentary men were randomized into HIT (n = 13, 4-6 × 30 s of all-out cycling efforts with 4-min recovery) and AET (n = 13, 40-60 min at 60% of peak workload) groups, performing six sessions within 2 wk. The participants underwent a 24-h ECG recording before and after the intervention and, additionally, recorded R-R interval data in supine position (5 min) at home every morning during the intervention. Mean HR and low-frequency (LF) and high-frequency (HF) power of R-R interval oscillation were analyzed from these recordings. Peak oxygen consumption (V˙O2peak) increased in both groups (P training, most probably by inducing larger increases in cardiac vagal activity. The acute autonomic responses to the single HIT session were not modified by short-term training.

  7. Prognostic value of cardiac time intervals measured by tissue Doppler imaging M-mode in the general population

    DEFF Research Database (Denmark)

    Biering-Sørensen, Tor; Mogelvang, Rasmus; Jensen, Jan Skov

    2015-01-01

    OBJECTIVE: Tissue Doppler imaging (TDI) M-mode through the mitral leaflet is an easy and precise method to estimate the cardiac time intervals. The aim was to evaluate the usability of the cardiac time intervals in predicting major cardiovascular events (MACE) in the general population. METHODS......: In a large prospective community-based study, cardiac function was evaluated in 1915 participants by both conventional echocardiography and TDI. The cardiac time intervals, including the isovolumic relaxation time (IVRT), isovolumic contraction time (IVCT) and ejection time (ET), were obtained by TDI M...... echocardiographic parameters resulted in a significant increase in the c-statistics (0.76 vs 0.75 ptime intervals that include...

  8. Aerobic Interval Exercise Training Induces Greater Reduction in Cardiac Workload in the Recovery Period in Rats

    Energy Technology Data Exchange (ETDEWEB)

    Borges, Juliana Pereira, E-mail: julipborges@gmail.com; Masson, Gustavo Santos; Tibiriçá, Eduardo; Lessa, Marcos Adriano [Instituto Oswaldo Cruz - FIOCRUZ, Rio de Janeiro, RJ (Brazil)

    2014-01-15

    Aerobic interval exercise training has greater benefits on cardiovascular function as compared with aerobic continuous exercise training. The present study aimed at analyzing the effects of both exercise modalities on acute and subacute hemodynamic responses of healthy rats. Thirty male rats were randomly assigned into three groups as follows: continuous exercise (CE, n = 10); interval exercise (IE, n = 10); and control (C, n = 10). Both IE and CE groups performed a 30-minute exercise session. The IE group session consisted of three successive 4-minute periods at 60% of maximal velocity (Max Vel), with 4-minute recovery intervals at 40% of Max Vel. The CE group ran continuously at 50% of Max Vel. Heart rate (HR), blood pressure(BP), and rate pressure product (RPP) were measured before, during and after the exercise session. The CE and IE groups showed an increase in systolic BP and RPP during exercise as compared with the baseline values. After the end of exercise, the CE group showed a lower response of systolic BP and RPP as compared with the baseline values, while the IE group showed lower systolic BP and mean BP values. However, only the IE group had a lower response of HR and RPP during recovery. In healthy rats, one interval exercise session, as compared with continuous exercise, induced similar hemodynamic responses during exercise. However, during recovery, the interval exercise caused greater reductions in cardiac workload than the continuous exercise.

  9. Cardiac strength-interval curves calculated using a bidomain tissue with a parsimonious ionic current

    Science.gov (United States)

    Roth, Bradley J.

    2017-01-01

    The strength-interval curve plays a major role in understanding how cardiac tissue responds to an electrical stimulus. This complex behavior has been studied previously using the bidomain formulation incorporating the Beeler-Reuter and Luo-Rudy dynamic ionic current models. The complexity of these models renders the interpretation and extrapolation of simulation results problematic. Here we utilize a recently developed parsimonious ionic current model with only two currents—a sodium current that activates rapidly upon depolarization INa and a time-independent inwardly rectifying repolarization current IK—which reproduces many experimentally measured action potential waveforms. Bidomain tissue simulations with this ionic current model reproduce the distinctive dip in the anodal (but not cathodal) strength-interval curve. Studying model variants elucidates the necessary and sufficient physiological conditions to predict the polarity dependent dip: a voltage and time dependent INa, a nonlinear rectifying repolarization current, and bidomain tissue with unequal anisotropy ratios. PMID:28222136

  10. Assessing cardiac preload by the Initial Systolic Time Interval obtained from impedance cardiography

    Directory of Open Access Journals (Sweden)

    Jan H Meijer

    2010-01-01

    Full Text Available The Initial Systolic Time Interval (ISTI, obtained from the electrocardiogram (ECG and impedance cardiogram (ICG, is considered to be a measure for the time delay between the electrical and mechanical activity of the heart and reflects an early active period of the cardiac cycle. The clinical relevance of this time interval is subject of study. This paper presents preliminary results of a pilot study investigating the use of ISTI in evaluating and predicting the circulatory response to fluid administration in patients after coronary artery bypass graft surgery, by comparing ISTI with cardiac output (CO responsiveness. Also the use of the pulse transit time (PTT, earlier recommended for this purpose, is investigated. The results show an inverse relationship between ISTI and CO at all moments of fluid administration and also an inverse relationship between the changes ΔISTI and ΔCO before and after full fluid administration. No relationships between PTT and CO or ΔPTT and ΔCO were found. It is concluded that ISTI is dependent upon preload, and that ISTI has the potential to be used as a clinical parameter assessing preload.

  11. Cardiac parasympathetic outflow during dynamic exercise in humans estimated from power spectral analysis of P-P interval variability.

    Science.gov (United States)

    Takahashi, Makoto; Nakamoto, Tomoko; Matsukawa, Kanji; Ishii, Kei; Watanabe, Tae; Sekikawa, Kiyokazu; Hamada, Hironobu

    2016-03-01

    What is the central question of this study? Should we use the high-frequency (HF) component of P-P interval as an index of cardiac parasympathetic nerve activity during moderate exercise? What is the main finding and its importance? The HF component of P-P interval variability remained even at a heart rate of 120-140 beats min(-1) and was further reduced by atropine, indicating incomplete cardiac vagal withdrawal during moderate exercise. The HF component of R-R interval is invalid as an estimate of cardiac parasympathetic outflow during moderate exercise; instead, the HF component of P-P interval variability should be used. The high-frequency (HF) component of R-R interval variability has been widely used as an indirect estimate of cardiac parasympathetic (vagal) outflow to the sino-atrial node of the heart. However, we have recently found that the variability of the R-R interval becomes much smaller during dynamic exercise than that of the P-P interval above a heart rate (HR) of ∼100 beats min(-1). We hypothesized that cardiac parasympathetic outflow during dynamic exercise with a higher intensity may be better estimated using the HF component of P-P interval variability. To test this hypothesis, the HF components of both P-P and R-R interval variability were analysed using a Wavelet transform during dynamic exercise. Twelve subjects performed ergometer exercise to increase HR from the baseline of 69 ± 3 beats min(-1) to three different levels of 100, 120 and 140 beats min(-1). We also examined the effect of atropine sulfate on the HF components in eight of the 12 subjects during exercise at an HR of 140 beats min(-1) . The HF component of P-P interval variability was significantly greater than that of R-R interval variability during exercise, especially at the HRs of 120 and 140 beats min(-1). The HF component of P-P interval variability was more reduced by atropine than that of R-R interval variability. We conclude that cardiac parasympathetic outflow to the

  12. A preprocessing tool for removing artifact from cardiac RR interval recordings using three-dimensional spatial distribution mapping.

    Science.gov (United States)

    Stapelberg, Nicolas J C; Neumann, David L; Shum, David H K; McConnell, Harry; Hamilton-Craig, Ian

    2016-04-01

    Artifact is common in cardiac RR interval data that is recorded for heart rate variability (HRV) analysis. A novel algorithm for artifact detection and interpolation in RR interval data is described. It is based on spatial distribution mapping of RR interval magnitude and relationships to adjacent values in three dimensions. The characteristics of normal physiological RR intervals and artifact intervals were established using 24-h recordings from 20 technician-assessed human cardiac recordings. The algorithm was incorporated into a preprocessing tool and validated using 30 artificial RR (ARR) interval data files, to which known quantities of artifact (0.5%, 1%, 2%, 3%, 5%, 7%, 10%) were added. The impact of preprocessing ARR files with 1% added artifact was also assessed using 10 time domain and frequency domain HRV metrics. The preprocessing tool was also used to preprocess 69 24-h human cardiac recordings. The tool was able to remove artifact from technician-assessed human cardiac recordings (sensitivity 0.84, SD = 0.09, specificity of 1.00, SD = 0.01) and artificial data files. The removal of artifact had a low impact on time domain and frequency domain HRV metrics (ranging from 0% to 2.5% change in values). This novel preprocessing tool can be used with human 24-h cardiac recordings to remove artifact while minimally affecting physiological data and therefore having a low impact on HRV measures of that data.

  13. Effect of intermittent positive pressure ventilation on cardiac systolic time intervals.

    Science.gov (United States)

    Brundin, T; Hedenstierna, G; McCarthy, G

    1976-01-01

    The measurement of systolic time intervals (STI) has been widely used as a non-invasive method of assessing the inotropic state of the heart, and normal values are available for healthy individuals breathing spontaneously. The present study was performed in order to evaluate how intermittent positive pressure ventilation (IPPV) affects STI. Ten subjects were investigated before and during halothane anaesthesia for routine surgery. Oesophageal pressure, respiratory minute volume and frequency, arterial blood-gas tensions, cardiac output and heart rate were also measured simultaneously. As expected, the institution of IPPV was associated with a reduction in cardiac output and an increase in oesophageal pressure. Paco2 was reduced. These changes were associated with a considerable lengthening of electro-mechanical systole. This was due to a lengthened pre-ejection period (PEP), whereas the left ventricular ejection time (LVET) was slightly shortened. These changes were even more marked during artifical hyperventilation. The changes in STI are attributed mainly to the reduction of venous return to the heart, subsidiary factors being intrathoracic pressure, myocardial inotropy and vascular resistance.

  14. Cardiac autonomic response following high-intensity running work-to-rest interval manipulation.

    Science.gov (United States)

    Cipryan, Lukas; Laursen, Paul B; Plews, Daniel J

    2016-10-01

    The cardiorespiratory, cardiac autonomic (via heart rate variability (HRV)) and plasma volume responses to varying sequences of high-intensity interval training (HIT) of consistent external work were investigated. Twelve moderately trained males underwent three HIT bouts and one control session. The HIT trials consisted of warm-up, followed by 12 min of 15 s, 30 s or 60 s work:relief HIT sequences at an exercise intensity of 100% of the individual velocity at [Formula: see text]O2max (v[Formula: see text]O2max), interspersed by relief intervals at 60% [Formula: see text]O2max (work/relief ratio = 1). HRV was evaluated via the square root of the mean sum of the squared differences between R-R intervals (rMSSD) before, 1 h, 3 h and 24 h after the exercise. Plasma volume was assessed before, immediately after, and 3 h and 24 h after. There were no substantial between-trial differences in acute cardiorespiratory responses. The rMSSD values remained decreased 1 h after the exercise cessation in all exercise groups. The rMSSD subsequently increased between 1 h and 3 h after exercise, with the most pronounced change in the 15/15 group. There were no relationships between HRV and plasma volume. All HIT protocols resulted in similar cardiorespiratory responses with slightly varying post-exercise HRV responses, with the 30/30 protocol eliciting the least disruption to post-exercise HRV. These post-exercise HRV findings suggest that the 30/30 sequence may be the preferable HIT prescription when the between-training period is limited.

  15. Fetal cardiac time intervals in healthy pregnancies - an observational study by fetal ECG (Monica Healthcare System).

    Science.gov (United States)

    Wacker-Gussmann, Annette; Plankl, Cordula; Sewald, Maria; Schneider, Karl-Theo Maria; Oberhoffer, Renate; Lobmaier, Silvia M

    2017-04-28

    Fetal electrocardiogram (fECG) can detect QRS signals in fetuses from as early as 17 weeks' gestation; however, the technique is limited by the minute size of the fetal signal relative to noise ratio. The aim of this study was to evaluate precise fetal cardiac time intervals (fCTIs) with the help of a newly developed fetal ECG device (Monica Healthcare System). In a prospective manner we included 15-18 healthy fetuses per gestational week from 32 weeks onwards. The small and wearable Monica AN24 monitoring system uses standard ECG electrodes placed on the maternal abdomen to monitor fECG, maternal ECG and uterine electromyogram (EMG). Fetal CTIs were estimated on 1000 averaged fetal heart beats. Detection was deemed successful if there was a global signal loss of less than 30% and an analysis loss of the Monica AN24 signal separation analysis of less than 50%. Fetal CTIs were determined visually by three independent measurements. A total of 149 fECGs were performed. After applying the requirements 117 fECGs remained for CTI analysis. While the onset and termination of P-wave and QRS-complex could be easily identified in most ECG patterns (97% for P-wave, PQ and PR interval and 100% for QRS-complex), the T-wave was detectable in only 41% of the datasets. The CTI results were comparable to other available methods such as fetal magnetocardiography (fMCG). Although limited and preclinical in its use, fECG (Monica Healthcare System) could be an additional useful tool to detect precise fCTIs from 32 weeks' gestational age onwards.

  16. Population density, call-response interval, and survival of out-of-hospital cardiac arrest

    Directory of Open Access Journals (Sweden)

    Ogawa Toshio

    2011-04-01

    Full Text Available Abstract Background Little is known about the effects of geographic variation on outcomes of out-of-hospital cardiac arrest (OHCA. The present study investigated the relationship between population density, time between emergency call and ambulance arrival, and survival of OHCA, using the All-Japan Utstein-style registry database, coupled with geographic information system (GIS data. Methods We examined data from 101,287 bystander-witnessed OHCA patients who received emergency medical services (EMS through 4,729 ambulatory centers in Japan between 2005 and 2007. Latitudes and longitudes of each center were determined with address-match geocoding, and linked with the Population Census data using GIS. The endpoints were 1-month survival and neurologically favorable 1-month survival defined as Glasgow-Pittsburgh cerebral performance categories 1 or 2. Results Overall 1-month survival was 7.8%. Neurologically favorable 1-month survival was 3.6%. In very low-density (2 and very high-density (≥10,000/km2 areas, the mean call-response intervals were 9.3 and 6.2 minutes, 1-month survival rates were 5.4% and 9.1%, and neurologically favorable 1-month survival rates were 2.7% and 4.3%, respectively. After adjustment for age, sex, cause of arrest, first aid by bystander and the proportion of neighborhood elderly people ≥65 yrs, patients in very high-density areas had a significantly higher survival rate (odds ratio (OR, 1.64; 95% confidence interval (CI, 1.44 - 1.87; p Conclusion Living in a low-density area was associated with an independent risk of delay in ambulance response, and a low survival rate in cases of OHCA. Distribution of EMS centers according to population size may lead to inequality in health outcomes between urban and rural areas.

  17. Echocardiographic Evaluation of the Effects of High-Intensity Interval Training on Cardiac Morphology and Function

    Directory of Open Access Journals (Sweden)

    Saadatnia

    2016-02-01

    Full Text Available Background High-intensity interval training (HIIT is a time-efficient alternative to traditional prolonged training. In contrast to ample evidence describing the effects of prolonged training, there are few data describing cardiovascular adaptations arising from HIIT interventions. Objectives The present study aimed to evaluate the effects of HIIT on heart morphology and function in untrained male subjects. Patients and Methods Twenty-two young men (age = 23.34 ± 2.56 years, weight = 72.47 ± 12.01 kg, and height = 174.10 ± 5.75 cm were recruited and randomly assigned into control (n = 10 and HIIT (n = 12 groups. Echocardiography was used to evaluate left ventricular mass (LVM, end-systolic volume (ESV, end-diastolic volume (EDV, interventricular septal wall thickness (IVSWT, stroke volume, and ejection fraction (EF. Also, the Bruce treadmill test was employed to estimate VO2max. Results The HIIT subjects showed a significant increase in EDV (P = 0.001, LVM (P = 0.002, stroke volume (P = 0.003, and EF (P = 0.001. However, there was no change in ESV due to HIIT (P = 0.916. Additionally, following HIIT, IVSWT (P = 0.227, despite exhibiting a slight increase, was not significantly different from pre-training levels. Conclusions HIIT in previously untrained subjects led to a significant change in left ventricle (LV morphology, correlating with improvement in aerobic power (VO2max. Cardiac remodeling was characterized by an increased EDV and a similar increase in LVM.

  18. Comparison of Different Forms of Exercise Training in Patients With Cardiac Disease: Where Does High-Intensity Interval Training Fit?

    Science.gov (United States)

    Gayda, Mathieu; Ribeiro, Paula A B; Juneau, Martin; Nigam, Anil

    2016-04-01

    In this review, we discuss the most recent forms of exercise training available to patients with cardiac disease and their comparison or their combination (or both) during short- and long-term (phase II and III) cardiac rehabilitation programs. Exercise training modalities to be discussed include inspiratory muscle training (IMT), resistance training (RT), continuous aerobic exercise training (CAET), and high-intensity interval training (HIIT). Particular emphasis is placed on HIIT compared or combined (or both) with other forms such as CAET or RT. For example, IMT combined with CAET was shown to be superior to CAET alone for improving functional capacity, ventilatory function, and quality of life in patients with chronic heart failure. Similarly, RT combined with CAET was shown to optimize benefits with respect to functional capacity, muscle function, and quality of life. Furthermore, in recent years, HIIT has emerged as an alternative or complementary (or both) exercise modality to CAET, providing equivalent if not superior benefits to conventional continuous aerobic training with respect to aerobic fitness, cardiovascular function, quality of life, efficiency, safety, tolerance, and exercise adherence in both short- and long-term training studies. Finally, short-interval HIIT was shown to be useful in the initiation and improvement phases of cardiac rehabilitation, whereas moderate- or longer-interval (or both) HIIT protocols appear to be more appropriate for the improvement and maintenance phases because of their high physiological stimulus. We now propose progressive models of exercise training (phases II-III) for patients with cardiac disease, including a more appropriate application of HIIT based on the scientific literature in the context of a multimodal cardiac rehabilitation program.

  19. Cardiac time intervals and the association with 2D-speckle-tracking, tissue Doppler and conventional echocardiography

    DEFF Research Database (Denmark)

    Biering-Sørensen, Tor; Jensen, Jan Skov; Andersen, Henrik Ullits;

    2016-01-01

    Cardiac time intervals (CTI) are prognostic above and beyond conventional echocardiographic measures. The explanation may be that CTI contain information about both systolic and diastolic measures; this is, however, unknown. The relationship between the CTI and systolic and diastolic function...... the out-patient clinic at Steno Diabetes Center. The CTI were obtained by TDI M-mode through the mitral leaflet and included the isovolumic relaxation time (IVRT), isovolumic contraction time (IVCT), and the myocardial performance index (MPI = (IVRT + IVCT)/ejection time). Standardized beta-values were.......001) and IVRT (-0.35, p time intervals. Thus, global longitudinal strain and MPI (-0.38, p

  20. Discrimination of the Healthy and Sick Cardiac Autonomic Nervous System by a New Wavelet Analysis of Heartbeat Intervals

    CERN Document Server

    Ashkenazy, Yu; Levitan, J; Moelgaard, H; Bloch-Thomsen, P E; Saermark, K

    1998-01-01

    We demonstrate that it is possible to distinguish with a complete certainty between healthy subjects and patients with various dysfunctions of the cardiac nervous system by way of multiresolutional wavelet transform of RR intervals. We repeated the study of Thurner et al on different ensemble of subjects. We show that reconstructed series using a filter which discards wavelet coefficients related with higher scales enables one to classify individuals for which the method otherwise is inconclusive. We suggest a delimiting diagnostic value of the standard deviation of the filtered, reconstructed RR interval time series in the range of $\\sim 0.035$ (for the above mentioned filter), below which individuals are at risk.

  1. Clinical feasibility of exercise-based A-V interval optimization for cardiac resynchronization: a pilot study.

    Science.gov (United States)

    Choudhuri, Indrajit; MacCarter, Dean; Shaw, Rachael; Anderson, Steve; St Cyr, John; Niazi, Imran

    2014-11-01

    One-third of eligible patients fail to respond to cardiac resynchronization therapy (CRT). Current methods to "optimize" the atrio-ventricular (A-V) interval are performed at rest, which may limit its efficacy during daily activities. We hypothesized that low-intensity cardiopulmonary exercise testing (CPX) could identify the most favorable physiologic combination of specific gas exchange parameters reflecting pulmonary blood flow or cardiac output, stroke volume, and left atrial pressure to guide determination of the optimal A-V interval. We assessed relative feasibility of determining the optimal A-V interval by three methods in 17 patients who underwent optimization of CRT: (1) resting echocardiographic optimization (the Ritter method), (2) resting electrical optimization (intrinsic A-V interval and QRS duration), and (3) during low-intensity, steady-state CPX. Five sequential, incremental A-V intervals were programmed in each method. Assessment of cardiopulmonary stability and potential influence on the CPX-based method were assessed. CPX and determination of a physiological optimal A-V interval was successfully completed in 94.1% of patients, slightly higher than the resting echo-based approach (88.2%). There was a wide variation in the optimal A-V delay determined by each method. There was no observed cardiopulmonary instability or impact of the implant procedure that affected determination of the CPX-based optimized A-V interval. Determining optimized A-V intervals by CPX is feasible. Proposed mechanisms explaining this finding and long-term impact require further study. ©2014 Wiley Periodicals, Inc.

  2. Differential cardiac effects of aerobic interval training versus moderate continuous training in a patient with schizophrenia: a case report.

    Directory of Open Access Journals (Sweden)

    Marco eHerbsleb

    2014-08-01

    Full Text Available Increased cardiovascular morbidity and mortality rates for patients with schizophrenia are reported to contribute to their reduced life expectancy. Common reasons for increased cardiac mortality rates include cigarette smoking, obesity, dyslipidemia, diabetes and poorer health behavior in general. The majority of excess mortality among people with schizophrenia is caused by cardiovascular complications. Reduced vagal activity might be one important mechanism leading to this increased cardiac mortality and has been consistently described in patients and their healthy first-degree relatives.In this case study, we compared two different aerobic exercise regimes in one patient with chronic schizophrenia to investigate their effects on cardiovascular regulation. The patient completed a 6-week period of moderate continuous training followed by a 6-week period of interval training, each regime 2 times per week, on a stationary bicycle. This was followed by a 6-week period of detraining. Primary outcome measures examined heart rate (HR and heart rate variability (HRV at rest while secondary measures assessed fitness parameters such as the ventilatory threshold 1 (VT1. We observed that interval training was far more effective than moderate continuous training in increasing HRV, as indicated by RMSSD (improvement to baseline 27% vs. 18%, and reducing resting heart rate (-14% vs. 0%. Improvement in VT1 (21% vs. -1% was only observed after interval training. Our study provides preliminary data that the type of intervention is highly influential for improving cardiac function in patients with schizophrenia. While cardiovascular function might be influenced by continuous training to some degree, no such effect was present in this patient with schizophrenia. In addition, the beneficial effect of interval training on heart rate regulation vanished completely after a very short period of detraining after the intervention.

  3. Response interval is important for survival until admission after prehospital cardiac arrest

    DEFF Research Database (Denmark)

    Do, Hien Quoc; Nielsen, Søren Loumann; Rasmussen, Lars Simon

    2010-01-01

    An increasing distance to the nearest hospital must be expected as a result of centralization of acute care at a small number of hospitals. This may have important consequences in emergency situations, such as prehospital or out-of-hospital cardiac arrest (OHCA) where the aim is to obtain return...

  4. Dependency of magnetocardiographically determined fetal cardiac time intervals on gestational age, gender and postnatal biometrics in healthy pregnancies

    Directory of Open Access Journals (Sweden)

    Geue Daniel

    2004-04-01

    Full Text Available Abstract Background Magnetocardiography enables the precise determination of fetal cardiac time intervals (CTI as early as the second trimester of pregnancy. It has been shown that fetal CTI change in course of gestation. The aim of this work was to investigate the dependency of fetal CTI on gestational age, gender and postnatal biometric data in a substantial sample of subjects during normal pregnancy. Methods A total of 230 fetal magnetocardiograms were obtained in 47 healthy fetuses between the 15th and 42nd week of gestation. In each recording, after subtraction of the maternal cardiac artifact and the identification of fetal beats, fetal PQRST courses were signal averaged. On the basis of therein detected wave onsets and ends, the following CTI were determined: P wave, PR interval, PQ interval, QRS complex, ST segment, T wave, QT and QTc interval. Using regression analysis, the dependency of the CTI were examined with respect to gestational age, gender and postnatal biometric data. Results Atrioventricular conduction and ventricular depolarization times could be determined dependably whereas the T wave was often difficult to detect. Linear and nonlinear regression analysis established strong dependency on age for the P wave and QRS complex (r2 = 0.67, p r2 = 0.66, p r2 = 0.21, p r2 = 0.13, p st week onward (p Conclusion We conclude that 1 from approximately the 18th week to term, fetal CTI which quantify depolarization times can be reliably determined using magnetocardiography, 2 the P wave and QRS complex duration show a high dependency on age which to a large part reflects fetal growth and 3 fetal gender plays a role in QRS complex duration in the third trimester. Fetal development is thus in part reflected in the CTI and may be useful in the identification of intrauterine growth retardation.

  5. Multiresolution wavelet analysis of heartbeat intervals discriminates healthy patients from those with cardiac pathology

    CERN Document Server

    Thurner, S; Teich, M C; Thurner, Stefan; Feurstein, Markus C.; Teich, Malvin C.

    1998-01-01

    We applied multiresolution wavelet analysis to the sequence of times between human heartbeats (R-R intervals) and have found a scale window, between 16 and 32 heartbeats, over which the widths of the R-R wavelet coefficients fall into disjoint sets for normal and heart-failure patients. This has enabled us to correctly classify every patient in a standard data set as either belonging to the heart-failure or normal group with 100% accuracy, thereby providing a clinically significant measure of the presence of heart-failure from the R-R intervals alone. Comparison is made with previous approaches, which have provided only statistically significant measures.

  6. Method to measure autonomic control of cardiac function using time interval parameters from impedance cardiography

    NARCIS (Netherlands)

    Meijer, J.H.; Boesveldt, S.; Elbertse, E.; Berendse, H.W.

    2008-01-01

    The time difference between the electrocardiogram and impedance cardiogram can be considered as a measure for the time delay between the electrical and mechanical activities of the heart. This time interval, characterized by the pre-ejection period (PEP), is related to the sympathetic autonomous ner

  7. High-intensity interval training is not superior to other forms of endurance training during cardiac rehabilitation.

    Science.gov (United States)

    Tschentscher, Marcus; Eichinger, Jörg; Egger, Andreas; Droese, Silke; Schönfelder, Martin; Niebauer, Josef

    2016-01-01

    High-intensity interval training has recently emerged as superior to continuous endurance training in cardiac rehabilitation upon other training regimes. Individually tailored continuous endurance training and pyramid training could induce comparable effects on peak work capacity as high intensity interval training. A prospective, randomized study. Effects of the following isocaloric cycle ergometer protocols on peak work capacity have been assessed in patients with coronary artery disease (n = 60) during 6 weeks of outpatient cardiac rehabilitation, i.e. 18 supervised sessions of exercise training: (1) continuous endurance training (n = 20): 33 min at 65-85% peak heart rate; (2) high intensity interval training (n = 20): 4 × 4 min intervals at 85-95% peak heart rate, each followed by 3 min of active recovery at 60-70% peak heart rate; (3) pyramid training (n = 20): 3 × 8 min of stepwise load increase and subsequent decrease from 65-95-65% peak heart rate, supplemented by 2 min recovery at 60-70% peak heart rate between pyramids. All protocols were preceded by 5 min of warm-up and followed by 5 min cool-down at 60-70% peak heart rate. Attendance during exercise sessions was 99.2%. There were significant increases in peak work capacity of comparable magnitude in all three training groups (begin vs. end: continuous endurance training: 136.0 ± 49.6 W vs. 163.4 ± 60.8 W (21.1 ± 8.5%); high-intensity interval training: 141.0 ± 60.4 W vs. 171.1 ± 69.8 W (22.8 ± 6.6%); pyramid training: 128.7 ± 50.6 W vs. 158.5 ± 57.9 W (24.8 ± 10.8%); within groups all p training protocols assessed in this study all led to significant increases in peak work capacity of comparable magnitude. Our findings suggest that these protocols can be used interchangeably, which will lead to further individualization of exercise prescription and may therefore result in improved adherence to lifelong

  8. The Dip in the Anodal Strength-Interval Curve in Cardiac Tissue

    Science.gov (United States)

    Kandel, Sunil; Roth, Bradley J.

    2012-10-01

    Heart disease -- specifically ventricular fibrillation -- is the leading cause of death in the United States. The most common treatment for this lethal arrhythmia is defibrillation: application of a strong electrical shock that resets the heart to its normal rhythm. The goal of this project is to obtain a better understanding of how anodal (hyperpolarizing) shocks affect the heart by using numerical simulations. To accomplish this goal, we will test four hypotheses to find the response of refractory tissue to an anodal shock. We will use bidomain model; the state-of-the-art mathematical description of how cardiac tissue responds to an electric shock. The innovative feature of this proposal is to integrate the bidomain model with an ion channel model (Luo-Rudy model, 1994) that includes intracellular calcium dynamics to get a detailed calculation of the mechanism of the excitation and to understand the electrical behavior of the heart, which is important for pacing and defibrillation.

  9. High intensity interval and endurance training have opposing effects on markers of heart failure and cardiac remodeling in hypertensive rats.

    Directory of Open Access Journals (Sweden)

    Tanya M Holloway

    Full Text Available There has been re-emerging interest and significant work dedicated to investigating the metabolic effects of high intensity interval training (HIIT in recent years. HIIT is considered to be a time efficient alternative to classic endurance training (ET that elicits similar metabolic responses in skeletal muscle. However, there is a lack of information on the impact of HIIT on cardiac muscle in disease. Therefore, we determined the efficacy of ET and HIIT to alter cardiac muscle characteristics involved in the development of diastolic dysfunction, such as ventricular hypertrophy, fibrosis and angiogenesis, in a well-established rodent model of hypertension-induced heart failure before the development of overt heart failure. ET decreased left ventricle fibrosis by ~40% (P < 0.05, and promoted a 20% (P<0.05 increase in the left ventricular capillary/fibre ratio, an increase in endothelial nitric oxide synthase protein (P<0.05, and a decrease in hypoxia inducible factor 1 alpha protein content (P<0.05. In contrast, HIIT did not decrease existing fibrosis, and HIIT animals displayed a 20% increase in left ventricular mass (P<0.05 and a 20% decrease in cross sectional area (P<0.05. HIIT also increased brain natriuretic peptide by 50% (P<0.05, in the absence of concomitant angiogenesis, strongly suggesting pathological cardiac remodeling. The current data support the longstanding belief in the effectiveness of ET in hypertension. However, HIIT promoted a pathological adaptation in the left ventricle in the presence of hypertension, highlighting the need for further research on the widespread effects of HIIT in the presence of disease.

  10. High intensity interval and endurance training have opposing effects on markers of heart failure and cardiac remodeling in hypertensive rats.

    Science.gov (United States)

    Holloway, Tanya M; Bloemberg, Darin; da Silva, Mayne L; Simpson, Jeremy A; Quadrilatero, Joe; Spriet, Lawrence L

    2015-01-01

    There has been re-emerging interest and significant work dedicated to investigating the metabolic effects of high intensity interval training (HIIT) in recent years. HIIT is considered to be a time efficient alternative to classic endurance training (ET) that elicits similar metabolic responses in skeletal muscle. However, there is a lack of information on the impact of HIIT on cardiac muscle in disease. Therefore, we determined the efficacy of ET and HIIT to alter cardiac muscle characteristics involved in the development of diastolic dysfunction, such as ventricular hypertrophy, fibrosis and angiogenesis, in a well-established rodent model of hypertension-induced heart failure before the development of overt heart failure. ET decreased left ventricle fibrosis by ~40% (P HIIT did not decrease existing fibrosis, and HIIT animals displayed a 20% increase in left ventricular mass (PHIIT also increased brain natriuretic peptide by 50% (PHIIT promoted a pathological adaptation in the left ventricle in the presence of hypertension, highlighting the need for further research on the widespread effects of HIIT in the presence of disease.

  11. Hemodynamic device-based optimization in cardiac resynchronization therapy: concordance with systematic echocardiographic assessment of AV and VV intervals

    Directory of Open Access Journals (Sweden)

    Oliveira MM

    2015-08-01

    Full Text Available Mário M Oliveira, Luisa M Branco, Ana Galrinho, Nogueira da Silva, Pedro S Cunha, Bruno Valente, Joana Feliciano, Ricardo Pimenta, Ana Sofia Delgado, Rui Cruz Ferreira Santa Marta Hospital, Lisbon, Portugal Background: Inappropriate settings of atrioventricular (AV and ventriculo-ventricular (VV intervals can be one of the factors impacting response to cardiac resynchronization therapy (CRT. Optimal concordance of AV and VV intervals between echocardiographic-based assessment and a device-based automatic programming with a hemodynamic sensor was investigated, together with left ventricle (LV reverse remodeling after 6 months of regular automatic device-based optimization.Methods: We evaluated blindly 30 systematic echocardiographic examinations during 6 months in 17 patients (12 men, 64±10 years, in sinus rhythm and New York Heart Association class III; 76% with non-ischemic dilated cardiomyopathy, LV ejection fraction [LVEF] <35%, QRS 130 milliseconds and LV dyssynchrony implanted with the SonRtip lead and a cardioverter-defibrillator device. Dyssynchrony (AV, VV, or intraventricular was evaluated by an experienced operator blinded to the device programming, using conventional echocardiography, tissue synchronization imaging, tissue Doppler imaging, radial strain, and 3D echocardiography.Results: Either no AV or VV dyssynchrony (n=11; 36.7% or a slight septal or lateral delay (n=13; 43.3% was found in most echocardiography examinations (80%. AV or VV dyssynchrony requiring further optimization was identified in one-fifth of the examinations (20%. At 6 months, 76.5% patients were responders with LV reverse remodeling, of which 69% were super-responders (LVEF >40%. A statistically significant increase in LVEF was observed between baseline and 6 months post implant (P<0.01. One patient died from non-cardiac causes.Conclusion: Concordance between echocardiographic methods and device-based hemodynamic sensor optimization was found in most

  12. Establishment of a reference interval for high-sensitivity cardiac troponin I in healthy adults from the Sichuan area.

    Science.gov (United States)

    Li, Shunjun; Zuo, Yue; Huang, Wenfang

    2017-04-01

    High-sensitivity cardiac troponin I (hs-cTnI) has been used in the diagnosis and risk stratification of acute myocardial infarction. However, there is no common consensus on an hs-cTnI reference interval for the Chinese population. The aim of this study was to describe the distribution of hs-TnI and establish the 99th percentile reference interval for hs-cTnI in healthy adults from the Sichuan area.Serum specimens were collected from 1485 healthy adults (731 men and 754 women ranging in age from 18 to 85 years) in Sichuan Provincial People's Hospital. All specimens were divided into 4 groups according to age distribution: 18 to 35 years, 36 to 50 years, 51 to 65 years, and ≥66 years. Specimens were further divided into younger/middle and older-aged groups based on a cut-off age of 50 years. The serum hs-cTnI concentration was determined using the Abbott ARCHITECT STAT hs-cTnI assay.The serum hs-cTnI concentration increased with age (P 51 to 65 years, and 27.9 versus 32.2 pg/mL for ≥66 years.The 99th percentile reference interval for hs-cTnI in healthy adults from the Sichuan area was similar to the manufacturer's recommendation. Men had a higher 99th percentile hs-cTnI value than women in the age range of 18 to 65 years.

  13. Color Tissue Doppler to Analyze Fetal Cardiac Time Intervals: Normal Values and Influence of Sample Gate Size.

    Science.gov (United States)

    Willruth, A M; Steinhard, J; Enzensberger, C; Axt-Fliedner, R; Gembruch, U; Doelle, A; Dimitriou, I; Fimmers, R; Bahlmann, F

    2016-02-04

    Purpose: To assess the time intervals of the cardiac cycle in healthy fetuses in the second and third trimester using color tissue Doppler imaging (cTDI) and to evaluate the influence of different sizes of sample gates on time interval values. Materials and Methods: Time intervals were measured from the cTDI-derived Doppler waveform using a small and large region of interest (ROI) in healthy fetuses. Results: 40 fetuses were included. The median gestational age at examination was 26 + 1 (range: 20 + 5 - 34 + 5) weeks. The median frame rate was 116/s (100 - 161/s) and the median heart rate 143 (range: 125 - 158) beats per minute (bpm). Using small and large ROIs, the second trimester right ventricular (RV) mean isovolumetric contraction times (ICTs) were 39.8 and 41.4 ms (p = 0.17), the mean ejection times (ETs) were 170.2 and 164.6 ms (p < 0.001), the mean isovolumetric relaxation times (IRTs) were 52.8 and 55.3 ms (p = 0.08), respectively. The left ventricular (LV) mean ICTs were 36.2 and 39.4 ms (p = 0.05), the mean ETs were 167.4 and 164.5 ms (p = 0.013), the mean IRTs were 53.9 and 57.1 ms (p = 0.05), respectively. The third trimester RV mean ICTs were 50.7 and 50.4 ms (p = 0.75), the mean ETs were 172.3 and 181.4 ms (p = 0.49), the mean IRTs were 50.2 and 54.6 ms (p = 0.03); the LV mean ICTs were 45.1 and 46.2 ms (p = 0.35), the mean ETs were 175.2 vs. 172.9 ms (p = 0.29), the mean IRTs were 47.1 and 50.0 ms (p = 0.01), respectively. Conclusion: Isovolumetric time intervals can be analyzed precisely and relatively independent of ROI size. In the near future, automatic time interval measurement using ultrasound systems will be feasible and the analysis of fetal myocardial function can become part of the clinical routine.

  14. Short-interval leg movements during sleep entail greater cardiac activation than periodic leg movements during sleep in restless legs syndrome patients.

    Science.gov (United States)

    Ferri, Raffaele; Rundo, Francesco; Silvani, Alessandro; Zucconi, Marco; Aricò, Debora; Bruni, Oliviero; Lanuzza, Bartolo; Ferini-Strambi, Luigi; Manconi, Mauro

    2017-10-01

    Periodic leg movements during sleep (PLMS) are sequences of ≥4 motor events with intermovement intervals (IMI) of 10-90 s. PLMS are a supportive diagnostic criterion for restless legs syndrome (RLS) and entail cardiac activation, particularly when associated with arousal. RLS patients also over-express short-interval leg movements during sleep (SILMS), which have IMI leg movements. We found that the duration of the R-R interval decrease with SILMS doublets was significantly longer than that with PLMS, whereas the maximal decrease in R-R interval was similar. Scoring SILMS in RLS patients may therefore be relevant from a cardiac autonomic perspective. © 2017 European Sleep Research Society.

  15. Cyamemazine metabolites: effects on human cardiac ion channels in-vitro and on the QTc interval in guinea pigs.

    Science.gov (United States)

    Crumb, William; Benyamina, Amine; Arbus, Christophe; Thomas, George P; Garay, Ricardo P; Hameg, Ahcène

    2008-11-01

    Monodesmethyl cyamemazine and cyamemazine sulfoxide, the two main metabolites of the antipsychotic and anxiolytic phenothiazine cyamemazine, were investigated for their effects on the human ether-à-go-go related gene (hERG) channel expressed in HEK 293 cells and on native I(Na), I(Ca), I(to), I(sus) or I(K1) of human atrial myocytes. Additionally, cyamemazine metabolites were compared with terfenadine for their effects on the QT interval in anaesthetized guinea pigs. Monodesmethyl cyamemazine and cyamemazine sulfoxide reduced hERG current amplitude, with IC50 values of 0.70 and 1.53 microM, respectively. By contrast, at a concentration of 1 microM, cyamemazine metabolites failed to significantly affect I(Na), I(to), I(sus) or I(K1) current amplitudes. Cyamemazine sulfoxide had no effect on I(Ca) at 1 microM, while at this concentration, monodesmethyl cyamemazine only slightly (17%), albeit significantly, inhibited I(Ca) current. Finally, cyamemazine metabolites (5 mg kg(-1) i v.) were unable to significantly prolong QTc values in the guinea pig. Conversely, terfenadine (5 mg kg(-1) i.v.) significantly increased QTc values. In conclusion, cyamemazine metabolite concentrations required to inhibit hERG current substantially exceed those necessary to achieve therapeutic activity of the parent compound in humans. Moreover, cyamemazine metabolites, in contrast to terfenadine, do not delay cardiac repolarization in the anaesthetized guinea pig. These non-clinical findings explain the excellent cardiac safety records of cyamemazine during its 30 years of extensive therapeutic use.

  16. A new method of assessing cardiac autonomic function and its comparison with spectral analysis and coefficient of variation of R-R interval.

    Science.gov (United States)

    Toichi, M; Sugiura, T; Murai, T; Sengoku, A

    1997-01-12

    A new non-linear method of assessing cardiac autonomic function was examined in a pharmacological experiment in ten healthy volunteers. The R-R interval data obtained under a control condition and in autonomic blockade by atropine and by propranolol were analyzed by each of the new methods employing Lorenz plot, spectral analysis and the coefficient of variation. With our method we derived two measures, the cardiac vagal index and the cardiac sympathetic index, which indicate vagal and sympathetic function separately. These two indices were found to be more reliable than those obtained by the other two methods. We anticipate that the non-invasive assessment of short-term cardiac autonomic function will come to be performed more reliably and conveniently by this method.

  17. Home-based aerobic interval training improves peak oxygen uptake equal to residential cardiac rehabilitation: a randomized, controlled trial.

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    Trine Moholdt

    Full Text Available Aerobic capacity, measured as the peak oxygen uptake, is a strong predictor of survival in cardiac patients. Aerobic interval training (AIT, walking/running four times four minutes at 85-95% of peak heart rate, has proven to be effective in increasing peak oxygen uptake in coronary heart disease patients. As some patients do not attend organized rehabilitation programs, home-based exercise should be an alternative. We investigated whether AIT could be performed effectively at home, and compared the effects on peak oxygen uptake with that observed after a standard care, four-week residential rehabilitation. Thirty patients undergoing coronary artery bypass surgery were randomized to residential rehabilitation or home-based AIT. At six months follow-up, peak oxygen uptake increased 4.6 (±2.7 and 3.9 (±3.6 mL·kg(-1 min(-1 (both p<0.005, non-significant between-group difference after residential rehabilitation and AIT, respectively. Quality of life increased significantly in both groups, with no statistical significant difference between groups. We found no evidence for a different treatment effect between patients randomized to home-based AIT compared to patients attending organized rehabilitation (95% confidence interval -1.8, 3.5. AIT patients reported good adherence to exercise training. Even though these first data indicate positive effects of home-based AIT in patients undergoing coronary artery bypass surgery, more studies are needed to provide supporting evidence for the application of this rehabilitation strategy.ClinicalTrials.gov NCT00363922.

  18. The impact of first responder turnout and curb-to-care intervals on survival from out-of-hospital cardiac arrest.

    Science.gov (United States)

    DeRuyter, Nicolaas P; Husain, Sofia; Yin, Lihua; Olsufka, Michele; McCoy, Andrew M; Maynard, Charles; Cobb, Leonard A; Rea, Thomas D; Sayre, Michael R

    2017-04-01

    Patients with out-of-hospital cardiac arrest (OHCA) more likely survive when emergency medical services (EMS) arrive quickly. We studied time response elements in OHCA with attention to EMS intervals before wheels roll and after wheels stop to understand their contribution to total time response and clinical outcome. We analyzed EMS responses to OHCA from 2009-2014 in an urban, fire department based system. The Call-to-Care Interval, from call receipt to hands-on EMS care, was comprised of four time intervals: 1) call received to EMS notification (Activation), 2) EMS notification to vehicle wheels rolling (Turnout), 3) wheels rolling to arrival at scene (Travel), and 4) arrival at scene to hands-on EMS care (Curb-to-Care). We created a new time interval (On-Feet) comprised of the turnout and curb-to-care intervals. Using logistic regression, we evaluated whether the total EMS response interval and discrete time intervals were related to survival to discharge. Of 1,831 cases, 1,806 (98.6%) had complete information. The mean lengths for the intervals were 7.2±3.6min. (call-to-care), 58±39s (activation), 63±29s (turnout), 2.5±1.3min (travel), 2.4±1.6min (curb-to-care), and 3.5±1.7min (on-feet). After adjustment, "On Feet" interval was associated with OHCA survival (OR=0.91 [95% CI=0.83-1.00] for each additional minute). Turnout and curb-to-care intervals were half of the total response interval in our EMS system. Measurement should incorporate these two intervals to accurately characterize and possibly reduce the professional response interval. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. DFA on Cardiac Rhythm: Fluctuation of the Heartbeat Interval Contain Useful Information for the Risk of Mortality in Both, Animal Models and Humans

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    Toru Yazawa

    2007-02-01

    Full Text Available We analyzed the heartbeat interval to test the possibility that the detrended fluctuation analysis (DFA distinguishes a sick condition from a healthy condition of the cardiac control network. The healthy heart exhibited exponents ranging from 0.8 to 1.0 in both, animal models and humans. In the sick animal models, the exponents declined with an approaching very low range leading to a natural death (~0.6 in the end. Other models, which had a myocardial injury, exhibited extremely high exponents (~1.4. The high exponent was maintained until they died. Human arrhythmic hearts exhibited low exponent (~0.7. A human subject who has an abnormally high heart rate exhibited high exponents (as high as 1.4. A Human transplanted heart, which has no nervous controls, exhibited exponent 1.2. The fluctuation of the heartbeat interval contains information for the risk of a cardiac cessation or mortality.

  20. Alteration in cardiac uncoupling proteins and eNOS gene expression following high-intensity interval training in favor of increasing mechanical efficiency

    OpenAIRE

    Ali Asghar Fallahi; Shahnaz Shekarfroush; Mostafa Rahimi; Amirhossain Jalali; Ali Khoshbaten

    2016-01-01

    Objective(s): High-intensity interval training (HIIT) increases energy expenditure and mechanical energy efficiency. Although both uncoupling proteins (UCPs) and endothelial nitric oxide synthase (eNOS) affect the mechanical efficiency and antioxidant capacity, their effects are inverse. The aim of this study was to determine whether the alterations of cardiac UCP2, UCP3, and eNOS mRNA expression following HIIT are in favor of increased mechanical efficiency or decreased oxidative stress. Mat...

  1. Cardiac Time Intervals by Tissue Doppler Imaging M-Mode: Normal Values and Association with Established Echocardiographic and Invasive Measures of Systolic and Diastolic Function.

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    Tor Biering-Sørensen

    Full Text Available To define normal values of the cardiac time intervals obtained by tissue Doppler imaging (TDI M-mode through the mitral valve (MV. Furthermore, to evaluate the association of the myocardial performance index (MPI obtained by TDI M-mode (MPITDI and the conventional method of obtaining MPI (MPIConv, with established echocardiographic and invasive measures of systolic and diastolic function.In a large community based population study (n = 974, where all are free of any cardiovascular disease and cardiovascular risk factors, cardiac time intervals, including isovolumic relaxation time (IVRT, isovolumic contraction time (IVCT, and ejection time (ET were obtained by TDI M-mode through the MV. IVCT/ET, IVRT/ET and the MPI ((IVRT+IVCT/ET were calculated. We also included a validation population (n = 44 of patients who underwent left heart catheterization and had the MPITDI and MPIConv measured.IVRT, IVRT/ET and MPI all increased significantly with increasing age in both genders (p<0.001 for all. IVCT, ET, IVRT/ET, and MPI differed significantly between males and females, displaying that women, in general exhibit better cardiac function. MPITDI was significantly associated with invasive (dP/dt max and echocardiographic measures of systolic (LVEF, global longitudinal strain and global strainrate s and diastolic function (e', global strainrate e(p<0.05 for all, whereas MPIConv was significantly associated with LVEF, e' and global strainrate e (p<0.05 for all.Normal values of cardiac time intervals differed between genders and deteriorated with increasing age. The MPITDI (but not MPIConv is associated with most invasive and established echocardiographic measures of systolic and diastolic function.

  2. Prolongation of heart rate-corrected QT interval is a predictor of cardiac autonomic dysfunction in patients with systemic lupus erythematosus.

    Science.gov (United States)

    Nomura, Atsushi; Kishimoto, Mitsumasa; Takahashi, Osamu; Deshpande, Gautam A; Yamaguchi, Kenichi; Okada, Masato

    2014-05-01

    Heart rate-corrected QT interval duration (QTc) has been shown to be related to cardiac autonomic dysfunction in patients with diabetes mellitus, although this association has not been previously described in patients with systemic lupus erythematosus (SLE). We retrospectively reviewed the medical records of 91 SLE patients and 144 non-SLE connective tissue disease patients visiting our clinic from November 2010 to April 2011. We compared ambulatory heart rate identified by pulse measured by automated machine in an outpatient waiting area versus resting heart rate identified on prior screening electrocardiogram. Heart rate differences were analyzed in relation to QTc interval and other characteristics. Ambulatory and resting heart rate differences were larger among SLE patients with QTc prolongation (QTc > 430 ms) than those without QTc prolongation (mean difference, 15.9 vs. 9.6, p = 0.001). In multivariate analysis, differences in heart rate were associated with QTc prolongation (OR 1.10, 95 % CI 1.01-1.21; p = 0.038), independent of age, duration of disease, immunosuppressant use, hydroxychloroquine use, diabetes mellitus, cardiac abnormality, anti-Ro/SS-A antibody positivity, or resting heart rate. Cardiac autonomic dysfunction is a common manifestation of SLE and may be related to QTc prolongation.

  3. Does rating of perceived exertion result in target exercise intensity during interval training in cardiac rehabilitation? A study of the Borg scale versus a heart rate monitor.

    Science.gov (United States)

    Aamot, Inger-Lise; Forbord, Siv Hege; Karlsen, Trine; Støylen, Asbjørn

    2014-09-01

    To assess whether rating of perceived exertion using the Borg 6-20 scale is a valid method for achieving target exercise intensity during high-intensity interval training in cardiac rehabilitation. A single-group cross-over design. Ten participants (56 (6.5) years) who were enrolled in a high-intensity interval training cardiac rehabilitation program were recruited. A target exercise intensity of Borg 17 (very hard) was used for exercise intensity guidance in the initial four exercise sessions that took place before a cardiopulmonary exercise test, as in usual care rehabilitation. The heart rate was recorded and blinded to the participants. After performing the test, the participants were then instructed using heart rate monitors openly for exercise guidance in four subsequent exercise sessions, at an intensity corresponding to 85-95% of peak heart rate. The mean exercise intensity during high-intensity bouts was 82% (6%) of peak heart rate for the rating of perceived exertion and 85% (6%) using heart rate monitors (p=0.005). Bland-Altman limits of agreement analysis with a mean bias showed a bias of 2.97 (-2.08, 8.02) percentage points for the two methods. Exercise intensity was highly repeatable with intra-class correlations of 0.95 (95% CI 0.86-0.99, pexercise sessions using rating of perceived exertion and percentage of peak heart rate for intensity control, respectively. Rating of perceived exertion results in an exercise intensity below target during high-intensity interval training bouts in cardiac rehabilitation. Heart rate monitoring should be used for accurate intensity guidance. Copyright © 2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  4. Electrocardiographic Screening for Prolonged QT Interval to Reduce Sudden Cardiac Death in Psychiatric Patients: A Cost-Effectiveness Analysis.

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    Antoine Poncet

    Full Text Available Sudden cardiac death is a leading cause of mortality in psychiatric patients. Long QT (LQT is common in this population and predisposes to Torsades-de-Pointes (TdP and subsequent mortality.To estimate the cost-effectiveness of electrocardiographic screening to detect LQT in psychiatric inpatients.We built a decision analytic model based on a decision tree to evaluate the cost-effectiveness and utility of LQT screening from a health care perspective. LQT proportion parameters were derived from an in-hospital cross-sectional study. We performed experts' elicitation to estimate the risk of TdP, given extent of QT prolongation. A TdP reduction of 65% after LQT detection was based on positive drug dechallenge rate and through adequate treatment and electrolyte adjustments. The base-case model uncertainty was assessed with one-way and probabilistic sensitivity analyses. Finally, the TdP related mortality and TdP avoidance parameters were varied in a two-way sensitivity analysis to assess their effect on the Incremental Cost-Effectiveness Ratio (ICER.Costs, Quality Ajusted Life Year (QALY, ICER, and probability of cost effectiveness thresholds ($ 10,000, $25,000, and $50,000 per QALY.In the base-case scenario, the numbers of patients needed to screen were 1128 and 2817 to avoid one TdP and one death, respectively. The ICER of systematic ECG screening was $8644 (95%CI, 3144-82 498 per QALY. The probability of cost-effectiveness was 96% at a willingness-to-pay of $50,000 for one QALY. In sensitivity analyses, results were sensitive to the case-fatality of TdP episodes and to the TdP reduction following the diagnosis of LQT.In psychiatric hospitals, performing systematic ECG screening at admission help reduce the number of sudden cardiac deaths in a cost-effective fashion.

  5. Persistent fluctuations in stride intervals under fractal auditory stimulation.

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    Vivien Marmelat

    Full Text Available Stride sequences of healthy gait are characterized by persistent long-range correlations, which become anti-persistent in the presence of an isochronous metronome. The latter phenomenon is of particular interest because auditory cueing is generally considered to reduce stride variability and may hence be beneficial for stabilizing gait. Complex systems tend to match their correlation structure when synchronizing. In gait training, can one capitalize on this tendency by using a fractal metronome rather than an isochronous one? We examined whether auditory cues with fractal variations in inter-beat intervals yield similar fractal inter-stride interval variability as isochronous auditory cueing in two complementary experiments. In Experiment 1, participants walked on a treadmill while being paced by either an isochronous or a fractal metronome with different variation strengths between beats in order to test whether participants managed to synchronize with a fractal metronome and to determine the necessary amount of variability for participants to switch from anti-persistent to persistent inter-stride intervals. Participants did synchronize with the metronome despite its fractal randomness. The corresponding coefficient of variation of inter-beat intervals was fixed in Experiment 2, in which participants walked on a treadmill while being paced by non-isochronous metronomes with different scaling exponents. As expected, inter-stride intervals showed persistent correlations similar to self-paced walking only when cueing contained persistent correlations. Our results open up a new window to optimize rhythmic auditory cueing for gait stabilization by integrating fractal fluctuations in the inter-beat intervals.

  6. Persistent fluctuations in stride intervals under fractal auditory stimulation.

    Science.gov (United States)

    Marmelat, Vivien; Torre, Kjerstin; Beek, Peter J; Daffertshofer, Andreas

    2014-01-01

    Stride sequences of healthy gait are characterized by persistent long-range correlations, which become anti-persistent in the presence of an isochronous metronome. The latter phenomenon is of particular interest because auditory cueing is generally considered to reduce stride variability and may hence be beneficial for stabilizing gait. Complex systems tend to match their correlation structure when synchronizing. In gait training, can one capitalize on this tendency by using a fractal metronome rather than an isochronous one? We examined whether auditory cues with fractal variations in inter-beat intervals yield similar fractal inter-stride interval variability as isochronous auditory cueing in two complementary experiments. In Experiment 1, participants walked on a treadmill while being paced by either an isochronous or a fractal metronome with different variation strengths between beats in order to test whether participants managed to synchronize with a fractal metronome and to determine the necessary amount of variability for participants to switch from anti-persistent to persistent inter-stride intervals. Participants did synchronize with the metronome despite its fractal randomness. The corresponding coefficient of variation of inter-beat intervals was fixed in Experiment 2, in which participants walked on a treadmill while being paced by non-isochronous metronomes with different scaling exponents. As expected, inter-stride intervals showed persistent correlations similar to self-paced walking only when cueing contained persistent correlations. Our results open up a new window to optimize rhythmic auditory cueing for gait stabilization by integrating fractal fluctuations in the inter-beat intervals.

  7. Acute Modification of Cardiac Autonomic Function of High-Intensity Interval Training in Collegiate Male Soccer Players with Different Chronotype: A Cross-Over Study

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    Matteo Bonato, Luca Agnello, Letizia Galasso, Angela Montaruli, Eliana Roveda, Giampiero Merati, Antonio La Torre, Jacopo A. Vitale

    2017-06-01

    Full Text Available The purpose of this study was to evaluate if the time of the day (8.00 a.m. vs 8.00 p.m. and chronotype could influence autonomic cardiac control in soccer players in relation to an acute session of high-intensity interval training. The morningness-eveningness questionnaire was administered to recruit Morning-type and Evening-type collegiate male soccer players. Therefore, 24 players (12 Morning-types and 12 Evening-types were randomly assigned, to either morning (n = 12; age 23 ± 3 years; height 1.75 ± 0.07 m; body mass 73 ± 10 kg; weekly training volume 8 2 hours, or evening (n = 12; age 21 ± 3 years; height 1.76 ± 0.05 m; body mass 75 ± 11 kg; weekly training volume 8 ± 3 hours training. Heart Rate Variability vagal and sympatho/vagal indices were calculated in time, frequency and complexity domains at rest, before, after 12 and 24 hours of high-intensity interval training. Before evening training session, a higher resting heart rate was observed which was determined by a marked parasympathetic withdrawal with a sympathetic predominance. Moreover, Evening-type subjects during morning training session, present a significant higher heart rate that corresponded to significant higher vagal indices with a significant lower parasympathetic tone that returned to the rest values after 24 hours of the cessation of high-intensity interval training exercise. On the contrary, Morning-type subjects did not reveal any significant differences with Evening-Type subjects during evening high-intensity interval training session. Stress response of high-intensity interval training is influenced by both the time of the day and by the chronotype. Understanding the Heart Rate Variability response to high-intensity interval training can be an additional important procedure for evaluating of cardiovascular recovery in soccer players. Moreover, these results suggest that an athlete’s chronotype should be taken into account when scheduling a high

  8. Acute Modification of Cardiac Autonomic Function of High-Intensity Interval Training in Collegiate Male Soccer Players with Different Chronotype: A Cross-Over Study.

    Science.gov (United States)

    Bonato, Matteo; Agnello, Luca; Galasso, Letizia; Montaruli, Angela; Roveda, Eliana; Merati, Giampiero; La Torre, Antonio; Vitale, Jacopo A

    2017-06-01

    The purpose of this study was to evaluate if the time of the day (8.00 a.m. vs 8.00 p.m.) and chronotype could influence autonomic cardiac control in soccer players in relation to an acute session of high-intensity interval training. The morningness-eveningness questionnaire was administered to recruit Morning-type and Evening-type collegiate male soccer players. Therefore, 24 players (12 Morning-types and 12 Evening-types) were randomly assigned, to either morning (n = 12; age 23 ± 3 years; height 1.75 ± 0.07 m; body mass 73 ± 10 kg; weekly training volume 8 2 hours), or evening (n = 12; age 21 ± 3 years; height 1.76 ± 0.05 m; body mass 75 ± 11 kg; weekly training volume 8 ± 3 hours) training. Heart Rate Variability vagal and sympatho/vagal indices were calculated in time, frequency and complexity domains at rest, before, after 12 and 24 hours of high-intensity interval training. Before evening training session, a higher resting heart rate was observed which was determined by a marked parasympathetic withdrawal with a sympathetic predominance. Moreover, Evening-type subjects during morning training session, present a significant higher heart rate that corresponded to significant higher vagal indices with a significant lower parasympathetic tone that returned to the rest values after 24 hours of the cessation of high-intensity interval training exercise. On the contrary, Morning-type subjects did not reveal any significant differences with Evening-Type subjects during evening high-intensity interval training session. Stress response of high-intensity interval training is influenced by both the time of the day and by the chronotype. Understanding the Heart Rate Variability response to high-intensity interval training can be an additional important procedure for evaluating of cardiovascular recovery in soccer players. Moreover, these results suggest that an athlete's chronotype should be taken into account when scheduling a high-intensity interval training

  9. High intensity interval training (HIIT) improves resting blood pressure, metabolic (MET) capacity and heart rate reserve without compromising cardiac function in sedentary aging men.

    Science.gov (United States)

    Grace, Fergal; Herbert, Peter; Elliott, Adrian D; Richards, Jo; Beaumont, Alexander; Sculthorpe, Nicholas F

    2017-05-13

    This study examined a programme of pre-conditioning exercise with subsequent high intensity interval training (HIIT) on blood pressure, echocardiography, cardiac strain mechanics and maximal metabolic (MET) capacity in sedentary (SED) aging men compared with age matched masters athletes (LEX). Using a STROBE compliant observational design, 39 aging male participants (SED; n=22, aged 62.7±5.2yrs) (LEX; n=17, aged=61.1±5.4yrs) were recruited to a study that necessitated three distinct assessment phases; enrolment (Phase A), following pre-conditioning exercise in SED (Phase B), then following 6weeks of HIIT performed once every five days by both groups before reassessment (Phase C). Hemodynamic, echocardiographic and cardiac strain mechanics were obtained at rest and maximal cardiorespiratory and chronotropic responses were obtained at each measurement phase. The training intervention improved systolic, mean arterial blood pressure, rate pressure product and heart rate reserve (each P<0.05) in SED and increased MET capacity in both SED and LEX (P<0.01) which was amplified by HIIT. Echocardiography and cardiac strain measures were unremarkable apart from trivial increase to intra-ventricular septum diastole (IVSd) (P<0.05) and decrease to left ventricular internal dimension diastole (LVId) (P<0.05) in LEX following HIIT. A programme of preconditioning exercise with HIIT induces clinically relevant improvements in blood pressure, rate pressure product and encourages recovery of heart rate reserve in SED, while improving maximal MET capacity in both SED and LEX without inducing any pathological cardiovascular remodeling. These data add to the emerging repute of HIIT as a safe and promising exercise prescription to improve cardiovascular function and metabolic capacity in sedentary aging. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  10. Alteration in cardiac uncoupling proteins and eNOS gene expression following high-intensity interval training in favor of increasing mechanical efficiency

    Science.gov (United States)

    Fallahi, Ali Asghar; Shekarfroush, Shahnaz; Rahimi, Mostafa; Jalali, Amirhossain; Khoshbaten, Ali

    2016-01-01

    Objective(s): High-intensity interval training (HIIT) increases energy expenditure and mechanical energy efficiency. Although both uncoupling proteins (UCPs) and endothelial nitric oxide synthase (eNOS) affect the mechanical efficiency and antioxidant capacity, their effects are inverse. The aim of this study was to determine whether the alterations of cardiac UCP2, UCP3, and eNOS mRNA expression following HIIT are in favor of increased mechanical efficiency or decreased oxidative stress. Materials and Methods: Wistar rats were divided into five groups: control group (n=12), HIIT for an acute bout (AT1), short term HIIT for 3 and 5 sessions (ST3 and ST5), long-term training for 8 weeks (LT) (6 in each group). The rats of the training groups were made to run on a treadmill for 60 min in three stages: 6 min running for warm-up, 7 intervals of 7 min running on treadmill with a slope of 5° to 20° (4 min with an intensity of 80-110% VO2max and 3 min at 50-60% VO2max), and 5-min running for cool-down. The control group did not participate in any exercise program. Rats were sacrificed and the hearts were extracted to analyze the levels of UCP2, UCP3 and eNOS mRNA by RT-PCR. Results: UCP3 expression was increased significantly following an acute training bout. Repeated HIIT for 8 weeks resulted in a significant decrease in UCPs mRNA and a significant increase in eNOS expression in cardiac muscle. Conclusion: This study indicates that Long term HIIT through decreasing UCPs mRNA and increasing eNOS mRNA expression may enhance energy efficiency and physical performance. PMID:27114795

  11. Comparison of different volumes of high intensity interval training on cardiac autonomic function in sedentary young women.

    Science.gov (United States)

    Bhati, Pooja; Bansal, Vishal; Moiz, Jamal Ali

    2017-08-24

    Purpose The present study was conducted to compare the effects of low volume of high intensity interval training (LVHIIT) and high volume of high intensity interval training (HVHIIT) on heart rate variability (HRV) as a primary outcome measure, and on maximum oxygen consumption (VO2max), body composition, and lower limb muscle strength as secondary outcome measures, in sedentary young women. Methods Thirty-six participants were recruited in this study. The LVHIIT group (n = 17) performed one 4-min bout of treadmill running at 85%-95% maximum heart rate (HRmax), followed by 3 min of recovery by running at 70% HRmax, three times per week for 6 weeks. The HVHIIT group (n = 15) performed four times 4-min bouts of treadmill running at 85%-95% HRmax, interspersed with 3-min of recovery by running at 70% HRmax, 3 times per week for 6 weeks. All criterion measures were measured before and after training in both the groups. Results Due to attrition of four cases, data of 32 participants was used for analysis. A significant increase in high frequency (HF) power (p high frequency power (LF/HF) ratio (p sedentary young women. However, HVHIIT induces parasympathetic dominance as well, as measured by HRV.

  12. Novel all-extremity high-intensity interval training improves aerobic fitness, cardiac function and insulin resistance in healthy older adults.

    Science.gov (United States)

    Hwang, Chueh-Lung; Yoo, Jeung-Ki; Kim, Han-Kyul; Hwang, Moon-Hyon; Handberg, Eileen M; Petersen, John W; Christou, Demetra D

    2016-09-01

    Aging is associated with decreased aerobic fitness and cardiac remodeling leading to increased risk for cardiovascular disease. High-intensity interval training (HIIT) on the treadmill has been reported to be more effective in ameliorating these risk factors compared with moderate-intensity continuous training (MICT) in patients with cardiometabolic disease. In older adults, however, weight-bearing activities are frequently limited due to musculoskeletal and balance problems. The purpose of this study was to examine the feasibility and safety of non-weight-bearing all-extremity HIIT in older adults. In addition, we tested the hypothesis that all-extremity HIIT will be more effective in improving aerobic fitness, cardiac function, and metabolic risk factors compared with all-extremity MICT. Fifty-one healthy sedentary older adults (age: 65±1years) were randomized to HIIT (n=17), MICT (n=18) or non-exercise control (CONT; n=16). HIIT (4×4min 90% of peak heart rate; HRpeak) and isocaloric MICT (70% of HRpeak) were performed on a non-weight-bearing all-extremity ergometer, 4×/week for 8weeks under supervision. All-extremity HIIT was feasible in older adults and resulted in no adverse events. Aerobic fitness (peak oxygen consumption; VO2peak) and ejection fraction (echocardiography) improved by 11% (PHIIT, while no changes were observed in MICT and CONT (P≥0.1). Greater improvements in ejection fraction were associated with greater improvements in VO2peak (r=0.57; PHIIT by 26% (P=0.016). Diastolic function, body composition, glucose and lipids were unaffected (P≥0.1). In conclusion, all-extremity HIIT is feasible and safe in older adults. HIIT, but not MICT, improved aerobic fitness, ejection fraction, and insulin resistance.

  13. Cardiac Autonomic Responses during Exercise and Post-exercise Recovery Using Heart Rate Variability and Systolic Time Intervals-A Review.

    Science.gov (United States)

    Michael, Scott; Graham, Kenneth S; Davis, Glen M

    2017-01-01

    Cardiac parasympathetic activity may be non-invasively investigated using heart rate variability (HRV), although HRV is not widely accepted to reflect sympathetic activity. Instead, cardiac sympathetic activity may be investigated using systolic time intervals (STI), such as the pre-ejection period. Although these autonomic indices are typically measured during rest, the "reactivity hypothesis" suggests that investigating responses to a stressor (e.g., exercise) may be a valuable monitoring approach in clinical and high-performance settings. However, when interpreting these indices it is important to consider how the exercise dose itself (i.e., intensity, duration, and modality) may influence the response. Therefore, the purpose of this investigation was to review the literature regarding how the exercise dosage influences these autonomic indices during exercise and acute post-exercise recovery. There are substantial methodological variations throughout the literature regarding HRV responses to exercise, in terms of exercise protocols and HRV analysis techniques. Exercise intensity is the primary factor influencing HRV, with a greater intensity eliciting a lower HRV during exercise up to moderate-high intensity, with minimal change observed as intensity is increased further. Post-exercise, a greater preceding intensity is associated with a slower HRV recovery, although the dose-response remains unclear. A longer exercise duration has been reported to elicit a lower HRV only during low-moderate intensity and when accompanied by cardiovascular drift, while a small number of studies have reported conflicting results regarding whether a longer duration delays HRV recovery. "Modality" has been defined multiple ways, with limited evidence suggesting exercise of a greater muscle mass and/or energy expenditure may delay HRV recovery. STI responses during exercise and recovery have seldom been reported, although limited data suggests that intensity is a key determining

  14. Frontal midline theta rhythm is correlated with cardiac autonomic activities during the performance of an attention demanding meditation procedure.

    Science.gov (United States)

    Kubota, Y; Sato, W; Toichi, M; Murai, T; Okada, T; Hayashi, A; Sengoku, A

    2001-04-01

    Frontal midline theta rhythm (Fm theta), recognized as distinct theta activity on EEG in the frontal midline area, reflects mental concentration as well as meditative state or relief from anxiety. Attentional network in anterior frontal lobes including anterior cingulate cortex is suspected to be the generator of this activity, and the regulative function of the frontal neural network over autonomic nervous system (ANS) during cognitive process is suggested. However no studies have examined peripheral autonomic activities during Fm theta induction, and interaction of central and peripheral mechanism associated with Fm theta remains unclear. In the present study, a standard procedure of Zen meditation requiring sustained attention and breath control was employed as the task to provoke Fm theta, and simultaneous EEG and ECG recordings were performed. For the subjects in which Fm theta activities were provoked (six men, six women, 48% of the total subjects), peripheral autonomic activities were evaluated during the appearance of Fm theta as well as during control periods. Successive inter-beat intervals were measured from the ECG, and a recently developed method of analysis by Toichi et al. (J. Auton. Nerv. Syst. 62 (1997) 79-84) based on heart rate variability was used to assess cardiac sympathetic and parasympathetic functions separately. Both sympathetic and parasympathetic indices were increased during the appearance of Fm theta compared with control periods. Theta band activities in the frontal area were correlated negatively with sympathetic activation. The results suggest a close relationship between cardiac autonomic function and activity of medial frontal neural circuitry.

  15. Prognostic Value of Cardiac Time Intervals by Tissue Doppler Imaging M-Mode in Patients With Acute ST-Segment-Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention

    DEFF Research Database (Denmark)

    Biering-Sørensen, Tor; Mogelvang, Rasmus; Søgaard, Peter;

    2013-01-01

    Background- Color tissue Doppler imaging M-mode through the mitral leaflet is an easy and precise method to estimate all cardiac time intervals from 1 cardiac cycle and thereby obtain the myocardial performance index (MPI). However, the prognostic value of the cardiac time intervals and the MPI...... assessed by color tissue Doppler imaging M-mode through the mitral leaflet in patients with ST-segment-elevation myocardial infarction (MI) is unknown. Methods and Results- In total, 391 patients were admitted with an ST-segment-elevation MI, treated with primary percutaneous coronary intervention......, and examined by echocardiography a median of 2 days after the ST-segment-elevation MI. Outcome was assessed according to death (n=33), hospitalization with heart failure (n=53), or new MI (n=25). Follow-up time was a median of 25 months. The population was stratified according to tertiles of the MPI. The risk...

  16. Effects of the New Aldose Reductase Inhibitor Benzofuroxane Derivative BF-5m on High Glucose Induced Prolongation of Cardiac QT Interval and Increase of Coronary Perfusion Pressure

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    C. Di Filippo

    2016-01-01

    Full Text Available This study investigated the effects of the new aldose reductase inhibitor benzofuroxane derivative 5(6-(benzo[d]thiazol-2-ylmethoxybenzofuroxane (BF-5m on the prolongation of cardiac QT interval and increase of coronary perfusion pressure (CPP in isolated, high glucose (33.3 mM D-glucose perfused rat hearts. BF-5m was dissolved in the Krebs solution at a final concentration of 0.01 μM, 0.05 μM, and 0.1 μM. 33.3 mM D-glucose caused a prolongation of the QT interval and increase of CPP up to values of 190 ± 12 ms and 110 ± 8 mmHg with respect to the values of hearts perfused with standard Krebs solution (11.1 mM D-glucose. The QT prolongation was reduced by 10%, 32%, and 41%, respectively, for the concentration of BF-5m 0.01 μM, 0.05 μM, and 0.1 μM. Similarly, the CPP was reduced by 20% for BF-5m 0.05 μM and by 32% for BF-5m 0.1 μM. BF-5m also increased the expression levels of sirtuin 1, MnSOD, eNOS, and FOXO-1, into the heart. The beneficial actions of BF-5m were partly abolished by the pretreatment of the rats with the inhibitor of the sirtuin 1 activity EX527 (10 mg/kg/day/7 days i.p. prior to perfusion of the hearts with high glucose + BF-5m (0.1 μM. Therefore, BF-5m supplies cardioprotection from the high glucose induced QT prolongation and increase of CPP.

  17. Single session of sprint interval training elicits similar cardiac output but lower oxygen uptake versus ramp exercise to exhaustion in men and women

    Science.gov (United States)

    Horn, Trevor; Roverud, Garret; Sutzko, Kandice; Browne, Melissa; Parra, Cristina; Astorino, Todd A

    2016-01-01

    Sprint interval training (SIT) elicits comparable long-term adaptations versus continuous exercise training (CEX) including increased maximal oxygen uptake (VO2max) and fat utilization. However, there is limited research examining acute hemodynamic responses to SIT. The aim of this study was to examine hemodynamic responses to low-volume SIT. Active men (n=6, VO2max = 39.8 ± 1.7 mL/kg/min) and women (n=7, VO2max = 37.3 ± 5.7 mL/kg/min) performed a ramp-based VO2max test (RAMP) to determine workload for the SIT session. Subjects returned within 1 wk and completed a session of SIT consisting of six 30-s bouts of “all-out” cycling at 130% maximal workload (Wmax) interspersed with 120 s of active recovery. Continuously during RAMP and exercise and recovery in SIT, VO2 was obtained and thoracic impedance was used to estimate heart rate (HR), stroke volume (SV), and cardiac output (CO). Results revealed no significant differences in COmax (p = 0.12, 19.7 ± 2.4 L/min vs. 20.3 ± 1.8 L/min) but lower SVmax (p = 0.004, 110.4 ± 15.7 mL vs. 119.4 ± 15.5 mL) in RAMP versus SIT. HRmax from SIT (179.0 ± 11.8 b/min) was lower (p = 0.008) versus RAMP (184.4 ± 7.9 b/min). Peak VO2 (L/min) was lower (p Sprint interval training consisting of 3 min of supramaximal exercise elicits similar CO yet lower VO2 compared to RAMP.

  18. On-chip constructive cell-Network study (I: Contribution of cardiac fibroblasts to cardiomyocyte beating synchronization and community effect

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    Yasuda Kenji

    2011-05-01

    Full Text Available Abstract Backgrounds To clarify the role of cardiac fibroblasts in beating synchronization, we have made simple lined-up cardiomyocyte-fibroblast network model in an on-chip single-cell-based cultivation system. Results The synchronization phenomenon of two cardiomyocyte networks connected by fibroblasts showed (1 propagation velocity of electrophysiological signals decreased a magnitude depending on the increasing number of fibroblasts, not the lengths of fibroblasts; (2 fluctuation of interbeat intervals of the synchronized two cardiomyocyte network connected by fibroblasts did not always decreased, and was opposite from homogeneous cardiomyocyte networks; and (3 the synchronized cardiomyocytes connected by fibroblasts sometimes loses their synchronized condition and recovered to synchronized condition, in which the length of asynchronized period was shorter less than 30 beats and was independent to their cultivation time, whereas the length of synchronized period increased according to cultivation time. Conclusions The results indicated that fibroblasts can connect cardiomyocytes electrically but do not significantly enhance and contribute to beating interval stability and synchronization. This might also mean that an increase in the number of fibroblasts in heart tissue reduces the cardiomyocyte 'community effect', which enhances synchronization and stability of their beating rhythms.

  19. Complex-periodic spiral waves in confluent cardiac cell cultures induced by localized inhomogeneities

    Science.gov (United States)

    Hwang, Seong-min; Kim, Tae Yun; Lee, Kyoung J.

    2005-07-01

    Spatiotemporal wave activities in excitable heart tissues have long been the subject of numerous studies because they underlie different forms of cardiac arrhythmias. In particular, understanding the dynamics and the instabilities of spiral waves have become very important because they can cause reentrant tachycardia and their subsequent transitions to fibrillation. Although many aspects of cardiac spiral waves have been investigated through experiments and model simulations, their complex properties are far from well understood. Here, we show that intriguing complex-periodic (such as period-2, period-3, period-4, or aperiodic) spiral wave states can arise in monolayer tissues of cardiac cell culture in vitro, and demonstrate that these different dynamic states can coexist with abrupt and spontaneous transitions among them without any change in system parameters; in other words, the medium supports multistability. Based on extensive image data analysis, we have confirmed that these spiral waves are driven by their tips tracing complex orbits whose unusual, meandering shapes are formed by delicate interplay between localized conduction blocks and nonlinear properties of the culture medium. Author contributions: S.-m.H. and K.J.L. designed research; S.-m.H. and T.Y.K. performed research; S.-m.H. contributed new reagents/analytic tools; S.-m.H., T.Y.K., and K.J.L. analyzed data; and S.-m.H. and K.J.L. wrote the paper.This paper was submitted directly (Track II) to the PNAS office.Abbreviations: IBI, interbeat interval; P-n, period-n.

  20. Analysis based on the Wavelet & Hilbert Transforms applied to the full time series of interbeats for a triad of failures at the heart

    CERN Document Server

    Ritto, P A

    2007-01-01

    A tetra of sets which elements are time series including interbeats has been obtained from the databank Physionet-MIT-BIH, corresponding to the following failures at the heart of humans: Obstructive Sleep Apnea, Congestive Heart Failure, and Atrial Fibrillation, and has been analyzed statistically using an already known technique based on the Wavelet and Hilbert Transforms. That technique has been applied to the time series of interbeats for 87 patients in order to find the intrinsical dynamics of their hearts. The length of the times series varies approachly from 7 to 24 h. The kind of wavelet selected for the study has been any one belonging to the families: Daubechies, Biortoghonal, and Gaussian. The analysis has been done for the complet set of scales ranging from: 1-128 heartbeats. Choosing the Biorthogonal wavelet: bior3.1, it is observed: (a) That a time serie has not to be cutted in shorter periods with the purpose of obtaining the collapse of the data, (b) An analytical, universal behavior of the dat...

  1. [Evaluation of the principles of distribution of electrocardiographic R-R intervals for elaboration of methods of automated diagnosis of cardiac rhythm disorders].

    Science.gov (United States)

    Tsukerman, B M; Finkel'shteĭn, I E

    1987-07-01

    A statistical analysis of prolonged ECG records has been carried out in patients with various heart rhythm and conductivity disorders. The distribution of absolute R-R duration values and relationships between adjacent intervals have been examined. A two-step algorithm has been constructed that excludes anomalous and "suspicious" intervals from a sample of consecutively recorded R-R intervals, until only the intervals between contractions of veritably sinus origin remain in the sample. The algorithm has been developed into a programme for microcomputer Electronica NC-80. It operates reliably even in cases of complex combined rhythm and conductivity disorders.

  2. Identification and Functional Characterization of a Novel CACNA1C-Mediated Cardiac Disorder Characterized by Prolonged QT Intervals with Hypertrophic Cardiomyopathy, Congenital Heart Defects, and Sudden Cardiac Death

    Science.gov (United States)

    Boczek, Nicole J.; Ye, Dan; Jin, Fang; Tester, David J.; Huseby, April; Bos, J. Martijn; Johnson, Aaron J.; Kanter, Ronald; Ackerman, Michael J.

    2016-01-01

    Background A portion of sudden cardiac deaths (SCD) can be attributed to structural heart diseases such as hypertrophic cardiomyopathy (HCM) or cardiac channelopathies such as long QT syndrome (LQTS); however, the underlying molecular mechanisms are quite distinct. Here, we identify a novel CACNA1C missense mutation with mixed loss-of-function/gain-of-function responsible for a complex phenotype of LQTS, HCM, SCD, and congenital heart defects (CHDs). Methods and Results Whole exome sequencing (WES) in combination with Ingenuity Variant Analysis was completed on three affected individuals and one unaffected individual from a large pedigree with concomitant LQTS, HCM, and CHDs and identified a novel CACNA1C mutation, p.Arg518Cys, as the most likely candidate mutation. Mutational analysis of exon 12 of CACNA1C was completed on 5 additional patients with a similar phenotype of LQTS plus a personal or family history of HCM-like phenotypes, and identified two additional pedigrees with mutations at the same position, p.Arg518Cys/His. Whole cell patch clamp technique was used to assess the electrophysiological effects of the identified mutations in CaV1.2, and revealed a complex phenotype, including loss of current density and inactivation in combination with increased window and late current. Conclusions Through WES and expanded cohort screening, we identified a novel genetic substrate p.Arg518Cys/His-CACNA1C, in patients with a complex phenotype including LQTS, HCM, and CHDs annotated as cardiac-only Timothy syndrome. Our electrophysiological studies, identification of mutations at the same amino acid position in multiple pedigrees, and co-segregation with disease in these pedigrees provides evidence that p.Arg518Cys/His is the pathogenic substrate for the observed phenotype. PMID:26253506

  3. Systolic Time Intervals and New Measurement Methods.

    Science.gov (United States)

    Tavakolian, Kouhyar

    2016-06-01

    Systolic time intervals have been used to detect and quantify the directional changes of left ventricular function. New methods of recording these cardiac timings, which are less cumbersome, have been recently developed and this has created a renewed interest and novel applications for these cardiac timings. This manuscript reviews these new methods and addresses the potential for the application of these cardiac timings for the diagnosis and prognosis of different cardiac diseases.

  4. Effects of High Intensity Interval versus Moderate Continuous Training on Markers of Ventilatory and Cardiac Efficiency in Coronary Heart Disease Patients

    Directory of Open Access Journals (Sweden)

    Gustavo G. Cardozo

    2015-01-01

    Full Text Available Background. We tested the hypothesis that high intensity interval training (HIIT would be more effective than moderate intensity continuous training (MIT to improve newly emerged markers of cardiorespiratory fitness in coronary heart disease (CHD patients, as the relationship between ventilation and carbon dioxide production (VE/VCO2 slope, oxygen uptake efficiency slope (OUES, and oxygen pulse (O2P. Methods. Seventy-one patients with optimized treatment were randomly assigned into HIIT (n=23, age = 56 ± 12 years, MIT (n=24, age = 62 ± 12 years, or nonexercise control group (CG (n=24, age = 64 ± 12 years. MIT performed 30 min of continuous aerobic exercise at 70–75% of maximal heart rate (HRmax, and HIIT performed 30 min sessions split in 2 min alternate bouts at 60%/90% HRmax (3 times/week for 16 weeks. Results. No differences among groups (before versus after were found for VE/VCO2 slope or OUES (P>0.05. After training the O2P slope increased in HIIT (22%, P0.05, while decreased in CG (−20%, P<0.05 becoming lower versus HIIT (P=0.03. Conclusion. HIIT was more effective than MIT for improving O2P slope in CHD patients, while VE/VCO2 slope and OUES were similarly improved by aerobic training regimens versus controls.

  5. Low-volume, high-intensity, aerobic interval exercise for sedentary adults: VO₂max, cardiac mass, and heart rate recovery.

    Science.gov (United States)

    Matsuo, Tomoaki; Saotome, Kousaku; Seino, Satoshi; Eto, Miki; Shimojo, Nobutake; Matsushita, Akira; Iemitsu, Motoyuki; Ohshima, Hiroshi; Tanaka, Kiyoji; Mukai, Chiaki

    2014-09-01

    The aim of this study was to compare the effects of low-volume, high-intensity aerobic interval training (HAIT) on maximal oxygen consumption (VO₂max), left ventricular (LV) mass, and heart rate recovery (HRR) with high-volume, moderate-intensity continuous aerobic training (CAT) in sedentary adults. Twenty-four healthy but sedentary male adults (aged 29.2 ± 7.2 years) participated in an 8-week, 3-day a week, supervised exercise intervention. They were randomly assigned to either HAIT (18 min, 180 kcal per exercise session) or CAT (45 min, 360 kcal). VO₂max, LV mass (3T-MRI), and HRR at 1 min (HRR-1) and 2 min (HRR-2) after maximal exercise were measured pre- and post-intervention. Changes in VO₂max during the 8-week intervention were significant (P < 0.01) in both groups (HAIT, 8.7 ± 3.2 ml kg(-1) min(-1), 22.4 ± 8.9%; CAT, 5.5 ± 2.8 ml kg(-1) min(-1), 14.7 ± 9.5%), while the VO₂max improvement in HAIT was greater (P = 0.02) than in CAT. LV mass in HAIT increased (5.1 ± 8.4 g, 5.7 ± 9.1%, P = 0.05), but not in CAT (0.9 ± 7.8 g, 1.1 ± 8.4%, P = 0.71). While changes in HRR-1 were not significant in either group, change in HRR-2 for HAIT (9.5 ± 6.4 bpm, 19.0 ± 16.0%, P < 0.01) was greater (P = 0.03) than for CAT (1.6 ± 10.9 bpm, 3.9 ± 16.2%, P = 0.42). This study suggests that HAIT has potential as a time-efficient training mode to improve cardiorespiratory capacity and autonomic nervous system function in sedentary adults.

  6. High-intensity interval training versus moderate-intensity steady-state training in UK cardiac rehabilitation programmes (HIIT or MISS UK): study protocol for a multicentre randomised controlled trial and economic evaluation.

    Science.gov (United States)

    McGregor, Gordon; Nichols, Simon; Hamborg, Thomas; Bryning, Lucy; Tudor-Edwards, Rhiannon; Markland, David; Mercer, Jenny; Birkett, Stefan; Ennis, Stuart; Powell, Richard; Begg, Brian; Haykowsky, Mark J; Banerjee, Prithwish; Ingle, Lee; Shave, Rob; Backx, Karianne

    2016-11-16

    Current international guidelines for cardiac rehabilitation (CR) advocate moderate-intensity exercise training (MISS, moderate-intensity steady state). This recommendation predates significant advances in medical therapy for coronary heart disease (CHD) and may not be the most appropriate strategy for the 'modern' patient with CHD. High-intensity interval training (HIIT) appears to be a safe and effective alternative, resulting in greater improvements in peak oxygen uptake (VO2 peak). To date, HIIT trials have predominantly been proof-of-concept studies in the laboratory setting and conducted outside the UK. The purpose of this multicentre randomised controlled trial is to compare the effects of HIIT and MISS training in patients with CHD attending UK CR programmes. This pragmatic study will randomly allocate 510 patients with CHD to 8 weeks of twice weekly HIIT or MISS training at 3 centres in the UK. HIIT will consist of 10 high-intensity (85-90% peak power output (PPO)) and 10 low-intensity (20-25% PPO) intervals, each lasting 1 min. MISS training will follow usual care recommendations, adhering to currently accepted UK guidelines (ie, >20 min continuous exercise at 40-70% heart rate reserve). Outcome measures will be assessed at baseline, 8 weeks and 12 months. The primary outcome for the trial will be change in VO2 peak as determined by maximal cardiopulmonary exercise testing. Secondary measures will assess physiological, psychosocial and economic outcomes. The study protocol V.1.0, dated 1 February 2016, was approved by the NHS Health Research Authority, East Midlands-Leicester South Research Ethics Committee (16/EM/0079). Recruitment will start in August 2016 and will be completed in June 2018. Results will be published in peer-reviewed journals, presented at national and international scientific meetings and are expected to inform future national guidelines for exercise training in UK CR. NCT02784873; pre-results. Published by the BMJ Publishing

  7. interval functions

    Directory of Open Access Journals (Sweden)

    J. A. Chatfield

    1978-01-01

    Full Text Available Suppose N is a Banach space of norm |•| and R is the set of real numbers. All integrals used are of the subdivision-refinement type. The main theorem [Theorem 3] gives a representation of TH where H is a function from R×R to N such that H(p+,p+, H(p,p+, H(p−,p−, and H(p−,p each exist for each p and T is a bounded linear operator on the space of all such functions H. In particular we show that TH=(I∫abfHdα+∑i=1∞[H(xi−1,xi−1+−H(xi−1+,xi−1+]β(xi−1+∑i=1∞[H(xi−,xi−H(xi−,xi−]Θ(xi−1,xiwhere each of α, β, and Θ depend only on T, α is of bounded variation, β and Θ are 0 except at a countable number of points, fH is a function from R to N depending on H and {xi}i=1∞ denotes the points P in [a,b]. for which [H(p,p+−H(p+,p+]≠0 or [H(p−,p−H(p−,p−]≠0. We also define an interior interval function integral and give a relationship between it and the standard interval function integral.

  8. QT interval prolongation after Premature Ventricular Contractions (PVCs

    Directory of Open Access Journals (Sweden)

    Mohammed Haroon Rashid

    2010-11-01

    Full Text Available Long QT syndrome (LQTS is an inherited ion channelopathy resulting in abnormal ventricular repolarization and abnormal prolongation of QT interval on the ECG. Syncope, fainting, cardiac arrest, and sudden death are common manifestations of LQTS. We present a case report that describes a patient with prolonged QT interval after extrasystoles and a family history of sudden cardiac deaths.

  9. QT interval variability in body surface ECG : measurement, physiological basis, and clinical value: position statement and consensus guidance endorsed by the European Heart Rhythm Association jointly with the ESC Working Group on Cardiac Cellular Electrophysiology

    NARCIS (Netherlands)

    Baumert, Mathias; Porta, Alberto; Vos, Marc A; Malik, Marek; Couderc, Jean-Philippe; Laguna, Pablo; Piccirillo, Gianfranco; Smith, Godfrey L; Tereshchenko, Larisa G; Volders, Paul G A

    2016-01-01

    This consensus guideline discusses the electrocardiographic phenomenon of beat-to-beat QT interval variability (QTV) on surface electrocardiograms. The text covers measurement principles, physiological basis, and clinical value of QTV. Technical considerations include QT interval measurement and the

  10. Automatic detection of atrial fibrillation using the coefficient of variation and density histograms of RR and deltaRR intervals.

    Science.gov (United States)

    Tateno, K; Glass, L

    2001-11-01

    The paper describes a method for the automatic detection of atrial fibrillation, an abnormal heart rhythm, based on the sequence of intervals between heartbeats. The RR interval is the interbeat interval, and deltaRR is the difference between two successive RR intervals. Standard density histograms of the RR and deltaRR intervals were prepared as templates for atrial fibrillation detection. As the coefficients of variation of the RR and deltaRR intervals were approximately constant during atrial fibrillation, the coefficients of variation in the test data could be compared with the standard coefficients of variation (CV test). Further, the similarities between the density histograms of the test data and the standard density histograms were estimated using the Kolmogorov-Smirnov test. The CV test based on the RR intervals showed a sensitivity of 86.6% and a specificity of 84.3%. The CV test based on the deltaRR intervals showed that the sensitivity and the specificity are both approximately 84%. The Kolmogorov-Smirnov test based on the RR intervals did not improve on the result of the CV test. In contrast, the Kolmogorov-Smirnov test based on the ARR intervals showed a sensitivity of 94.4% and a specificity of 97.2%.

  11. Serial binary interval ratios improve rhythm reproduction.

    Science.gov (United States)

    Wu, Xiang; Westanmo, Anders; Zhou, Liang; Pan, Junhao

    2013-01-01

    Musical rhythm perception is a natural human ability that involves complex cognitive processes. Rhythm refers to the organization of events in time, and musical rhythms have an underlying hierarchical metrical structure. The metrical structure induces the feeling of a beat and the extent to which a rhythm induces the feeling of a beat is referred to as its metrical strength. Binary ratios are the most frequent interval ratio in musical rhythms. Rhythms with hierarchical binary ratios are better discriminated and reproduced than rhythms with hierarchical non-binary ratios. However, it remains unclear whether a superiority of serial binary over non-binary ratios in rhythm perception and reproduction exists. In addition, how different types of serial ratios influence the metrical strength of rhythms remains to be elucidated. The present study investigated serial binary vs. non-binary ratios in a reproduction task. Rhythms formed with exclusively binary (1:2:4:8), non-binary integer (1:3:5:6), and non-integer (1:2.3:5.3:6.4) ratios were examined within a constant meter. The results showed that the 1:2:4:8 rhythm type was more accurately reproduced than the 1:3:5:6 and 1:2.3:5.3:6.4 rhythm types, and the 1:2.3:5.3:6.4 rhythm type was more accurately reproduced than the 1:3:5:6 rhythm type. Further analyses showed that reproduction performance was better predicted by the distribution pattern of event occurrences within an inter-beat interval, than by the coincidence of events with beats, or the magnitude and complexity of interval ratios. Whereas rhythm theories and empirical data emphasize the role of the coincidence of events with beats in determining metrical strength and predicting rhythm performance, the present results suggest that rhythm processing may be better understood when the distribution pattern of event occurrences is taken into account. These results provide new insights into the mechanisms underlining musical rhythm perception.

  12. Serial binary interval ratios improve rhythm reproduction

    Directory of Open Access Journals (Sweden)

    Xiang eWu

    2013-08-01

    Full Text Available Musical rhythm perception is a natural human ability that involves complex cognitive processes. Rhythm refers to the organization of events in time, and musical rhythms have an underlying hierarchical metrical structure. The metrical structure induces the feeling of a beat and the extent to which a rhythm induces the feeling of a beat is referred to as its metrical strength. Binary ratios are the most frequent interval ratio in musical rhythms. Rhythms with hierarchical binary ratios are better discriminated and reproduced than rhythms with hierarchical non-binary ratios. However, it remains unclear whether a superiority of serial binary over non-binary ratios in rhythm perception and reproduction exists. In addition, how different types of serial ratios influence the metrical strength of rhythms remains to be elucidated. The present study investigated serial binary vs. non-binary ratios in a reproduction task. Rhythms formed with exclusively binary (1:2:4:8, non-binary integer (1:3:5:6, and non-integer (1:2.3:5.3:6.4 ratios were examined within a constant meter. The results showed that the 1:2:4:8 rhythm type was more accurately reproduced than the 1:3:5:6 and 1:2.3:5.3:6.4 rhythm types, and the 1:2.3:5.3:6.4 rhythm type was more accurately reproduced than the 1:3:5:6 rhythm type. Further analyses showed that reproduction performance was better predicted by the distribution pattern of event occurrences within an inter-beat interval, than by the coincidence of events with beats, or the magnitude and complexity of interval ratios. Whereas rhythm theories and empirical data emphasize the role of the coincidence of events with beats in determining metrical strength and predicting rhythm performance, the present results suggest that rhythm processing may be better understood when the distribution pattern of event occurrences is taken into account. These results provide new insights into the mechanisms underlining musical rhythm perception.

  13. Cardiac involvement in myotonic dystrophy

    DEFF Research Database (Denmark)

    Lund, Marie; Diaz, Lars Jorge; Ranthe, Mattis Flyvholm

    2014-01-01

    disorders, arrhythmias, and device implantation). In the DM cohort, SIR for any cardiac disease was 3.42 [95% confidence interval (CI) 3.01-3.86]; for a cardiac disease belonging to the selected subgroups 6.91 (95% CI: 5.93-8.01) and for other cardiac disease 2.59 (95% CI: 2.03-3.25). For a cardiac disease......AIMS: To quantify the association between myotonic dystrophy (DM) and cardiac disease in a nationwide cohort. METHODS AND RESULTS: We identified a nationwide cohort of 1146 DM patients (period 1977-2011) using the National Patient Registry (NPR) and a subcohort of 485 patients who had undergone...... genetic testing for DM1. Information on incident cardiac diseases was obtained from the NPR. We estimated standardized incidence ratios (SIRs) of cardiac disease compared with the background population, overall and according to selected diagnostic subgroups (cardiomyopathy, heart failure, conduction...

  14. Cardiac arrest

    Science.gov (United States)

    ... Article.jsp. Accessed June 16, 2014. Myerburg RJ, Castellanos A. Approach to cardiac arrest and life-threatening ... PA: Elsevier Saunders; 2011:chap 63. Myerburg RJ, Castellanos A. Cardiac arrest and audden aardiac death. In: ...

  15. Preliminary evidence for the evolution in complexity of heart rate dynamics during autonomic maturation in neonatal swine.

    Science.gov (United States)

    Lipsitz, L A; Pincus, S M; Morin, R J; Tong, S; Eberle, L P; Gootman, P M

    1997-07-14

    Previous studies suggest that the autonomic nervous system plays an important role in the generation of complex heart rate dynamics. Therefore, we hypothesized that the complexity (irregularity) of cardiac interbeat intervals would evolve with the maturation of autonomic innervation to the heart. Twelve healthy newborn piglets were implanted with ECG transmitters and studied at one or more different ages up to 33 days of age, the period during which pigs develop functional sympathetic innervation of the heart from the stellate ganglia. Three animals underwent right stellate ganglionectomy, two a left stellate ganglionectomy, two a right cardiac vagotomy and five a sham procedure. The statistic, approximate entropy (ApEn), was used to quantify the regularity of interbeat interval fluctuations. Sham-operated animals showed an increase in the standard deviation (SD) and irregularity (ApEn) of cardiac interval fluctuations with increasing age. Right stellate ganglionectomized piglets had lower interbeat interval ApEn values, but similar SD's by 26-27 days of age compared to sham-operated animals. Left stellate ganglionectomy, which affects cardiac inotropy rather than chronotropy, had no effect on cardiac interval irregularity, while vagotomy had an indeterminant effect. The increasing irregularity of interbeat interval dynamics during autonomic maturation and the apparent attenuation of heartbeat irregularity when right stellate ganglion innervation is interrupted, provides empirical support for the notion that complex heartbeat dynamics in the mature animal are the result of a network of autonomic neural pathways that enables an organism to adapt to stress.

  16. QT interval changes in term pregnant women living at moderately ...

    African Journals Online (AJOL)

    2015-12-20

    Dec 20, 2015 ... Objective: This study aimed to compare the QT interval changes in women with term pregnancy living at ... as an increase in circulating volume, heart rate, and cardiac ..... exercise before and after an himalayan expedition.

  17. Statistical coding and decoding of heartbeat intervals.

    Science.gov (United States)

    Lucena, Fausto; Barros, Allan Kardec; Príncipe, José C; Ohnishi, Noboru

    2011-01-01

    The heart integrates neuroregulatory messages into specific bands of frequency, such that the overall amplitude spectrum of the cardiac output reflects the variations of the autonomic nervous system. This modulatory mechanism seems to be well adjusted to the unpredictability of the cardiac demand, maintaining a proper cardiac regulation. A longstanding theory holds that biological organisms facing an ever-changing environment are likely to evolve adaptive mechanisms to extract essential features in order to adjust their behavior. The key question, however, has been to understand how the neural circuitry self-organizes these feature detectors to select behaviorally relevant information. Previous studies in computational perception suggest that a neural population enhances information that is important for survival by minimizing the statistical redundancy of the stimuli. Herein we investigate whether the cardiac system makes use of a redundancy reduction strategy to regulate the cardiac rhythm. Based on a network of neural filters optimized to code heartbeat intervals, we learn a population code that maximizes the information across the neural ensemble. The emerging population code displays filter tuning proprieties whose characteristics explain diverse aspects of the autonomic cardiac regulation, such as the compromise between fast and slow cardiac responses. We show that the filters yield responses that are quantitatively similar to observed heart rate responses during direct sympathetic or parasympathetic nerve stimulation. Our findings suggest that the heart decodes autonomic stimuli according to information theory principles analogous to how perceptual cues are encoded by sensory systems.

  18. Statistical coding and decoding of heartbeat intervals.

    Directory of Open Access Journals (Sweden)

    Fausto Lucena

    Full Text Available The heart integrates neuroregulatory messages into specific bands of frequency, such that the overall amplitude spectrum of the cardiac output reflects the variations of the autonomic nervous system. This modulatory mechanism seems to be well adjusted to the unpredictability of the cardiac demand, maintaining a proper cardiac regulation. A longstanding theory holds that biological organisms facing an ever-changing environment are likely to evolve adaptive mechanisms to extract essential features in order to adjust their behavior. The key question, however, has been to understand how the neural circuitry self-organizes these feature detectors to select behaviorally relevant information. Previous studies in computational perception suggest that a neural population enhances information that is important for survival by minimizing the statistical redundancy of the stimuli. Herein we investigate whether the cardiac system makes use of a redundancy reduction strategy to regulate the cardiac rhythm. Based on a network of neural filters optimized to code heartbeat intervals, we learn a population code that maximizes the information across the neural ensemble. The emerging population code displays filter tuning proprieties whose characteristics explain diverse aspects of the autonomic cardiac regulation, such as the compromise between fast and slow cardiac responses. We show that the filters yield responses that are quantitatively similar to observed heart rate responses during direct sympathetic or parasympathetic nerve stimulation. Our findings suggest that the heart decodes autonomic stimuli according to information theory principles analogous to how perceptual cues are encoded by sensory systems.

  19. Interval arithmetic in calculations

    Science.gov (United States)

    Bairbekova, Gaziza; Mazakov, Talgat; Djomartova, Sholpan; Nugmanova, Salima

    2016-10-01

    Interval arithmetic is the mathematical structure, which for real intervals defines operations analogous to ordinary arithmetic ones. This field of mathematics is also called interval analysis or interval calculations. The given math model is convenient for investigating various applied objects: the quantities, the approximate values of which are known; the quantities obtained during calculations, the values of which are not exact because of rounding errors; random quantities. As a whole, the idea of interval calculations is the use of intervals as basic data objects. In this paper, we considered the definition of interval mathematics, investigated its properties, proved a theorem, and showed the efficiency of the new interval arithmetic. Besides, we briefly reviewed the works devoted to interval analysis and observed basic tendencies of development of integral analysis and interval calculations.

  20. Cardiac Sarcoidosis.

    Science.gov (United States)

    Birnie, David; Ha, Andrew C T; Gula, Lorne J; Chakrabarti, Santabhanu; Beanlands, Rob S B; Nery, Pablo

    2015-12-01

    Studies suggest clinically manifest cardiac involvement occurs in 5% of patients with pulmonary/systemic sarcoidosis. The principal manifestations of cardiac sarcoidosis (CS) are conduction abnormalities, ventricular arrhythmias, and heart failure. Data indicate that an 20% to 25% of patients with pulmonary/systemic sarcoidosis have asymptomatic (clinically silent) cardiac involvement. An international guideline for the diagnosis and management of CS recommends that patients be screened for cardiac involvement. Most studies suggest a benign prognosis for patients with clinically silent CS. Immunosuppression therapy is advocated for clinically manifest CS. Device therapy, with implantable cardioverter defibrillators, is recommended for some patients.

  1. Cardiac Malpositions

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Shi Joon; Im, Chung Gie; Yeon, Kyung Mo; Hasn, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1979-06-15

    Cardiac Malposition refers to any position of the heart other than a left-sided heart in a situs solitus individual. Associated cardiac malformations are so complex that even angiocardiographic and autopsy studies may not afford an accurate information. Although the terms and classifications used to describe the internal cardiac anatomy and their arterial connections in cardiac malpositions differ and tend to be confusing, common agreement exists on the need for a segmental approach to diagnosis. Authors present 18 cases of cardiac malpositions in which cardiac catheterization and angiocardiography were done at the Department of Radiology, Seoul National University Hospital between 1971 and 1979. Authors analyzed the clinical, radiographic, operative and autopsy findings with the emphasis on the angiocardiographic findings. The results are as follows: 1. Among 18 cases with cardiac malpositions, 6 cases had dextrocardia with situs inversus, 9 cases had dextrocardia with situs solitus and 3 cases had levocardia with situs inversus. 2. There was no genuine exception to visceroatrial concordance rule. 3. Associated cardiac malpositions were variable and complex with a tendency of high association of transposition and double outlet varieties with dextrocardia in situs solitus and levocardia in situs inversus. Only one in 6 cases of dextrocardia with situs inversus had pure transposition. 4. In two cases associated pulmonary atresia was found at surgery which was not predicted by angiocardiography. 5. Because many of the associated complex lesions can be corrected surgically provided the diagnosis is accurate, the selective biplane angiocardiography with or without cineradiography is essential.

  2. Big Boss Interval Games

    NARCIS (Netherlands)

    Alparslan-Gok, S.Z.; Brânzei, R.; Tijs, S.H.

    2008-01-01

    In this paper big boss interval games are introduced and various characterizations are given. The structure of the core of a big boss interval game is explicitly described and plays an important role relative to interval-type bi-monotonic allocation schemes for such games. Specifically, each element

  3. Prolonged QT interval in Rett syndrome

    OpenAIRE

    1999-01-01

    Rett syndrome is a severe neurodevelopmental disorder of unknown aetiology. A prolonged QT interval has been described previously in patients with Rett syndrome. To investigate QT prolongation and the presence of cardiac tachyarrhythmias in Rett syndrome electrocardiography and 24 hour Holter monitoring were performed prospectively in a cohort of 34 girls with Rett syndrome. The corrected QT value was prolonged in nine patients. Compared with a group of healthy controls of a...

  4. Response to cardiac resynchronization therapy

    DEFF Research Database (Denmark)

    Versteeg, Henneke; Schiffer, Angélique A; Widdershoven, Jos W

    2009-01-01

    Cardiac resynchronization therapy (CRT) is a promising treatment for a subgroup of patients with advanced congestive heart failure and a prolonged QRS interval. Despite the majority of patients benefiting from CRT, 10-40% of patients do not respond to this treatment and are labeled as nonresponders...

  5. Seizures following hippocampal kindling induce QT interval prolongation and increased susceptibility to arrhythmias in rats.

    Science.gov (United States)

    Bealer, Steven L; Little, Jason G

    2013-07-01

    The prolonged seizures of status epilepticus produce chronic arrhythmogenic changes in cardiac function. This study was designed to determine if repeated, self-limiting seizures administered to kindled rats induce similar cardiac dysfunction. Multiple seizures administered to rats following hippocampal kindling resulted in cardiac QT interval prolongation and increased susceptibility to experimental arrhythmias. These data suggest that multiple, self-limiting seizures of intractable epilepsy may have cardiac effects that can contribute to sudden unexpected death in epilepsy (SUDEP).

  6. QT-Interval Duration and Mortality Rate

    Science.gov (United States)

    Zhang, Yiyi; Post, Wendy S.; Dalal, Darshan; Blasco-Colmenares, Elena; Tomaselli, Gordon F.; Guallar, Eliseo

    2012-01-01

    Background Extreme prolongation or reduction of the QT interval predisposes patients to malignant ventricular arrhythmias and sudden cardiac death, but the association of variations in the QT interval within a reference range with mortality end points in the general population is unclear. Methods We included 7828 men and women from the Third National Health and Nutrition Examination Survey. Baseline QT interval was measured via standard 12-lead electrocardiographic readings. Mortality end points were assessed through December 31, 2006 (2291 deaths). Results After an average follow-up of 13.7 years, the association between QT interval and mortality end points was U-shaped. The multivariate-adjusted hazard ratios comparing participants at or above the 95th percentile of age-, sex-, race-, and R-R interval–corrected QT interval (≥439 milliseconds) with participants in the middle quintile (401 to <410 milliseconds) were 2.03 (95% confidence interval, 1.46-2.81) for total mortality, 2.55 (1.59-4.09) for mortality due to cardiovascular disease (CVD), 1.63 (0.96-2.75) for mortality due to coronary heart disease, and 1.65 (1.16-2.35) for non-CVD mortality. The corresponding hazard ratios comparing participants with a corrected QT interval below the fifth percentile (<377 milliseconds) with those in the middle quintile were 1.39 (95% confidence interval, 1.02-1.88) for total mortality, 1.35 (0.77-2.36) for CVD mortality, 1.02 (0.44-2.38) for coronary heart disease mortality, and 1.42 (0.97-2.08) for non-CVD mortality. Increased mortality also was observed with less extreme deviations of QT-interval duration. Similar, albeit weaker, associations also were observed with Bazett-corrected QT intervals. Conclusion Shortened and prolonged QT-interval durations, even within a reference range, are associated with increased mortality risk in the general population. PMID:22025428

  7. Circadian profile of QT interval and QT interval variability in 172 healthy volunteers

    DEFF Research Database (Denmark)

    Bonnemeier, Hendrik; Wiegand, Uwe K H; Braasch, Wiebke

    2003-01-01

    of sleep. QT and R-R intervals revealed a characteristic day-night-pattern. Diurnal profiles of QT interval variability exhibited a significant increase in the morning hours (6-9 AM; P ...-to-beat QT interval duration (QT, QTapex [QTa], Tend [Te]), variability (QTSD, QTaSD), and the mean R-R interval were determined from 24-hour ambulatory electrocardiograms after exclusion of artifacts and premature beats. All volunteers were fully active, awoke at approximately 7:00 AM, and had 6-8 hours...... alterations mainly at daytime with normal aging. Furthermore, the diurnal course of the QT interval variability strongly suggests that it is related to cardiac sympathetic activity and to the reported diurnal pattern of malignant ventricular arrhythmias....

  8. Cardiac cameras.

    Science.gov (United States)

    Travin, Mark I

    2011-05-01

    Cardiac imaging with radiotracers plays an important role in patient evaluation, and the development of suitable imaging instruments has been crucial. While initially performed with the rectilinear scanner that slowly transmitted, in a row-by-row fashion, cardiac count distributions onto various printing media, the Anger scintillation camera allowed electronic determination of tracer energies and of the distribution of radioactive counts in 2D space. Increased sophistication of cardiac cameras and development of powerful computers to analyze, display, and quantify data has been essential to making radionuclide cardiac imaging a key component of the cardiac work-up. Newer processing algorithms and solid state cameras, fundamentally different from the Anger camera, show promise to provide higher counting efficiency and resolution, leading to better image quality, more patient comfort and potentially lower radiation exposure. While the focus has been on myocardial perfusion imaging with single-photon emission computed tomography, increased use of positron emission tomography is broadening the field to include molecular imaging of the myocardium and of the coronary vasculature. Further advances may require integrating cardiac nuclear cameras with other imaging devices, ie, hybrid imaging cameras. The goal is to image the heart and its physiological processes as accurately as possible, to prevent and cure disease processes.

  9. 高敏感方法检测心肌肌钙蛋白T的分析性能评价%The analytical performance assessment of high-sensitivity cardiac troponin T reference intervals investigation

    Institute of Scientific and Technical Information of China (English)

    宋凌燕; 吴炯; 宋斌斌; 邵文琦; 张春燕; 王蓓丽; 郭玮; 潘柏申

    2010-01-01

    Objective To assess the analytical performance of hs-cTnT and biological variations in healthy population as well as establish hs-cTnT reference intervals. Methods The serum samples from 100 acute myocardial infraction patients and 474 apparently healthy subjects were collected. The functional sensitivity,within- and between-run imprecision were determined. The hs-cTnT assay and con-cTnT assay were evaluated. The serum hs-cTnT levels were detected in apparently healthy subjects to establish reference intervals. Moreover,the long-term and short-term biological variations for hs-cTnT in healthy volunteers were assessed. Results The functional sensitivity of hs-cTnT was 0. 005 μg/L. The within- and between-run precision for lower level control(0. 014 μg/L) and higher level control(2. 500 μg/L) was 2. 97% vs 3. 64%and 0. 66% vs 1.01% ,respectively. The correlation between hs-cTnT assay and con-cTnT assay was good ( R2 =0. 972 ,P <0. 01 ). The 99th percentile in apparently healthy subjects was 0. 003 μg/L for women less than60 years, 0.008 μg/L for men less than 60 years, 0.015 μg/L for women above 60 years and 0. 021 μg/L for men above 60 years. The CVa, CVi, CVg and CVt of short-term biological variations in detecting hs-cTnT from 22 apparently healthy subjects were 3.8%, 4. 8%, 49.9% and 58.5%,respectively. The CVa,CVi ,CVg and CVt of long-term biological variations were 5. 3% ,6. 4% ,56. 6% and 68. 3% respectively. Conclusions The analytical performance of the hs-cTnT is better than con-cTnT assay,achieving acceptable level according to guideline. Our experimental result could provide the basis for the new high sensitivity cTnT assay in the diagnosis of acute myocardial infarction.%目的 评价hs-cTnT的分析性能,了解其生物学变异,建立本实验室参考范围.方法 收集AMI患者100例及表面健康人474名的血清,评价hs-cTnT检测的功能灵敏度和批内、批间不精密度(以CV表示),并与目前使用的con-cTnT进行比较,

  10. The interval ordering problem

    CERN Document Server

    Dürr, Christoph; Spieksma, Frits C R; Nobibon, Fabrice Talla; Woeginger, Gerhard J

    2011-01-01

    For a given set of intervals on the real line, we consider the problem of ordering the intervals with the goal of minimizing an objective function that depends on the exposed interval pieces (that is, the pieces that are not covered by earlier intervals in the ordering). This problem is motivated by an application in molecular biology that concerns the determination of the structure of the backbone of a protein. We present polynomial-time algorithms for several natural special cases of the problem that cover the situation where the interval boundaries are agreeably ordered and the situation where the interval set is laminar. Also the bottleneck variant of the problem is shown to be solvable in polynomial time. Finally we prove that the general problem is NP-hard, and that the existence of a constant-factor-approximation algorithm is unlikely.

  11. Interval Scheduling: A Survey

    NARCIS (Netherlands)

    Kolen, A.W.J.; Lenstra, J.K.; Papadimitriou, C.H.; Spieksma, F.C.R.

    2007-01-01

    In interval scheduling, not only the processing times of the jobs but also their starting times are given. This article surveys the area of interval scheduling and presents proofs of results that have been known within the community for some time. We first review the complexity and approximability o

  12. Estimating duration intervals

    NARCIS (Netherlands)

    Ph.H.B.F. Franses (Philip Hans); B.L.K. Vroomen (Björn)

    2003-01-01

    textabstractDuration intervals measure the dynamic impact of advertising on sales. More precise, the p per cent duration interval measures the time lag between the advertising impulse and the moment that p per cent of its effect has decayed. In this paper, we derive an expression for the duration

  13. Simultaneous Interval Graphs

    CERN Document Server

    Jampani, Krishnam Raju

    2010-01-01

    In a recent paper, we introduced the simultaneous representation problem (defined for any graph class C) and studied the problem for chordal, comparability and permutation graphs. For interval graphs, the problem is defined as follows. Two interval graphs G_1 and G_2, sharing some vertices I (and the corresponding induced edges), are said to be `simultaneous interval graphs' if there exist interval representations R_1 and R_2 of G_1 and G_2, such that any vertex of I is mapped to the same interval in both R_1 and R_2. Equivalently, G_1 and G_2 are simultaneous interval graphs if there exist edges E' between G_1-I and G_2-I such that G_1 \\cup G_2 \\cup E' is an interval graph. Simultaneous representation problems are related to simultaneous planar embeddings, and have applications in any situation where it is desirable to consistently represent two related graphs, for example: interval graphs capturing overlaps of DNA fragments of two similar organisms; or graphs connected in time, where one is an updated versi...

  14. Cardiac echinococcosis

    Directory of Open Access Journals (Sweden)

    Ivanović-Krstić Branislava A.

    2002-01-01

    Full Text Available Cardiac hydatid disease is rare. We report on an uncommon hydatid cyst localized in the right ventricular wall, right atrial wall tricuspid valve left atrium and pericard. A 33-year-old woman was treated for cough, fever and chest pain. Cardiac echocardiograpic examination revealed a round tumor (5.8 x 4 cm in the right ventricular free wall and two smaller cysts behind that tumor. There were cysts in right atrial wall and tricuspidal valve as well. Serologic tests for hydatidosis were positive. Computed tomography finding was consistent with diagnosis of hydatid cyst in lungs and right hylar part. Surgical treatment was rejected due to great risk of cardiac perforation. Medical treatment with albendazole was unsuccessful and the patient died due to systemic hydatid involvement of the lungs, liver and central nervous system.

  15. Cardiac Rehabilitation

    Science.gov (United States)

    ... your risk of future heart problems, and to improve your health and quality of life. Cardiac rehabilitation programs increase ... exercise routine at home or at a local gym. You may also continue to ... health concerns. Education about nutrition, lifestyle and weight loss ...

  16. Lesson Twenty-five Prevalence and Prognostic significance of Short QT Interval

    Institute of Scientific and Technical Information of China (English)

    鲁端; 王劲

    2008-01-01

    @@ Background-Short-QT syndrome is an inherited disorder characterized by a short QT interval and an increased risk of sudden cardiac death.The clinical significance of a short OT interval observed in a randomly recorded ECG is not known.Therefore,we assessed the prevalence and prognostic significance of a short QT interval in a general population.

  17. Multicentre study of fetal cardiac time intervals using magnetocardiography

    NARCIS (Netherlands)

    Stinstra, J.; Golbach, E.; Leeuwen, van P.; Lange, S.; Menendez, T.; Moshage, W.; Schleussner, E.; Kaehler, C.; Horigome, H.; Shigemitsu, S.; Peters, M.J.

    2002-01-01

    Objective: A database with reference values of the durations of the various waveforms in a magnetocardiogram of fetuses in uncomplicated pregnancies is assessed. This database will be of help to discriminate between pathologic and healthy fetuses. A fetal magnetocardiogram is a recording of the magn

  18. Electrocardiographic QT interval and mortality: a meta-analysis

    Science.gov (United States)

    Zhang, Yiyi; Post, Wendy S.; Blasco-Colmenares, Elena; Dalal, Darshan; Tomaselli, Gordon F.; Guallar, Eliseo

    2011-01-01

    Background Extremely abnormal prolongation of the electrocardiographic QT interval is associated with malignant ventricular arrhythmias and sudden cardiac death. However, the implications of variations in QT-interval length within normal limits for mortality in the general population are still unclear. Methods We performed a meta-analysis to investigate the relation of QT interval with mortality endpoints. Inverse-variance weighted random-effects models were used to summarize the relative risks across studies. Twenty-three observational studies were included. Results The pooled relative risk estimates comparing the highest with the lowest categories of QT-interval length were 1.35 (95% confidence interval = 1.24–1.46) for total mortality, 1.51 (1.29–1.78) for cardiovascular mortality, 1.71 (1.36–2.15) for coronary heart disease mortality, and 1.44 (1.01–2.04) for sudden cardiac death. A 50 msec increase in QT interval was associated with a relative risk of 1.20 (1.15–1.26) for total mortality, 1.29 (1.15–1.46) for cardiovascular mortality, 1.49 (1.25–1.76) for coronary heart disease mortality, and 1.24 (0.97–1.60) for sudden cardiac death. Conclusions We found consistent associations between prolonged QT interval and increased risk of total, cardiovascular, coronary, and sudden cardiac death. QT-interval length is a determinant of mortality in the general population. PMID:21709561

  19. Cardiac Calcification

    Directory of Open Access Journals (Sweden)

    Morteza Joorabian

    2011-05-01

    Full Text Available There is a spectrum of different types of cardiac"ncalcifications with the importance and significance"nof each type of cardiac calcification, especially"ncoronary artery calcification. Radiologic detection of"ncalcifications within the heart is quite common. The"namount of coronary artery calcification correlates"nwith the severity of coronary artery disease (CAD."nCalcification of the aortic or mitral valve may indicate"nhemodynamically significant valvular stenosis."nMyocardial calcification is a sign of prior infarction,"nwhile pericardial calcification is strongly associated"nwith constrictive pericarditis. A spectrum of different"ntypes of cardiac calcifications (linear, annular,"ncurvilinear,... could be seen in chest radiography and"nother imaging modalities. So a carful inspection for"ndetection and reorganization of these calcifications"nshould be necessary. Numerous modalities exist for"nidentifying coronary calcification, including plain"nradiography, fluoroscopy, intravascular ultrasound,"nMRI, echocardiography, and conventional, helical and"nelectron-beam CT (EBCT. Coronary calcifications"ndetected on EBCT or helical CT can be quantifie,"nand a total calcification score (Cardiac Calcification"nScoring may be calculated. In an asymptomatic"npopulation and/or patients with concomitant risk"nfactors like diabetes mellitus, determination of the"npresence of coronary calcifications identifies the"npatients at risk for future myocardial infarction and"ncoronary artery disease. In patients without coronary"ncalcifications, future cardiovascular events could"nbe excluded. Therefore, detecting and recognizing"ncalcification related to the heart on chest radiography"nand other imaging modalities such as fluoroscopy, CT"nand echocardiography may have important clinical"nimplications.

  20. Product interval automata

    Indian Academy of Sciences (India)

    Deepak D’Souza; P S Thiagarajan

    2002-04-01

    We identify a subclass of timed automata called product interval automata and develop its theory. These automata consist of a network of timed agents with the key restriction being that there is just one clock for each agent and the way the clocks are read and reset is determined by the distribution of shared actions across the agents. We show that the resulting automata admit a clean theory in both logical and language theoretic terms. We also show that product interval automata are expressive enough to model the timed behaviour of asynchronous digital circuits.

  1. Electrogastrographic and autonomic responses during oculovestibular recoupling in flight simulation.

    Science.gov (United States)

    Cevette, Michael J; Pradhan, Gaurav N; Cocco, Daniela; Crowell, Michael D; Galea, Anna M; Bartlett, Jennifer; Stepanek, Jan

    2014-01-01

    Simulator sickness causes vestibulo-autonomic responses that increase sympathetic activity and decrease parasympathetic activity. The purpose of the study was to quantify these responses through electrogastrography and cardiac interbeat intervals during flight simulation. There were 29 subjects that were randomly assigned to 2 parallel arms: (1) oculovestibular recoupling, where galvanic vestibular stimulation was synchronous with the visual field; and (2) control. Electrogastrography and interbeat interval data were collected during baseline, simulation, and post-simulation periods. A simulator sickness questionnaire was administered. Statistically significant differences were observed in percentage of recording time with the dominant frequency of electrogastrography in normogastric and bradygastric domains between the oculovestibular recoupling and control groups. Normogastria was dominant during simulation in the oculovestibular recoupling group. In the control group, the percentage of recording time with the dominant frequency decreased by 22% in normogastria and increased by 20% in bradygastria. The percentage change of the dominant power instability coefficient from baseline to simulation was 26% in the oculovestibular recoupling group vs. 108% in the control group. The power of high-frequency components for interbeat intervals did not change significantly in the oculovestibular recoupling group and was decreased during simulation in the control group. Electrogastrography and interbeat intervals are sensitive indices of autonomic changes in subjects undergoing flight simulation. These data demonstrate the potential of oculovestibular recoupling to stabilize gastric activity and cardiac autonomic changes altered during simulator and motion sickness.

  2. Interval methods: An introduction

    DEFF Research Database (Denmark)

    Achenie, L.E.K.; Kreinovich, V.; Madsen, Kaj

    2006-01-01

    . An important characteristic of the computer performance in scientific computing is the accuracy of the Computation results. Often, we can estimate this accuracy by using traditional statistical techniques. However, in many practical situations, we do not know the probability distributions of different...... the potential for solving increasingly difficult computational problems. However, given the complexity of modern computer architectures, the task of realizing this potential needs careful attention. A main concern of HPC is the development of software that optimizes the performance of a given computer...... measurement, estimation, and/or roundoff errors, we only know estimates of the upper bounds on the corresponding measurement errors, i.e., we only know an interval of possible values of each such error. The papers from the following chapter contain the description of the corresponding '' interval computation...

  3. Varieties of Confidence Intervals.

    Science.gov (United States)

    Cousineau, Denis

    2017-01-01

    Error bars are useful to understand data and their interrelations. Here, it is shown that confidence intervals of the mean (CI M s) can be adjusted based on whether the objective is to highlight differences between measures or not and based on the experimental design (within- or between-group designs). Confidence intervals (CIs) can also be adjusted to take into account the sampling mechanisms and the population size (if not infinite). Names are proposed to distinguish the various types of CIs and the assumptions underlying them, and how to assess their validity is explained. The various CIs presented here are easily obtained from a succession of multiplicative adjustments to the basic (unadjusted) CI width. All summary results should present a measure of precision, such as CIs, as this information is complementary to effect sizes.

  4. Applications of interval computations

    CERN Document Server

    Kreinovich, Vladik

    1996-01-01

    Primary Audience for the Book • Specialists in numerical computations who are interested in algorithms with automatic result verification. • Engineers, scientists, and practitioners who desire results with automatic verification and who would therefore benefit from the experience of suc­ cessful applications. • Students in applied mathematics and computer science who want to learn these methods. Goal Of the Book This book contains surveys of applications of interval computations, i. e. , appli­ cations of numerical methods with automatic result verification, that were pre­ sented at an international workshop on the subject in EI Paso, Texas, February 23-25, 1995. The purpose of this book is to disseminate detailed and surveyed information about existing and potential applications of this new growing field. Brief Description of the Papers At the most fundamental level, interval arithmetic operations work with sets: The result of a single arithmetic operation is the set of all possible results as the o...

  5. Anthracycline-induced cardiomyopathy: favourable effects of cardiac resynchronization therapy

    DEFF Research Database (Denmark)

    Ahlehoff, Ole; Galløe, Anders M; Hansen, Peter R

    2010-01-01

    We report a case of severe refractory congestive heart failure after anthracycline chemotherapy in a patient with a narrow QRS interval on the electrocardiogram and echocardiographic evidence of left ventricular dyssynchrony, where cardiac resynchronization therapy resulted in normalization of left...

  6. Probing cardiac repolarization reserve in drug safety assessment

    NARCIS (Netherlands)

    Nalos, L.

    2011-01-01

    Excessive prolongation of cardiac repolarization, manifested as QT prolongation on ECG, is common unwanted side effect of many drugs and drug candidates. Prolongation of QT interval may lead to life threatening cardiac arrhythmia – Torsade de Point (TdP). Number of drugs was withdrawn from the marke

  7. Pneumothorax in cardiac pacing

    DEFF Research Database (Denmark)

    Kirkfeldt, Rikke Esberg; Johansen, Jens Brock; Nohr, Ellen Aagaard;

    2012-01-01

    AIM: To identify risk factors for pneumothorax treated with a chest tube after cardiac pacing device implantation in a population-based cohort.METHODS AND RESULTS: A nationwide cohort study was performed based on data on 28 860 patients from the Danish Pacemaker Register, which included all Danish...... patients who received their first pacemaker (PM) or cardiac resynchronization device from 1997 to 2008. Multiple logistic regression was used to estimate adjusted odds ratios (aOR) with 95% confidence intervals for the association between risk factors and pneumothorax treated with a chest tube. The median...... age was 77 years (25th and 75th percentile: 69-84) and 55% were male (n = 15 785). A total of 190 patients (0.66%) were treated for pneumothorax, which was more often in women [aOR 1.9 (1.4-2.6)], and in patients with age >80 years [aOR 1.4 (1.0-1.9)], a prior history of chronic obstructive pulmonary...

  8. Interval methods: An introduction

    DEFF Research Database (Denmark)

    Achenie, L.E.K.; Kreinovich, V.; Madsen, Kaj

    2006-01-01

    This chapter contains selected papers presented at the Minisymposium on Interval Methods of the PARA'04 Workshop '' State-of-the-Art in Scientific Computing ''. The emphasis of the workshop was on high-performance computing (HPC). The ongoing development of ever more advanced computers provides....... An important characteristic of the computer performance in scientific computing is the accuracy of the Computation results. Often, we can estimate this accuracy by using traditional statistical techniques. However, in many practical situations, we do not know the probability distributions of different...... '' techniques, and the applications of these techniques to various problems of scientific computing....

  9. Interval-based Synthesis

    Directory of Open Access Journals (Sweden)

    Angelo Montanari

    2014-08-01

    Full Text Available We introduce the synthesis problem for Halpern and Shoham's modal logic of intervals extended with an equivalence relation over time points, abbreviated HSeq. In analogy to the case of monadic second-order logic of one successor, the considered synthesis problem receives as input an HSeq formula phi and a finite set Sigma of propositional variables and temporal requests, and it establishes whether or not, for all possible evaluations of elements in Sigma in every interval structure, there exists an evaluation of the remaining propositional variables and temporal requests such that the resulting structure is a model for phi. We focus our attention on decidability of the synthesis problem for some meaningful fragments of HSeq, whose modalities are drawn from the set A (meets, Abar (met by, B (begins, Bbar (begun by, interpreted over finite linear orders and natural numbers. We prove that the fragment ABBbareq is decidable (non-primitive recursive hard, while the fragment AAbarBBbar turns out to be undecidable. In addition, we show that even the synthesis problem for ABBbar becomes undecidable if we replace finite linear orders by natural numbers.

  10. Interval probabilistic neural network.

    Science.gov (United States)

    Kowalski, Piotr A; Kulczycki, Piotr

    2017-01-01

    Automated classification systems have allowed for the rapid development of exploratory data analysis. Such systems increase the independence of human intervention in obtaining the analysis results, especially when inaccurate information is under consideration. The aim of this paper is to present a novel approach, a neural networking, for use in classifying interval information. As presented, neural methodology is a generalization of probabilistic neural network for interval data processing. The simple structure of this neural classification algorithm makes it applicable for research purposes. The procedure is based on the Bayes approach, ensuring minimal potential losses with regard to that which comes about through classification errors. In this article, the topological structure of the network and the learning process are described in detail. Of note, the correctness of the procedure proposed here has been verified by way of numerical tests. These tests include examples of both synthetic data, as well as benchmark instances. The results of numerical verification, carried out for different shapes of data sets, as well as a comparative analysis with other methods of similar conditioning, have validated both the concept presented here and its positive features.

  11. Chaos on the interval

    CERN Document Server

    Ruette, Sylvie

    2017-01-01

    The aim of this book is to survey the relations between the various kinds of chaos and related notions for continuous interval maps from a topological point of view. The papers on this topic are numerous and widely scattered in the literature; some of them are little known, difficult to find, or originally published in Russian, Ukrainian, or Chinese. Dynamical systems given by the iteration of a continuous map on an interval have been broadly studied because they are simple but nevertheless exhibit complex behaviors. They also allow numerical simulations, which enabled the discovery of some chaotic phenomena. Moreover, the "most interesting" part of some higher-dimensional systems can be of lower dimension, which allows, in some cases, boiling it down to systems in dimension one. Some of the more recent developments such as distributional chaos, the relation between entropy and Li-Yorke chaos, sequence entropy, and maps with infinitely many branches are presented in book form for the first time. The author gi...

  12. Interval arithmetic operations for uncertainty analysis with correlated interval variables

    Institute of Scientific and Technical Information of China (English)

    Chao Jiang; Chun-Ming Fu; Bing-Yu Ni; Xu Han

    2016-01-01

    A new interval arithmetic method is proposed to solve interval functions with correlated intervals through which the overestimation problem existing in interval analy-sis could be significantly alleviated. The correlation between interval parameters is defined by the multidimensional par-allelepiped model which is convenient to describe the correlative and independent interval variables in a unified framework. The original interval variables with correlation are transformed into the standard space without correlation, and then the relationship between the original variables and the standard interval variables is obtained. The expressions of four basic interval arithmetic operations, namely addi-tion, subtraction, multiplication, and division, are given in the standard space. Finally, several numerical examples and a two-step bar are used to demonstrate the effectiveness of the proposed method.

  13. Cardiac effects of sertindole and quetiapine

    DEFF Research Database (Denmark)

    Nielsen, Jimmi; Matz, Jørgen; Mittoux, Aurelia;

    2015-01-01

    The QT interval is the most widely used surrogate marker for predicting TdP; however, several alternative surrogate markers, such as Tpeak-Tend (TpTe) and a quantitative T-wave morphology combination score (MCS) have emerged. This study investigated the cardiac effects of sertindole and quetiapin...

  14. Cardiac MRI in Athletes

    NARCIS (Netherlands)

    Luijkx, T.

    2012-01-01

    Cardiac magnetic resonance imaging (CMR) is often used in athletes to image cardiac anatomy and function and is increasingly requested in the context of screening for pathology that can cause sudden cardiac death (SCD). In this thesis, patterns of cardiac adaptation to sports are investigated with C

  15. INTERVAL ARITHMETIC AND STATIC INTERVAL FINITE ELEMENT METHOD

    Institute of Scientific and Technical Information of China (English)

    郭书祥; 吕震宙

    2001-01-01

    When the uncertainties of structures may be bounded in intervals, through some suitable discretization, interval finite element method can be constructed by combining the interval analysis with the traditional finite element method(FEM). The two parameters,median and deviation, were used to represent the uncertainties of interval variables. Based on the arithmetic rules of intervals, some properties and arithmetic rules of interval variables were demonstrated. Combining the procedure of interval analysis with FEM, a static linear interval finite element method was presented to solve the non-random uncertain structures. The solving of the characteristic parameters of n-freedom uncertain displacement field of the static governing equation was transformed into 2 n-order linear equations. It is shown by a numerical example that the proposed method is practical and effective.

  16. What Is Cardiac Rehabilitation?

    Science.gov (United States)

    ANSWERS by heart Treatments + Tests What Is Cardiac Rehabilitation? A cardiac rehabilitation (rehab) program takes place in a hospital or ... special help in making lifestyle changes. During your rehabilitation program you’ll… • Have a medical evaluation to ...

  17. Cardiac tamponade (image)

    Science.gov (United States)

    Cardiac tamponade is a condition involving compression of the heart caused by blood or fluid accumulation in the space ... they cannot adequately fill or pump blood. Cardiac tamponade is an emergency condition that requires hospitalization.

  18. Cardiac Procedures and Surgeries

    Science.gov (United States)

    ... Procedure Learn more about cardiac medications , including dual antiplatelet therapy, that you may need to take after your ... Procedure Learn more about cardiac medications , including dual antiplatelet therapy, that you may need to take after your ...

  19. Echocardiographic assessment of cardiac morphology and function in Xenopus.

    Science.gov (United States)

    Bartlett, Heather L; Escalera, Robert B; Patel, Sonali S; Wedemeyer, Elesa W; Volk, Kenneth A; Lohr, Jamie L; Reinking, Benjamin E

    2010-04-01

    Advances using Xenopus as a model permit valuable inquiries into cardiac development from embryo to adult. Noninvasive methods are needed to study cardiac function longitudinally. The objective of this study was to evaluate the feasibility of echocardiographic studies in Xenopus and establish normative data of adult cardiac structure and function. Doppler and 2D echocardiograms and electrocardiograms were acquired from adult Xenopus laevis and X. tropicalis. Frogs were exposed to either isoflurane or tricaine to discern the effect of sedating agents on cardiac function. Cardiac dimensions, morphology, flow velocities, and electrophysiologic intervals were measured and evaluated by using bivariate and regression analyses. Normal cardiac dimensions relative to body weight and species were established by echocardiography. Normal conduction intervals were determined by electrocardiography and did not vary by body weight or species. Anesthetic agent did not affect ejection fraction or flow velocity but did alter the QRS duration and QT interval. Echocardiographic and electrocardiographic studies in Xenopus provide information about cardiac anatomy and physiology and can readily be used for longitudinal analyses of developmental inquiries. Body weight, species, and anesthetic agent are factors that should be considered in experimental design and analyses.

  20. Relationship of cardiac sympathetic nerve innervation and excitability to cardiac hypertrophy in very elderly male hypertensive patients.

    Science.gov (United States)

    Li, Shijun; Zhang, Li; Guo, Yuanyuan; Li, Xiaoying

    2013-09-01

    Our study aimed to disclose the relationship of cardiac sympathetic nerve innervation and excitability to myocardial hypertrophy in very old elderly male hypertensive patients with low serum testosterone level. A total of 80 elderly male hypertensive patients aged from 80 to 95 years were recruited. Heart rate variability is determined by 24 h dynamic electrocardiogram and heart rate variability analysis system. Cardiac function and left ventricular mass index were determined using color Doppler ultrasound. Standard deviation of all normal sinus R-R intervals over 24 h (SDNN) significantly decreased in hypertensive cardiac hypertrophy patients as compared with those without cardiac hypertrophy. SDANN and Standard deviation of the average normal sinus R-R intervals for all 5-min segment index, time-domain index reflecting sympathetic nerve tension, obviously decreased and LFnu and LFnu/HFnu, frequency-domain index representing sympathetic nerve excitability, significantly increased in hypertensive cardiac hypertrophy patients as compared with those without cardiac hypertrophy. Myocardial norepinephrine content significantly increased while tyrosine hydroxylase expression significantly lowered in hypertensive cardiac hypertrophy patients, and a negative correlation between myocardial tyrosine hydroxylase expression and myocardial norepinephrine content was present. Serum total testosterone level decreased in hypertensive cardiac hypertrophy patients and was an independent risk factor for the increase in myocardial norepinephrine content and decrease in tyrosine hydroxylase expression. These data confirm that cardiac sympathetic nerve hypoinnervation and relative increase in cardiac sympathetic nerve excitability are closely related to cardiac hypertrophy in very old hypertensive patients. A lower serum total testosterone level was the independent risk factor of cardiac sympathetic nerve hypoinnervation and relative increase in excitability in very old male

  1. Modeling bipolar stimulation of cardiac tissue

    Science.gov (United States)

    Galappaththige, Suran K.; Gray, Richard A.; Roth, Bradley J.

    2017-09-01

    Unipolar stimulation of cardiac tissue is often used in the design of cardiac pacemakers because of the low current required to depolarize the surrounding tissue at rest. However, the advantages of unipolar over bipolar stimulation are not obvious at shorter coupling intervals when the tissue near the pacing electrode is relatively refractory. Therefore, this paper analyzes bipolar stimulation of cardiac tissue. The strength-interval relationship for bipolar stimulation is calculated using the bidomain model and a recently developed parsimonious ionic current model. The strength-interval curves obtained using different electrode separations and arrangements (electrodes placed parallel to the fibers versus perpendicular to the fibers) indicate that bipolar stimulation results in more complex activation patterns compared to unipolar stimulation. An unusually low threshold stimulus current is observed when the electrodes are close to each other (a separation of 1 mm) because of break excitation. Unlike for unipolar stimulation, anode make excitation is not present during bipolar stimulation, and an abrupt switch from anode break to cathode make excitation can cause dramatic changes in threshold with very small changes in the interval. These results could impact the design of implantable pacemakers and defibrillators.

  2. Cardiac sodium channelopathies

    NARCIS (Netherlands)

    Amin, A.S.; Asghari-Roodsari, A.; Tan, H.L.

    2010-01-01

    Cardiac sodium channel are protein complexes that are expressed in the sarcolemma of cardiomyocytes to carry a large inward depolarizing current (I-Na) during phase 0 of the cardiac action potential. The importance of I-Na for normal cardiac electrical activity is reflected by the high incidence of

  3. Cardiac sodium channelopathies

    NARCIS (Netherlands)

    Amin, A.S.; Asghari-Roodsari, A.; Tan, H.L.

    2010-01-01

    Cardiac sodium channel are protein complexes that are expressed in the sarcolemma of cardiomyocytes to carry a large inward depolarizing current (I-Na) during phase 0 of the cardiac action potential. The importance of I-Na for normal cardiac electrical activity is reflected by the high incidence of

  4. Normal electrocardiographic QT interval in race-fit Standardbred horses at rest and its rate dependence during exercise

    DEFF Research Database (Denmark)

    Pedersen, Philip J; Kanters, Jørgen K.; Buhl, Rikke

    2013-01-01

    Cardiac repolarization, measured as QT and Tpeak to Tend (TpTe) intervals on the ECG, is important, as irregularities caused by diseases, ventricular hypertrophy, drugs and genetic defects can trigger arrhythmias which predispose human patients to syncope and sudden cardiac death. In horses, repo...

  5. [Effects of temporary dual-chamber cardiac pacing in refractory cardiac failure].

    Science.gov (United States)

    Scanu, P; Lecluse, E; Michel, L; Bureau, G; Saloux, E; Cleron, S; Valette, B; Grollier, G; Potier, J C; Foucault, J P

    1996-12-01

    The authors studied 18 patients (15 men, 3 women) with an average age of 67 +/- 8 years with refractory cardiac failure. In order to determine the potential of pacing to raise cardiac output in severe cardiac failure. The average ejection fraction was 26 +/- 6.5%. All patients were in sinus rhythm:resting cardiac output was 3.35 l/min. Two temporary pacing catheters were positioned in the right atrium and at the apex of the right ventricle for dual-chamber mode pacing triggered by the spontaneous P waves. Changes in cardiac output were measured by Doppler echocardiography at different values of atrioventricular delay. Patients were considered to be responders if their cardiac outputs rose by 15%. In 7 patients meeting this criterion, the average increase in cardiac output was 27% (2.99 +/- 0.7 to 3.81 +/- 0.86 l/mn; p < 0.01); all had dilated cardiomyopathies with left bundle branch block and the optimal AV delay was 103 +/- 21 ms (80-140 ms); the duration of diastolic filling increased from 212 +/- 98 to 292 +/- 116 ms (p = 0.02). In the non-responding group (11 patients with an increase of cardiac output of only 3.6 +/- 0.09 to 3.9 +/- 0.92 l/mn; p < 0.01), the underlying disease process was mainly ischaemic. Two predictive factors of efficacy of dual-chamber pacing were identified: a short ventricular filling period (29 +/- 8% of the RR interval in the responders vs 44 +/- 9% in the non-responders; p < 0.01) and the presence of 1st degree atrioventricular block. Dual-chamber pacing could be a valuable method of increasing resting cardiac outputs in a selected group of patients with severe, refractory, cardiac failure.

  6. Minimax confidence intervals in geomagnetism

    Science.gov (United States)

    Stark, Philip B.

    1992-01-01

    The present paper uses theory of Donoho (1989) to find lower bounds on the lengths of optimally short fixed-length confidence intervals (minimax confidence intervals) for Gauss coefficients of the field of degree 1-12 using the heat flow constraint. The bounds on optimal minimax intervals are about 40 percent shorter than Backus' intervals: no procedure for producing fixed-length confidence intervals, linear or nonlinear, can give intervals shorter than about 60 percent the length of Backus' in this problem. While both methods rigorously account for the fact that core field models are infinite-dimensional, the application of the techniques to the geomagnetic problem involves approximations and counterfactual assumptions about the data errors, and so these results are likely to be extremely optimistic estimates of the actual uncertainty in Gauss coefficients.

  7. Reference Intervals in Neonatal Hematology.

    Science.gov (United States)

    Henry, Erick; Christensen, Robert D

    2015-09-01

    The various blood cell counts of neonates must be interpreted in accordance with high-quality reference intervals based on gestational and postnatal age. Using very large sample sizes, we generated neonatal reference intervals for each element of the complete blood count (CBC). Knowledge of whether a patient has CBC values that are too high (above the upper reference interval) or too low (below the lower reference interval) provides important insights into the specific disorder involved and in many instances suggests a treatment plan. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Acute resistance exercise reduces heart rate complexity and increases QTc interval.

    Science.gov (United States)

    Heffernan, K S; Sosnoff, J J; Jae, S Y; Gates, G J; Fernhall, B

    2008-04-01

    Acute resistance exercise (RE) has been shown to reduce cardiac vagal control. Whether this would in turn affect QTc interval (an index of ventricular depolarization/repolarization) or heart rate complexity is not known. Heart rate variability (HRV), heart rate complexity (SampEn), and QT interval (rate corrected using Bazett, Fridericia, Hodges, and Framingham) were measured before and 5 min after an acute RE bout in twelve healthy young men. Normalized high frequency power of HRV (an index of cardiac parasympathetic modulation; HF (nu)), and SampEn were reduced following RE (p heart rate complexity and increased QTc length. Thus, during recovery from acute RE, there is prolongation of depolarization and repolarization of the ventricles concomitant with reduced cardiac irregularity, and this may be related to a reduction in cardiac vagal control.

  9. Mechanisms of cardiac pain.

    Science.gov (United States)

    Foreman, Robert D; Garrett, Kennon M; Blair, Robert W

    2015-04-01

    Angina pectoris is cardiac pain that typically is manifested as referred pain to the chest and upper left arm. Atypical pain to describe localization of the perception, generally experienced more by women, is referred to the back, neck, and/or jaw. This article summarizes the neurophysiological and pharmacological mechanisms for referred cardiac pain. Spinal cardiac afferent fibers mediate typical anginal pain via pathways from the spinal cord to the thalamus and ultimately cerebral cortex. Spinal neurotransmission involves substance P, glutamate, and transient receptor potential vanilloid-1 (TRPV1) receptors; release of neurokinins such as nuclear factor kappa b (NF-kb) in the spinal cord can modulate neurotransmission. Vagal cardiac afferent fibers likely mediate atypical anginal pain and contribute to cardiac ischemia without accompanying pain via relays through the nucleus of the solitary tract and the C1-C2 spinal segments. The psychological state of an individual can modulate cardiac nociception via pathways involving the amygdala. Descending pathways originating from nucleus raphe magnus and the pons also can modulate cardiac nociception. Sensory input from other visceral organs can mimic cardiac pain due to convergence of this input with cardiac input onto spinothalamic tract neurons. Reduction of converging nociceptive input from the gallbladder and gastrointestinal tract can diminish cardiac pain. Much work remains to be performed to discern the interactions among complex neural pathways that ultimately produce or do not produce the sensations associated with cardiac pain.

  10. Genetic association study of QT interval highlights role for calcium signaling pathways in myocardial repolarization

    DEFF Research Database (Denmark)

    Arking, Dan E; Pulit, Sara L; Crotti, Lia

    2014-01-01

    The QT interval, an electrocardiographic measure reflecting myocardial repolarization, is a heritable trait. QT prolongation is a risk factor for ventricular arrhythmias and sudden cardiac death (SCD) and could indicate the presence of the potentially lethal mendelian long-QT syndrome (LQTS). Usi....... Our integration of common variant association, expression and orthogonal protein-protein interaction screens provides new insights into cardiac electrophysiology and identifies new candidate genes for ventricular arrhythmias, LQTS and SCD. © 2014 Nature America, Inc....

  11. Cardiac tumours in children

    Directory of Open Access Journals (Sweden)

    Parsons Jonathan M

    2007-03-01

    Full Text Available Abstract Cardiac tumours are benign or malignant neoplasms arising primarily in the inner lining, muscle layer, or the surrounding pericardium of the heart. They can be primary or metastatic. Primary cardiac tumours are rare in paediatric practice with a prevalence of 0.0017 to 0.28 in autopsy series. In contrast, the incidence of cardiac tumours during foetal life has been reported to be approximately 0.14%. The vast majority of primary cardiac tumours in children are benign, whilst approximately 10% are malignant. Secondary malignant tumours are 10–20 times more prevalent than primary malignant tumours. Rhabdomyoma is the most common cardiac tumour during foetal life and childhood. It accounts for more than 60% of all primary cardiac tumours. The frequency and type of cardiac tumours in adults differ from those in children with 75% being benign and 25% being malignant. Myxomas are the most common primary tumours in adults constituting 40% of benign tumours. Sarcomas make up 75% of malignant cardiac masses. Echocardiography, Computing Tomography (CT and Magnetic Resonance Imaging (MRI of the heart are the main non-invasive diagnostic tools. Cardiac catheterisation is seldom necessary. Tumour biopsy with histological assessment remains the gold standard for confirmation of the diagnosis. Surgical resection of primary cardiac tumours should be considered to relieve symptoms and mechanical obstruction to blood flow. The outcome of surgical resection in symptomatic, non-myxomatous benign cardiac tumours is favourable. Patients with primary cardiac malignancies may benefit from palliative surgery but this approach should not be recommended for patients with metastatic cardiac tumours. Surgery, chemotherapy and radiotherapy may prolong survival. The prognosis for malignant primary cardiac tumours is generally extremely poor.

  12. Automatic Error Analysis Using Intervals

    Science.gov (United States)

    Rothwell, E. J.; Cloud, M. J.

    2012-01-01

    A technique for automatic error analysis using interval mathematics is introduced. A comparison to standard error propagation methods shows that in cases involving complicated formulas, the interval approach gives comparable error estimates with much less effort. Several examples are considered, and numerical errors are computed using the INTLAB…

  13. Explorations in Statistics: Confidence Intervals

    Science.gov (United States)

    Curran-Everett, Douglas

    2009-01-01

    Learning about statistics is a lot like learning about science: the learning is more meaningful if you can actively explore. This third installment of "Explorations in Statistics" investigates confidence intervals. A confidence interval is a range that we expect, with some level of confidence, to include the true value of a population parameter…

  14. Evidence Based Review: Risk of Cardiac Rhythm Problems During Spaceflight

    Science.gov (United States)

    Platts, Steven H.; Stenger, Michael B.; Phillips, Tiffany R.; Brown, Angela K.; Arzeno, Natalia M.; Levine, Benjamin; Summers, Richard

    2009-01-01

    Very little research has systematically evaluated the prevalence (or potential risk) of cardiac arrhythmias during space flight. There are several observational reports of non life-threatening but potentially concerning arrhythmias. At least two potential risk factors for arrhythmias have been reported either during or immediately after space flight: cardiac atrophy and a prolonged QTc interval. The potential severity of the mission impact of a serious arrhythmia requires that a systematic evaluation be conducted of the risk of arrhythmia due to space flight.

  15. Cardiac health status implementation on mobile phone

    Directory of Open Access Journals (Sweden)

    Prasad Pomaji

    2012-11-01

    Full Text Available An ECG is a bio-medical signal which records the hearts electrical signal versus time. It is an important diagnosis tool for assessing hearts functions. The features extracted from the ECG signal play a significant role in diagnosing most of the cardiac diseases. Our focus is on developing an integrated electrocardiogram (ECG beat detector on mobile phone for health monitoring purpose. The feature extraction scheme determines the amplitude and intervals in the ECG signal for subsequent analysis. The amplitude and interval values of the P-QRS-T segment determines the functioning of heart of every human.

  16. Cardiac arrhythmias in adult patients with asthma

    DEFF Research Database (Denmark)

    Warnier, Miriam J; Rutten, Frans H; Kors, Jan A;

    2012-01-01

    OBJECTIVE: The pathogenesis of cardiac arrhythmias in asthma patients has not been fully elucidated. Adverse drug effects, particularly those of β2-mimetics, may play a role. The aim of this study was to determine whether asthma is associated with the risk of cardiac arrhythmias and electrocardio......OBJECTIVE: The pathogenesis of cardiac arrhythmias in asthma patients has not been fully elucidated. Adverse drug effects, particularly those of β2-mimetics, may play a role. The aim of this study was to determine whether asthma is associated with the risk of cardiac arrhythmias...... and electrocardiographic characteristics of arrhythmogenicity (ECG) and to explore the role of β2-mimetics. METHODS: A cross-sectional study was conducted among 158 adult patients with a diagnosis of asthma and 6303 participants without asthma from the cohort of the Utrecht Health Project-an ongoing, longitudinal, primary...... or flutter). Secondary outcomes were tachycardia, bradycardia, PVC, atrial fibrillation or flutter, mean heart rate, mean corrected QT (QTc) interval length, and prolonged QTc interval. RESULTS: Tachycardia and PVCs were more prevalent in patients with asthma (3% and 4%, respectively) than those without...

  17. Stimulating endogenous cardiac regeneration

    Directory of Open Access Journals (Sweden)

    Amanda eFinan

    2015-09-01

    Full Text Available The healthy adult heart has a low turnover of cardiac myocytes. The renewal capacity, however, is augmented after cardiac injury. Participants in cardiac regeneration include cardiac myocytes themselves, cardiac progenitor cells, and peripheral stem cells, particularly from the bone marrow compartment. Cardiac progenitor cells and bone marrow stem cells are augmented after cardiac injury, migrate to the myocardium, and support regeneration. Depletion studies of these populations have demonstrated their necessary role in cardiac repair. However, the potential of these cells to completely regenerate the heart is limited. Efforts are now being focused on ways to augment these natural pathways to improve cardiac healing, primarily after ischemic injury but in other cardiac pathologies as well. Cell and gene therapy or pharmacological interventions are proposed mechanisms. Cell therapy has demonstrated modest results and has passed into clinical trials. However, the beneficial effects of cell therapy have primarily been their ability to produce paracrine effects on the cardiac tissue and recruit endogenous stem cell populations as opposed to direct cardiac regeneration. Gene therapy efforts have focused on prolonging or reactivating natural signaling pathways. Positive results have been demonstrated to activate the endogenous stem cell populations and are currently being tested in clinical trials. A potential new avenue may be to refine pharmacological treatments that are currently in place in the clinic. Evidence is mounting that drugs such as statins or beta blockers may alter endogenous stem cell activity. Understanding the effects of these drugs on stem cell repair while keeping in mind their primary function may strike a balance in myocardial healing. To maximize endogenous cardiac regeneration,a combination of these approaches couldameliorate the overall repair process to incorporate the participation ofmultiple cell players.

  18. Circular Interval Arithmetic Applied on LDMT for Linear Interval System

    Directory of Open Access Journals (Sweden)

    Stephen Ehidiamhen Uwamusi

    2014-07-01

    Full Text Available The paper considers the LDMT Factorization of a general nxn matrix arising from system of interval linear equations. We paid special emphasis on Interval Cholesky Factorization. The basic computational tool used is the square root method of circular interval arithmetic in a sense analogous to Gargantini and Henrici as well as the generalized square root method due to Petkovic which enables the construction of the square root of the resulting diagonal matrix. We also made use of Rump’s method for multiplying two intervals expressed in the form of midpoint-radius respectively. Numerical example of matrix factorization in this regard is given which forms the basis of discussion. It is shown that LDMT even though is a numerically stable method for any diagonally dominant matrix it also can lead to excess width of the solution set. It is also pointed out that in spite of the above mentioned objection to interval LDMT it has in addition , the advantage that in the presence of several solution sets sharing the same interval matrix the LDMT Factorization requires to be computed only once which helps in saving substantial computational time. This may be found applicable in the development of military hard ware which requires shooting at a single point but produces multiple broadcast at all other points

  19. QTc interval in children with chronic renal failure and with renal transplants.

    Science.gov (United States)

    Butani, Lavjay; Berg, Gerre; Makker, Sudesh P

    2002-01-01

    Prolongation of the QTc interval, a risk factor for cardiac arrhythmias, has been observed in adult hemodialysis patients; there are few data on the QTc interval in children with chronic renal failure (CRF) and following renal transplantation (Tx). The purpose of our study was to determine the QTc interval in children with CRF and post renal Tx. Twenty children with CRF and 16 children with renal Tx who were followed at the University of California, Davis, underwent prospective EKG monitoring. The mean QTc interval in the CRF and post-Tx cohorts was normal at 407.9 ms and 408.2 ms, respectively. None of the children with CRF had QTc prolongation. Two Tx recipients had QTc prolongation; both had cardiac dilatation on echocardiography (ECHO). There was no correlation between the QTc interval and the creatinine clearance in either group. However, a significant correlation was noted between QTc prolongation and cardiac dilatation on ECHO in the Tx group (P=0.02, Fisher's exact test). In conclusion, QTc prolongation is uncommon in children with CRF and following Tx, in the absence of cardiac dilatation. However, caution is still needed before prescribing medications known to cause QTc prolongation.

  20. Cardiac sodium channelopathies.

    Science.gov (United States)

    Amin, Ahmad S; Asghari-Roodsari, Alaleh; Tan, Hanno L

    2010-07-01

    Cardiac sodium channel are protein complexes that are expressed in the sarcolemma of cardiomyocytes to carry a large inward depolarizing current (INa) during phase 0 of the cardiac action potential. The importance of INa for normal cardiac electrical activity is reflected by the high incidence of arrhythmias in cardiac sodium channelopathies, i.e., arrhythmogenic diseases in patients with mutations in SCN5A, the gene responsible for the pore-forming ion-conducting alpha-subunit, or in genes that encode the ancillary beta-subunits or regulatory proteins of the cardiac sodium channel. While clinical and genetic studies have laid the foundation for our understanding of cardiac sodium channelopathies by establishing links between arrhythmogenic diseases and mutations in genes that encode various subunits of the cardiac sodium channel, biophysical studies (particularly in heterologous expression systems and transgenic mouse models) have provided insights into the mechanisms by which INa dysfunction causes disease in such channelopathies. It is now recognized that mutations that increase INa delay cardiac repolarization, prolong action potential duration, and cause long QT syndrome, while mutations that reduce INa decrease cardiac excitability, reduce electrical conduction velocity, and induce Brugada syndrome, progressive cardiac conduction disease, sick sinus syndrome, or combinations thereof. Recently, mutation-induced INa dysfunction was also linked to dilated cardiomyopathy, atrial fibrillation, and sudden infant death syndrome. This review describes the structure and function of the cardiac sodium channel and its various subunits, summarizes major cardiac sodium channelopathies and the current knowledge concerning their genetic background and underlying molecular mechanisms, and discusses recent advances in the discovery of mutation-specific therapies in the management of these channelopathies.

  1. Marketing cardiac CT programs.

    Science.gov (United States)

    Scott, Jason

    2010-01-01

    There are two components of cardiac CT discussed in this article: coronary artery calcium scoring (CACS) and coronary computed tomography angiography (CCTA).The distinctive advantages of each CT examination are outlined. In order to ensure a successful cardiac CT program, it is imperative that imaging facilities market their cardiac CT practices effectively in order to gain a competitive advantage in this valuable market share. If patients receive quality care by competent individuals, they are more likely to recommend the facility's cardiac CT program. Satisfied patients will also be more willing to come back for any further testing.

  2. Cardiac event monitors

    Science.gov (United States)

    ... ECG) - ambulatory; Continuous electrocardiograms (EKGs); Holter monitors; Transtelephonic event monitors ... attached. You can carry or wear a cardiac event monitor up to 30 days. You carry the ...

  3. Cardiac stem cell niches

    Directory of Open Access Journals (Sweden)

    Annarosa Leri

    2014-11-01

    Full Text Available The critical role that stem cell niches have in cardiac homeostasis and myocardial repair following injury is the focus of this review. Cardiac niches represent specialized microdomains where the quiescent and activated state of resident stem cells is regulated. Alterations in niche function with aging and cardiac diseases result in abnormal sites of cardiomyogenesis and inadequate myocyte formation. The relevance of Notch1 signaling, gap-junction formation, HIF-1α and metabolic state in the regulation of stem cell growth and differentiation within the cardiac niches are discussed.

  4. High-sensitive cardiac troponin T measurements in prediction of non-cardiac complications after major abdominal surgery.

    Science.gov (United States)

    Noordzij, P G; van Geffen, O; Dijkstra, I M; Boerma, D; Meinders, A J; Rettig, T C D; Eefting, F D; van Loon, D; van de Garde, E M W; van Dongen, E P A

    2015-06-01

    Postoperative non-cardiac complication rates are as high as 11-28% after high-risk abdominal procedures. Emerging evidence indicates that postoperative cardiac troponin T elevations are associated with adverse outcome in non-cardiac surgery. The aim of this study was to determine the relationship between postoperative high-sensitive cardiac troponin T elevations and non-cardiac complications in patients after major abdominal surgery. This prospective observational single-centre cohort study included patients at risk for coronary artery disease undergoing elective major abdominal surgery. Cardiac troponin was measured before surgery and at day 1, 3, and 7. Multivariable logistic regression analysis was performed to examine the adjusted association for different cut-off concentrations of postoperative myocardial injury and non-cardiac outcome. In 203 patients, 690 high-sensitive cardiac troponin T measurements were performed. Fifty-three patients (26%) had a non-cardiac complication within 30 days after surgery. Hospital mortality was 4% (8/203). An increase in cardiac troponin T concentration ≥100% compared with baseline was a superior independent predictor of non-cardiac postoperative clinical complications (adjusted odds ratio 4.3, 95% confidence interval 1.8-10.1, Pcardiac troponin T increase ≥100% is a strong predictor of non-cardiac 30 day complications, increased hospital stay and hospital mortality in patients undergoing major abdominal surgery. NCT02150486. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  5. [Advances in cardiac pacing].

    Science.gov (United States)

    de Carranza, María-José Sancho-Tello; Fidalgo-Andrés, María Luisa; Ferrer, José Martínez; Mateas, Francisco Ruiz

    2012-01-01

    This article contains a review of the current status of remote monitoring and follow-up involving cardiac pacing devices and of the latest developments in cardiac resynchronization therapy. In addition, the most important articles published in the last year are discussed.

  6. Drug-induced QT-interval shortening following antiepileptic treatment with oral rufinamide.

    Science.gov (United States)

    Schimpf, Rainer; Veltmann, Christian; Papavassiliu, Theano; Rudic, Boris; Göksu, Turgay; Kuschyk, Jürgen; Wolpert, Christian; Antzelevitch, Charles; Ebner, Alois; Borggrefe, Martin; Brandt, Christian

    2012-05-01

    The arrhythmogenic potential of short QT intervals has recently been highlighted in patients with a short QT syndrome. Drug-induced QT-interval prolongation is a known risk factor for ventricular tachyarrhythmias. However, reports on drug-induced QT-interval shortening are rare and proarrhythmic effects remain unclear. Recently, rufinamide, a new antiepileptic drug for the add-on treatment of Lennox-Gastaut syndrome, was approved in the European Union and the United States. Initial trials showed drug-induced QT-interval shortening. The aim of our study was to evaluate the effects of rufinamide on QT intervals in patients with difficult-to-treat epilepsies. Nineteen consecutive patients with Lennox-Gastaut syndrome and other epilepsy syndromes were included (n = 12 men; mean age 41 ± 12 years). QRS, QT, and T(peak)-T(end) intervals were analyzed before and during rufinamide treatment. The mean QT interval shortened significantly following rufinamide administration (QT interval 349 ± 23 ms vs 327 ± 17 ms; corrected QT interval 402 ± 22 ms vs 382 ± 16 ms; P = .002). T(peak)-T(end) intervals were 79 ± 17 ms before and 70 ± 20 ms on treatment (P = .07). The mean reduction of the corrected QT interval was 20 ± 18 ms. During follow-up (3.04 ± 1.09 years), no adverse events including symptomatic cardiac arrhythmias or sudden cardiac deaths were observed. QTc-interval shortening following oral rufinamide administration in a small patient group was not associated with significant clinical adverse effects. These observations notwithstanding, the ability of rufinamide to significantly shorten the QT interval portends a potential arrhythmogenic risk that may best be guarded against by periodic electrocardiographic recordings. Copyright © 2012 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  7. Mathematical cardiac electrophysiology

    CERN Document Server

    Colli Franzone, Piero; Scacchi, Simone

    2014-01-01

    This book covers the main mathematical and numerical models in computational electrocardiology, ranging from microscopic membrane models of cardiac ionic channels to macroscopic bidomain, monodomain, eikonal models and cardiac source representations. These advanced multiscale and nonlinear models describe the cardiac bioelectrical activity from the cell level to the body surface and are employed in both the direct and inverse problems of electrocardiology. The book also covers advanced numerical techniques needed to efficiently carry out large-scale cardiac simulations, including time and space discretizations, decoupling and operator splitting techniques, parallel finite element solvers. These techniques are employed in 3D cardiac simulations illustrating the excitation mechanisms, the anisotropic effects on excitation and repolarization wavefronts, the morphology of electrograms in normal and pathological tissue and some reentry phenomena. The overall aim of the book is to present rigorously the mathematica...

  8. Biomaterials for cardiac regeneration

    CERN Document Server

    Ruel, Marc

    2015-01-01

    This book offers readers a comprehensive biomaterials-based approach to achieving clinically successful, functionally integrated vasculogenesis and myogenesis in the heart. Coverage is multidisciplinary, including the role of extracellular matrices in cardiac development, whole-heart tissue engineering, imaging the mechanisms and effects of biomaterial-based cardiac regeneration, and autologous bioengineered heart valves. Bringing current knowledge together into a single volume, this book provides a compendium to students and new researchers in the field and constitutes a platform to allow for future developments and collaborative approaches in biomaterials-based regenerative medicine, even beyond cardiac applications. This book also: Provides a valuable overview of the engineering of biomaterials for cardiac regeneration, including coverage of combined biomaterials and stem cells, as well as extracellular matrices Presents readers with multidisciplinary coverage of biomaterials for cardiac repair, including ...

  9. Sudden cardiac death

    Directory of Open Access Journals (Sweden)

    Neeraj Parakh

    2015-01-01

    Full Text Available Sudden cardiac death is one of the most common cause of mortality worldwide. Despite significant advances in the medical science, there is little improvement in the sudden cardiac death related mortality. Coronary artery disease is the most common etiology behind sudden cardiac death, in the above 40 years population. Even in the apparently healthy population, there is a small percentage of patients dying from sudden cardiac death. Given the large denominator, this small percentage contributes to the largest burden of sudden cardiac death. Identification of this at risk group among the apparently healthy individual is a great challenge for the medical fraternity. This article looks into the causes and methods of preventing SCD and at some of the Indian data. Details of Brugada syndrome, Long QT syndrome, Genetics of SCD are discussed. Recent guidelines on many of these causes are summarised.

  10. Haemostatic reference intervals in pregnancy

    DEFF Research Database (Denmark)

    Szecsi, Pal Bela; Jørgensen, Maja; Klajnbard, Anna;

    2010-01-01

    Haemostatic reference intervals are generally based on samples from non-pregnant women. Thus, they may not be relevant to pregnant women, a problem that may hinder accurate diagnosis and treatment of haemostatic disorders during pregnancy. In this study, we establish gestational age......-specific reference intervals for coagulation tests during normal pregnancy. Eight hundred one women with expected normal pregnancies were included in the study. Of these women, 391 had no complications during pregnancy, vaginal delivery, or postpartum period. Plasma samples were obtained at gestational weeks 13......-20, 21-28, 29-34, 35-42, at active labor, and on postpartum days 1 and 2. Reference intervals for each gestational period using only the uncomplicated pregnancies were calculated in all 391 women for activated partial thromboplastin time (aPTT), fibrinogen, fibrin D-dimer, antithrombin, free protein S...

  11. Hospital discharge diagnoses of ventricular arrhythmias and cardiac arrest were useful for epidemiologic research

    DEFF Research Database (Denmark)

    De Bruin, M L; van Hemel, N M; Leufkens, H G M

    2005-01-01

    OBJECTIVE: We investigated the validity of hospital discharge diagnosis regarding ventricular arrhythmias and cardiac arrest. METHODS: We identified patients whose record in the PHARMO record linkage system database showed a code for ventricular or unspecified cardiac arrhythmias according to codes...... through manual review of hospital clinical records. The positive predictive value (PPV) was calculated, and differences between characteristics of true and false positives were evaluated. RESULTS: The PPV of ICD codes for ventricular arrhythmias and cardiac arrest was 82% (95% confidence interval CI = 72......-92). True positive results were associated with male gender (P = .09) and younger age (P = .05). Of the unspecified cardiac arrhythmias 10% (95% CI = 2-18) were identified as ventricular arrhythmias or cardiac arrest. CONCLUSION: Hospitalizations for ventricular cardiac arrhythmias and cardiac arrest (coded...

  12. Genetic association study of QT interval highlights role for calcium signaling pathways in myocardial repolarization

    NARCIS (Netherlands)

    Arking, Dan E.; Pulit, Sara L.; Crotti, Lia; Van der Harst, Pim; Munroe, Patricia B.; Koopmann, Tamara T.; Sotoodehnia, Nona; Rossin, Elizabeth J.; Morley, Michael; Wang, Xinchen; Johnson, Andrew D.; Lundby, Alicia; Gudbjartsson, Daniel F.; Noseworthy, Peter A.; Eijgelsheim, Mark; Bradford, Yuki; Tarasov, Kirill V.; Dorr, Marcus; Miiller-Nurasyid, Martina; Lahtinen, Annukka M.; Nolte, Ilja M.; Smith, Albert Vernon; Bis, Joshua C.; Isaacs, Aaron; Newhouse, Stephen J.; Evans, Daniel S.; Post, Wendy S.; Waggott, Daryl; Lyytikainen, Leo-Pekka; Hicks, Andrew A.; Eisele, Lewin; Ellinghaus, David; Hayward, Caroline; Navarro, Pau; Ulivi, Sheila; Tanaka, Toshiko; Tester, David J.; Chatel, Stephanie; Gustafsson, Stefan; Kumari, Meena; Morris, Richard W.; Naluai, Asa T.; Padmanabhan, Sandosh; Kluttig, Alexander; Strohmer, Bernhard; Panayiotou, Andrie G.; Torres, Maria; Knoflach, Michael; Hubacek, Jaroslav A.; Slowikowski, Kamil; Raychaudhuri, Soumya; Kumar, Runjun D.; Harris, Tamara B.; Launer, Lenore J.; Shuldiner, Alan R.; Alonso, Alvaro; Bader, Joel S.; EhreT, Georg; Huang, Hailiang; Kao, W. H. Linda; Strait, James B.; Macfarlane, Peter W.; Brown, Morris; Caulfield, Mark J.; Samani, Nilesh J.; Kronenberg, Florian; Willeit, Johann; Smith, J. Gustav; Greiser, Karin H.; Schwabedissen, Henriette Meyer Zu; Werdan, Karl; Carella, Massimo; Zelante, Leopoldo; Heckbert, Susan R.; Psaty, Bruce M.; Rotter, Jerome I.; Kolcic, Ivana; Poagek, Ozren; Wright, Alan F.; Griffin, Maura; Daly, Mark J.; Arnar, David O.; Holm, Hilma; Thorsteinsdottir, Unnur; Denny, Joshua C.; Roden, Dan M.; Zuvich, Rebecca L.; Emilsson, Valur; Plump, Andrew S.; Larson, Martin G.; O'Donnell, Christopher J.; Yin, Xiaoyan; Bobboll, Marco; D'Adamo, Adamo P.; Iorio, Annamaria; Sinagra, Gianfranco; Carracedo, Angel; Cummings, Steven R.; Nalls, Michael A.; Jula, Antti; Kontula, Kimmo K.; Marjamaa, Annukka; Oikarinen, Lasse; Perola, Markus; Porthan, Kimmo; Erbe, Raimund; Hoffmann, Per; Jockel, Karl-Heinz; Kalsch, Hagen; Nothen, Markus M.; Den Hoed, Marcel; Loos, Ruth J. F.; Thelle, Dag S.; Gieger, Christian; Meitinger, Thomas; Perz, Siegfried; Peters, Annette; Pruchal, Hanna; Sinner, Moritz F.; Waldenberger, Melanie; De Boer, Rudolf A.; Franke, Lude; Van der Vleuten, Pieter A.; Beckmann, Britt Maria; Martens, Eimo; Bardail, Abdennasser; Hofman, Nynke; Wilde, Arthur A. M.; Behr, Elijah R.; Dalageorgou, Chrysoula; Giudicessi, John R.; Medeiros-Domingo, Argelia; Barc, Julien; Kyndt, Florence; Probst, Vincent; Ghidoni, Alice; Insolia, Roberto; Hamilton, Robert M.; Scherer, Stephen W.; Brandimarto, Jeffrey; Margulies, Kenneth; Moravec, Christine E.; Del Greco, Fabiola; Fuchsberger, Christian; O'Connell, Jeffrey R.; Lee, Wai K.; Watt, Graham C. M.; Campbell, Harry; Wild, Sarah H.; El Mokhtari, Nour E.; Frey, Norbert; Asselbergs, Folkert W.; Mateo Leach, Irene; Navis, Gerjan; Van den Berg, Maarten P.; Van Veldhuisen, Dirk J.; Kellis, Manolis; Krijthe, Bouwe P.; Franco, Oscar H.; Hofman, Albert; Kors, Jan A.; Uitterlinden, Andre G.; Witteman, Jacqueline C. M.; Kedenko, Lyudmyla; Lamina, Claudia; Oostra, Ben A.; Abecasis, Goncalo R.; Lakatta, Edward G.; Mulas, Antonella; Orru, Marco; Schlessinger, David; Uda, Manuela; Markus, Marcello R. P.; Volker, Uwe; Snieder, Harold; Spector, Timothy D.; Arnlov, Johan; Lind, Lars; Sundstrom, Johan; Syvanen, Ann-Christine; Kivimaki, Mika; Kahonen, Mika; Mononen, Nina; Raitakari, I. T.; Viikari, Jorma S.; Adamkova, Vera; Kiech, Stefan; Brion, Maria; Nicolaides, Andrew N.; Paulweber, Bernhard; Haerting, Johannes; Dominiczak, Anna F.; Nyberg, Fredrik; Whincup, Peter H.; Hingorani, Aroon D.; Schott, Jean-Jacques; Bezzina, Connie R.; Ingelsson, Erik; Ferrucci, Luigi; Gaspariniin, Paolo; Wilson, James F.; Rudan, Igor; Franke, Andre; Miihleisen, Thomas W.; Pramstaller, Peter P.; Lehtimaki, Terho J.; Paterson, Andrew D.; Parsa, Afshin; Liu, Yongmei; Van Duijn, Cornelia M.; Siscovick, David S.; Gudnason, Vilmundur; Jamshidi, Yalda; Salomaa, Veikko; Felix, Stephan B.; Sanna, Serena; Ritchie, Marylyn D.; Stricker, Bruno H.; Stefansson, Karl; Boyer, Laurie A.; Cappola, Thomas P.; Olsen, Jesper V.; Lage, Kasper; Schwartz, Peter J.; Kaab, Stefan; Chakravarti, Aravinda; Ackerman, Michael J.; Pfeufer, Arne; De Bakker, Paul I. W.; Newton-Cheh, Christopher

    2014-01-01

    The QT interval, an electrocardiographic measure reflecting myocardial repolarization, is a heritable trait. QT prolongation is a risk factor for ventricular arrhythmias and sudden cardiac death (SCD) and could indicate the presence of the potentially lethal mendelian long-QT syndrome (LQTS). Using

  13. Genetic association study of QT interval highlights role for calcium signaling pathways in myocardial repolarization

    NARCIS (Netherlands)

    D.E. Arking (Dan); S.L. Pulit (Sara); L. Crotti (Lia); P. van der Harst (Pim); P. Munroe (Patricia); T.T. Koopmann (Tamara); N. Sotoodehnia (Nona); E. Rossin (Elizabeth); M. Morley (Michael); X. Wang (Xinchen); A.D. Johnson (Andrew); A. Lundby (Alicia); D.F. Gudbjartsson (Daniel); P.A. Noseworthy (Peter); M. Eijgelsheim (Mark); Y. Bradford (Yuki); K.V. Tarasov (Kirill); M. Dörr (Marcus); M. Müller-Nurasyid (Martina); A.M. Lahtinen (Annukka); I.M. Nolte (Ilja); G.D. Smith; J.C. Bis (Joshua); A.J. Isaacs (Aaron); S.J. Newhouse (Stephen); D.S. Evans (Daniel); W.S. Post (Wendy S.); D. Waggott (Daryl); L.-P. Lyytikäinen (Leo-Pekka); A.A. Hicks (Andrew); L. Eisele (Lewin); D. Ellinghaus (David); C. Hayward (Caroline); P. Navarro (Pau); S. Ulivi (Shelia); T. Tanaka (Toshiko); D.J. Tester (David); S. Chatel (Stéphanie); S. Gustafsson (Stefan); M. Kumari (Meena); R. Morris (Richard); A.T. Naluai (Asa); S. Padmanabhan (Sandosh); A. Kluttig (Alexander); B. Strohmer (Bernhard); A.G. Panayiotou (Andrie); M. Torres (Maria); M. Knoflach (Michael); J.A. Hubacek (Jaroslav A.); K. Slowikowski (Kamil); S. Raychaudhuri (Soumya); R.D. Kumar (Runjun); T.B. Harris (Tamara); L.J. Launer (Lenore); A.R. Shuldiner (Alan); A. Alonso (Alvaro); J.S. Bader (Joel); G.B. Ehret (Georg); H. Huang (Hailiang); W.H.L. Kao (Wen); J.B. Strait (James); P.W. Macfarlane (Peter); M.J. Brown (Morris); M. Caulfield (Mark); N.J. Samani (Nilesh); F. Kronenberg (Florian); J. Willeit (Johann); J.G. Smith (J. Gustav); K.H. Greiser (Karin Halina); H.M. Zu Schwabedissen (Henriette Meyer); K. Werdan (Karl); C. Carella (Cintia); L. Zelante (Leopoldo); S.R. Heckbert (Susan); B.M. Psaty (Bruce); J.I. Rotter (Jerome); I. Kolcic (Ivana); O. Polasek (Ozren); A.F. Wright (Alan); M. Griffin (Maura); M.J. Daly (Mark); D.O. Arnar (David); H. Hólm (Hilma); U. Thorsteinsdottir (Unnur); J.C. Denny (Joshua); D.M. Roden (Dan); R.L. Zuvich (Rebecca); V. Emilsson (Valur); A.S. Plump (Andrew); M.G. Larson (Martin); C.J. O'Donnell (Christopher); X. Yin (Xiaoyan); M. Bobbo (Marco); P. d' Adamo (Pio); A. Iorio (Annamaria); G. Sinagra (Gianfranco); A. Carracedo (Angel); S.R. Cummings (Steven); M.A. Nalls (Michael); A. Jula (Antti); K.K. Kontula (Kimmo); A. Marjamaa (Annukka); L. Oikarinen (Lasse); M. Perola (Markus); K. Porthan (Kimmo); R. Erbel (Raimund); P. Hoffmann (Per); K.-H. Jöckel (Karl-Heinz); H. Kälsch (Hagen); M.M. Nöthen (Markus); M. den Hoed (Marcel); R.J.F. Loos (Ruth); D.S. Thelle (Dag); C. Gieger (Christian); T. Meitinger (Thomas); S. Perz (Siegfried); A. Peters (Annette); H. Prucha (Hanna); M.F. Sinner (Moritz); M. Waldenberger (Melanie); R.A. de Boer (Rudolf); L. Franke (Lude); P.A. van der Vleuten (Pieter); B.M. Beckmann (Britt); E. Martens (Eimo); A. Bardai (Abdennasser); N. Hofman (Nynke); A.A.M. Wilde (Arthur); E.R. Behr (Elijah ); C. Dalageorgou (Chrysoula); J.R. Giudicessi (John); A. Medeiros-Domingo (Argelia); J. Barc (Julien); F. Kyndt (Florence); V. Probst (Vincent); A. Ghidoni (Alice); R. Insolia (Roberto); R.M. Hamilton (Robert); S.W. Scherer (Stephen); J. Brandimarto (Jeffrey); K. Margulies (Kenneth); C.E. Moravec (Christine); F. Del Greco M (Fabiola); C. Fuchsberger (Christian); J.R. O'Connell (Jeffery); W.K. Lee (Wai); G.C.M. Watt (Graham); H. Campbell (Harry); S.H. Wild (Sarah); N.E. El Mokhtari (Nour); N. Frey (Norbert); F.W. Asselbergs (Folkert); I.M. Leach (Irene Mateo); G. Navis (Gerjan); M.P. van den Berg (Maarten); D.J. van Veldhuisen (Dirk); M. Kellis (Manolis); B.P. Krijthe (Bouwe); O.H. Franco (Oscar); A. Hofman (Albert); J.A. Kors (Jan); A.G. Uitterlinden (André); J.C.M. Witteman (Jacqueline); L. Kedenko (Lyudmyla); C. Lamina (Claudia); B.A. Oostra (Ben); G.R. Abecasis (Gonçalo); E. Lakatta (Edward); A. Mulas (Antonella); M. Orrù (Marco); D. Schlessinger (David); M. Uda (Manuela); M.R.P. Markus (Marcello R. P.); U. Völker (Uwe); H. Snieder (Harold); T.D. Spector (Timothy); J. Ärnlöv (Johan); L. Lind (Lars); J. Sundstrom (Johan); A.C. Syvanen; M. Kivimaki (Mika); M. Kähönen (Mika); K. Mononen (Kari); O. Raitakari (Olli); J. Viikari (Jorma); V. Adamkova (Vera); S. Kiechl (Stefan); M.-J. Brion (Maria); A.N. Nicolaides (Andrew); B. Paulweber (Bernhard); J. Haerting (Johannes); A. Dominiczak (Anna); F. Nyberg (Fredrik); P.H. Whincup (Peter); A. Hingorani (Aroon); J.-J. Schott (Jean-Jacques); C.R. Bezzina (Connie); E. Ingelsson (Erik); L. Ferrucci (Luigi); P. Gasparini (Paolo); J.F. Wilson (James); I. Rudan (Igor); A. Franke (Andre); T.W. Mühleisen (Thomas); P.P. Pramstaller (Peter Paul); T. Lehtimäki (Terho); A.D. Paterson (Andrew); A. Parsa (Afshin); Y. Liu (Yongmei); C.M. van Duijn (Cock); D.S. Siscovick (David); V. Gudnason (Vilmundur); Y. Jamshidi (Yalda); V. Salomaa (Veikko); S.B. Felix (Stephan); S. Sanna (Serena); M.D. Ritchie (Marylyn); B.H.Ch. Stricker (Bruno); J-A. Zwart (John-Anker); L.A. Boyer (Laurie); T.P. Cappola (Thomas); J.V. Olsen (Jesper); P. Lage (Pedro); P.J. Schwartz (Peter); S. Kääb (Stefan); A. Chakravarti (Aravinda); M. Ackerman (Margaret); A. Pfeufer (Arne); P.I.W. de Bakker (Paul); C. Newton-Cheh (Christopher)

    2014-01-01

    textabstractThe QT interval, an electrocardiographic measure reflecting myocardial repolarization, is a heritable trait. QT prolongation is a risk factor for ventricular arrhythmias and sudden cardiac death (SCD) and could indicate the presence of the potentially lethal mendelian long-QT syndrome (L

  14. Changes In QTc Interval Duration Among Heroin Addicts On Methadone Treatment

    Directory of Open Access Journals (Sweden)

    Jovanovic Mirjana

    2015-09-01

    Full Text Available This paper aimed to collect and unite facts known about the effect of methadone treatment on QTc interval prolongation that could determine precipitating factors in the development of heart arrhythmias and their consequences (Torsade de Pointes and sudden cardiac death, and to raise the methadone treatment safety level.

  15. Genetic association study of QT interval highlights role for calcium signaling pathways in myocardial repolarization

    NARCIS (Netherlands)

    D.E. Arking (Dan); S.L. Pulit (Sara); L. Crotti (Lia); P. van der Harst (Pim); P. Munroe (Patricia); T.T. Koopmann (Tamara); N. Sotoodehnia (Nona); E. Rossin (Elizabeth); M. Morley (Michael); X. Wang (Xinchen); A.D. Johnson (Andrew); A. Lundby (Alicia); D.F. Gudbjartsson (Daniel); P.A. Noseworthy (Peter); M. Eijgelsheim (Mark); Y. Bradford (Yuki); K.V. Tarasov (Kirill); M. Dörr (Marcus); M. Müller-Nurasyid (Martina); A.M. Lahtinen (Annukka); I.M. Nolte (Ilja); G.D. Smith; J.C. Bis (Joshua); A.J. Isaacs (Aaron); S.J. Newhouse (Stephen); D.S. Evans (Daniel); W.S. Post (Wendy S.); D. Waggott (Daryl); L.-P. Lyytikäinen (Leo-Pekka); A.A. Hicks (Andrew); L. Eisele (Lewin); D. Ellinghaus (David); C. Hayward (Caroline); P. Navarro (Pau); S. Ulivi (Shelia); T. Tanaka (Toshiko); D.J. Tester (David); S. Chatel (Stéphanie); S. Gustafsson (Stefan); M. Kumari (Meena); R. Morris (Richard); A.T. Naluai (Asa); S. Padmanabhan (Sandosh); A. Kluttig (Alexander); B. Strohmer (Bernhard); A.G. Panayiotou (Andrie); M. Torres (Maria); M. Knoflach (Michael); J.A. Hubacek (Jaroslav A.); K. Slowikowski (Kamil); S. Raychaudhuri (Soumya); R.D. Kumar (Runjun); T.B. Harris (Tamara); L.J. Launer (Lenore); A.R. Shuldiner (Alan); A. Alonso (Alvaro); J.S. Bader (Joel); G.B. Ehret (Georg); H. Huang (Hailiang); W.H.L. Kao (Wen); J.B. Strait (James); P.W. Macfarlane (Peter); M.J. Brown (Morris); M. Caulfield (Mark); N.J. Samani (Nilesh); F. Kronenberg (Florian); J. Willeit (Johann); J.G. Smith (J. Gustav); K.H. Greiser (Karin Halina); H.M. Zu Schwabedissen (Henriette Meyer); K. Werdan (Karl); C. Carella (Cintia); L. Zelante (Leopoldo); S.R. Heckbert (Susan); B.M. Psaty (Bruce); J.I. Rotter (Jerome); I. Kolcic (Ivana); O. Polasek (Ozren); A.F. Wright (Alan); M. Griffin (Maura); M.J. Daly (Mark); D.O. Arnar (David); H. Hólm (Hilma); U. Thorsteinsdottir (Unnur); J.C. Denny (Joshua); D.M. Roden (Dan); R.L. Zuvich (Rebecca); V. Emilsson (Valur); A.S. Plump (Andrew); M.G. Larson (Martin); C.J. O'Donnell (Christopher); X. Yin (Xiaoyan); M. Bobbo (Marco); P. d' Adamo (Pio); A. Iorio (Annamaria); G. Sinagra (Gianfranco); A. Carracedo (Angel); S.R. Cummings (Steven); M.A. Nalls (Michael); A. Jula (Antti); K.K. Kontula (Kimmo); A. Marjamaa (Annukka); L. Oikarinen (Lasse); M. Perola (Markus); K. Porthan (Kimmo); R. Erbel (Raimund); P. Hoffmann (Per); K.-H. Jöckel (Karl-Heinz); H. Kälsch (Hagen); M.M. Nöthen (Markus); M. den Hoed (Marcel); R.J.F. Loos (Ruth); D.S. Thelle (Dag); C. Gieger (Christian); T. Meitinger (Thomas); S. Perz (Siegfried); A. Peters (Annette); H. Prucha (Hanna); M.F. Sinner (Moritz); M. Waldenberger (Melanie); R.A. de Boer (Rudolf); L. Franke (Lude); P.A. van der Vleuten (Pieter); B.M. Beckmann (Britt); E. Martens (Eimo); A. Bardai (Abdennasser); N. Hofman (Nynke); A.A.M. Wilde (Arthur); E.R. Behr (Elijah ); C. Dalageorgou (Chrysoula); J.R. Giudicessi (John); A. Medeiros-Domingo (Argelia); J. Barc (Julien); F. Kyndt (Florence); V. Probst (Vincent); A. Ghidoni (Alice); R. Insolia (Roberto); R.M. Hamilton (Robert); S.W. Scherer (Stephen); J. Brandimarto (Jeffrey); K. Margulies (Kenneth); C.E. Moravec (Christine); F. Del Greco M (Fabiola); C. Fuchsberger (Christian); J.R. O'Connell (Jeffery); W.K. Lee (Wai); G.C.M. Watt (Graham); H. Campbell (Harry); S.H. Wild (Sarah); N.E. El Mokhtari (Nour); N. Frey (Norbert); F.W. Asselbergs (Folkert); I.M. Leach (Irene Mateo); G. Navis (Gerjan); M.P. van den Berg (Maarten); D.J. van Veldhuisen (Dirk); M. Kellis (Manolis); B.P. Krijthe (Bouwe); O.H. Franco (Oscar); A. Hofman (Albert); J.A. Kors (Jan); A.G. Uitterlinden (André); J.C.M. Witteman (Jacqueline); L. Kedenko (Lyudmyla); C. Lamina (Claudia); B.A. Oostra (Ben); G.R. Abecasis (Gonçalo); E. Lakatta (Edward); A. Mulas (Antonella); M. Orrù (Marco); D. Schlessinger (David); M. Uda (Manuela); M.R.P. Markus (Marcello R. P.); U. Völker (Uwe); H. Snieder (Harold); T.D. Spector (Timothy); J. Ärnlöv (Johan); L. Lind (Lars); J. Sundstrom (Johan); A.C. Syvanen; M. Kivimaki (Mika); M. Kähönen (Mika); K. Mononen (Kari); O. Raitakari (Olli); J. Viikari (Jorma); V. Adamkova (Vera); S. Kiechl (Stefan); M.-J. Brion (Maria); A.N. Nicolaides (Andrew); B. Paulweber (Bernhard); J. Haerting (Johannes); A. Dominiczak (Anna); F. Nyberg (Fredrik); P.H. Whincup (Peter); A. Hingorani (Aroon); J.-J. Schott (Jean-Jacques); C.R. Bezzina (Connie); E. Ingelsson (Erik); L. Ferrucci (Luigi); P. Gasparini (Paolo); J.F. Wilson (James); I. Rudan (Igor); A. Franke (Andre)

    2014-01-01

    textabstractThe QT interval, an electrocardiographic measure reflecting myocardial repolarization, is a heritable trait. QT prolongation is a risk factor for ventricular arrhythmias and sudden cardiac death (SCD) and could indicate the presence of the potentially lethal mendelian long-QT syndrome

  16. Genetic association study of QT interval highlights role for calcium signaling pathways in myocardial repolarization

    NARCIS (Netherlands)

    Arking, Dan E.; Pulit, Sara L.; Crotti, Lia; Van der Harst, Pim; Munroe, Patricia B.; Koopmann, Tamara T.; Sotoodehnia, Nona; Rossin, Elizabeth J.; Morley, Michael; Wang, Xinchen; Johnson, Andrew D.; Lundby, Alicia; Gudbjartsson, Daniel F.; Noseworthy, Peter A.; Eijgelsheim, Mark; Bradford, Yuki; Tarasov, Kirill V.; Dorr, Marcus; Miiller-Nurasyid, Martina; Lahtinen, Annukka M.; Nolte, Ilja M.; Smith, Albert Vernon; Bis, Joshua C.; Isaacs, Aaron; Newhouse, Stephen J.; Evans, Daniel S.; Post, Wendy S.; Waggott, Daryl; Lyytikainen, Leo-Pekka; Hicks, Andrew A.; Eisele, Lewin; Ellinghaus, David; Hayward, Caroline; Navarro, Pau; Ulivi, Sheila; Tanaka, Toshiko; Tester, David J.; Chatel, Stephanie; Gustafsson, Stefan; Kumari, Meena; Morris, Richard W.; Naluai, Asa T.; Padmanabhan, Sandosh; Kluttig, Alexander; Strohmer, Bernhard; Panayiotou, Andrie G.; Torres, Maria; Knoflach, Michael; Hubacek, Jaroslav A.; Slowikowski, Kamil; Raychaudhuri, Soumya; Kumar, Runjun D.; Harris, Tamara B.; Launer, Lenore J.; Shuldiner, Alan R.; Alonso, Alvaro; Bader, Joel S.; EhreT, Georg; Huang, Hailiang; Kao, W. H. Linda; Strait, James B.; Macfarlane, Peter W.; Brown, Morris; Caulfield, Mark J.; Samani, Nilesh J.; Kronenberg, Florian; Willeit, Johann; Smith, J. Gustav; Greiser, Karin H.; Schwabedissen, Henriette Meyer Zu; Werdan, Karl; Carella, Massimo; Zelante, Leopoldo; Heckbert, Susan R.; Psaty, Bruce M.; Rotter, Jerome I.; Kolcic, Ivana; Poagek, Ozren; Wright, Alan F.; Griffin, Maura; Daly, Mark J.; Arnar, David O.; Holm, Hilma; Thorsteinsdottir, Unnur; Denny, Joshua C.; Roden, Dan M.; Zuvich, Rebecca L.; Emilsson, Valur; Plump, Andrew S.; Larson, Martin G.; O'Donnell, Christopher J.; Yin, Xiaoyan; Bobboll, Marco; D'Adamo, Adamo P.; Iorio, Annamaria; Sinagra, Gianfranco; Carracedo, Angel; Cummings, Steven R.; Nalls, Michael A.; Jula, Antti; Kontula, Kimmo K.; Marjamaa, Annukka; Oikarinen, Lasse; Perola, Markus; Porthan, Kimmo; Erbe, Raimund; Hoffmann, Per; Jockel, Karl-Heinz; Kalsch, Hagen; Nothen, Markus M.; Den Hoed, Marcel; Loos, Ruth J. F.; Thelle, Dag S.; Gieger, Christian; Meitinger, Thomas; Perz, Siegfried; Peters, Annette; Pruchal, Hanna; Sinner, Moritz F.; Waldenberger, Melanie; De Boer, Rudolf A.; Franke, Lude; Van der Vleuten, Pieter A.; Beckmann, Britt Maria; Martens, Eimo; Bardail, Abdennasser; Hofman, Nynke; Wilde, Arthur A. M.; Behr, Elijah R.; Dalageorgou, Chrysoula; Giudicessi, John R.; Medeiros-Domingo, Argelia; Barc, Julien; Kyndt, Florence; Probst, Vincent; Ghidoni, Alice; Insolia, Roberto; Hamilton, Robert M.; Scherer, Stephen W.; Brandimarto, Jeffrey; Margulies, Kenneth; Moravec, Christine E.; Del Greco, Fabiola; Fuchsberger, Christian; O'Connell, Jeffrey R.; Lee, Wai K.; Watt, Graham C. M.; Campbell, Harry; Wild, Sarah H.; El Mokhtari, Nour E.; Frey, Norbert; Asselbergs, Folkert W.; Mateo Leach, Irene; Navis, Gerjan; Van den Berg, Maarten P.; Van Veldhuisen, Dirk J.; Kellis, Manolis; Krijthe, Bouwe P.; Franco, Oscar H.; Hofman, Albert; Kors, Jan A.; Uitterlinden, Andre G.; Witteman, Jacqueline C. M.; Kedenko, Lyudmyla; Lamina, Claudia; Oostra, Ben A.; Abecasis, Goncalo R.; Lakatta, Edward G.; Mulas, Antonella; Orru, Marco; Schlessinger, David; Uda, Manuela; Markus, Marcello R. P.; Volker, Uwe; Snieder, Harold; Spector, Timothy D.; Arnlov, Johan; Lind, Lars; Sundstrom, Johan; Syvanen, Ann-Christine; Kivimaki, Mika; Kahonen, Mika; Mononen, Nina; Raitakari, I. T.; Viikari, Jorma S.; Adamkova, Vera; Kiech, Stefan; Brion, Maria; Nicolaides, Andrew N.; Paulweber, Bernhard; Haerting, Johannes; Dominiczak, Anna F.; Nyberg, Fredrik; Whincup, Peter H.; Hingorani, Aroon D.; Schott, Jean-Jacques; Bezzina, Connie R.; Ingelsson, Erik; Ferrucci, Luigi; Gaspariniin, Paolo; Wilson, James F.; Rudan, Igor; Franke, Andre; Miihleisen, Thomas W.; Pramstaller, Peter P.; Lehtimaki, Terho J.; Paterson, Andrew D.; Parsa, Afshin; Liu, Yongmei; Van Duijn, Cornelia M.; Siscovick, David S.; Gudnason, Vilmundur; Jamshidi, Yalda; Salomaa, Veikko; Felix, Stephan B.; Sanna, Serena; Ritchie, Marylyn D.; Stricker, Bruno H.; Stefansson, Karl; Boyer, Laurie A.; Cappola, Thomas P.; Olsen, Jesper V.; Lage, Kasper; Schwartz, Peter J.; Kaab, Stefan; Chakravarti, Aravinda; Ackerman, Michael J.; Pfeufer, Arne; De Bakker, Paul I. W.; Newton-Cheh, Christopher

    The QT interval, an electrocardiographic measure reflecting myocardial repolarization, is a heritable trait. QT prolongation is a risk factor for ventricular arrhythmias and sudden cardiac death (SCD) and could indicate the presence of the potentially lethal mendelian long-QT syndrome (LQTS). Using

  17. Genetic association study of QT interval highlights role for calcium signaling pathways in myocardial repolarization

    NARCIS (Netherlands)

    D.E. Arking (Dan); S.L. Pulit (Sara); L. Crotti (Lia); P. van der Harst (Pim); P. Munroe (Patricia); T.T. Koopmann (Tamara); N. Sotoodehnia (Nona); E. Rossin (Elizabeth); M. Morley (Michael); X. Wang (Xinchen); A.D. Johnson (Andrew); A. Lundby (Alicia); D.F. Gudbjartsson (Daniel); P.A. Noseworthy (Peter); M. Eijgelsheim (Mark); Y. Bradford (Yuki); K.V. Tarasov (Kirill); M. Dörr (Marcus); M. Müller-Nurasyid (Martina); A.M. Lahtinen (Annukka); I.M. Nolte (Ilja); G.D. Smith; J.C. Bis (Joshua); A.J. Isaacs (Aaron); S.J. Newhouse (Stephen); D.S. Evans (Daniel); W.S. Post (Wendy S.); D. Waggott (Daryl); L.-P. Lyytikäinen (Leo-Pekka); A.A. Hicks (Andrew); L. Eisele (Lewin); D. Ellinghaus (David); C. Hayward (Caroline); P. Navarro (Pau); S. Ulivi (Shelia); T. Tanaka (Toshiko); D.J. Tester (David); S. Chatel (Stéphanie); S. Gustafsson (Stefan); M. Kumari (Meena); R. Morris (Richard); A.T. Naluai (Asa); S. Padmanabhan (Sandosh); A. Kluttig (Alexander); B. Strohmer (Bernhard); A.G. Panayiotou (Andrie); M. Torres (Maria); M. Knoflach (Michael); J.A. Hubacek (Jaroslav A.); K. Slowikowski (Kamil); S. Raychaudhuri (Soumya); R.D. Kumar (Runjun); T.B. Harris (Tamara); L.J. Launer (Lenore); A.R. Shuldiner (Alan); A. Alonso (Alvaro); J.S. Bader (Joel); G.B. Ehret (Georg); H. Huang (Hailiang); W.H.L. Kao (Wen); J.B. Strait (James); P.W. Macfarlane (Peter); M.J. Brown (Morris); M. Caulfield (Mark); N.J. Samani (Nilesh); F. Kronenberg (Florian); J. Willeit (Johann); J.G. Smith (J. Gustav); K.H. Greiser (Karin Halina); H.M. Zu Schwabedissen (Henriette Meyer); K. Werdan (Karl); C. Carella (Cintia); L. Zelante (Leopoldo); S.R. Heckbert (Susan); B.M. Psaty (Bruce); J.I. Rotter (Jerome); I. Kolcic (Ivana); O. Polasek (Ozren); A.F. Wright (Alan); M. Griffin (Maura); M.J. Daly (Mark); D.O. Arnar (David); H. Hólm (Hilma); U. Thorsteinsdottir (Unnur); J.C. Denny (Joshua); D.M. Roden (Dan); R.L. Zuvich (Rebecca); V. Emilsson (Valur); A.S. Plump (Andrew); M.G. Larson (Martin); C.J. O'Donnell (Christopher); X. Yin (Xiaoyan); M. Bobbo (Marco); P. d' Adamo (Pio); A. Iorio (Annamaria); G. Sinagra (Gianfranco); A. Carracedo (Angel); S.R. Cummings (Steven); M.A. Nalls (Michael); A. Jula (Antti); K.K. Kontula (Kimmo); A. Marjamaa (Annukka); L. Oikarinen (Lasse); M. Perola (Markus); K. Porthan (Kimmo); R. Erbel (Raimund); P. Hoffmann (Per); K.-H. Jöckel (Karl-Heinz); H. Kälsch (Hagen); M.M. Nöthen (Markus); M. den Hoed (Marcel); R.J.F. Loos (Ruth); D.S. Thelle (Dag); C. Gieger (Christian); T. Meitinger (Thomas); S. Perz (Siegfried); A. Peters (Annette); H. Prucha (Hanna); M.F. Sinner (Moritz); M. Waldenberger (Melanie); R.A. de Boer (Rudolf); L. Franke (Lude); P.A. van der Vleuten (Pieter); B.M. Beckmann (Britt); E. Martens (Eimo); A. Bardai (Abdennasser); N. Hofman (Nynke); A.A.M. Wilde (Arthur); E.R. Behr (Elijah ); C. Dalageorgou (Chrysoula); J.R. Giudicessi (John); A. Medeiros-Domingo (Argelia); J. Barc (Julien); F. Kyndt (Florence); V. Probst (Vincent); A. Ghidoni (Alice); R. Insolia (Roberto); R.M. Hamilton (Robert); S.W. Scherer (Stephen); J. Brandimarto (Jeffrey); K. Margulies (Kenneth); C.E. Moravec (Christine); F. Del Greco M (Fabiola); C. Fuchsberger (Christian); J.R. O'Connell (Jeffery); W.K. Lee (Wai); G.C.M. Watt (Graham); H. Campbell (Harry); S.H. Wild (Sarah); N.E. El Mokhtari (Nour); N. Frey (Norbert); F.W. Asselbergs (Folkert); I.M. Leach (Irene Mateo); G. Navis (Gerjan); M.P. van den Berg (Maarten); D.J. van Veldhuisen (Dirk); M. Kellis (Manolis); B.P. Krijthe (Bouwe); O.H. Franco (Oscar); A. Hofman (Albert); J.A. Kors (Jan); A.G. Uitterlinden (André); J.C.M. Witteman (Jacqueline); L. Kedenko (Lyudmyla); C. Lamina (Claudia); B.A. Oostra (Ben); G.R. Abecasis (Gonçalo); E. Lakatta (Edward); A. Mulas (Antonella); M. Orrù (Marco); D. Schlessinger (David); M. Uda (Manuela); M.R.P. Markus (Marcello R. P.); U. Völker (Uwe); H. Snieder (Harold); T.D. Spector (Timothy); J. Ärnlöv (Johan); L. Lind (Lars); J. Sundstrom (Johan); A.C. Syvanen; M. Kivimaki (Mika); M. Kähönen (Mika); K. Mononen (Kari); O. Raitakari (Olli); J. Viikari (Jorma); V. Adamkova (Vera); S. Kiechl (Stefan); M.-J. Brion (Maria); A.N. Nicolaides (Andrew); B. Paulweber (Bernhard); J. Haerting (Johannes); A. Dominiczak (Anna); F. Nyberg (Fredrik); P.H. Whincup (Peter); A. Hingorani (Aroon); J.-J. Schott (Jean-Jacques); C.R. Bezzina (Connie); E. Ingelsson (Erik); L. Ferrucci (Luigi); P. Gasparini (Paolo); J.F. Wilson (James); I. Rudan (Igor); A. Franke (Andre); T.W. Mühleisen (Thomas); P.P. Pramstaller (Peter Paul); T. Lehtimäki (Terho); A.D. Paterson (Andrew); A. Parsa (Afshin); Y. Liu (Yongmei); C.M. van Duijn (Cock); D.S. Siscovick (David); V. Gudnason (Vilmundur); Y. Jamshidi (Yalda); V. Salomaa (Veikko); S.B. Felix (Stephan); S. Sanna (Serena); M.D. Ritchie (Marylyn); B.H.Ch. Stricker (Bruno); J-A. Zwart (John-Anker); L.A. Boyer (Laurie); T.P. Cappola (Thomas); J.V. Olsen (Jesper); P. Lage (Pedro); P.J. Schwartz (Peter); S. Kääb (Stefan); A. Chakravarti (Aravinda); M. Ackerman (Margaret); A. Pfeufer (Arne); P.I.W. de Bakker (Paul); C. Newton-Cheh (Christopher)

    2014-01-01

    textabstractThe QT interval, an electrocardiographic measure reflecting myocardial repolarization, is a heritable trait. QT prolongation is a risk factor for ventricular arrhythmias and sudden cardiac death (SCD) and could indicate the presence of the potentially lethal mendelian long-QT syndrome (L

  18. Genetic association study of QT interval highlights role for calcium signaling pathways in myocardial repolarization

    NARCIS (Netherlands)

    Arking, Dan E.; Pulit, Sara L.; Crotti, Lia; Van der Harst, Pim; Munroe, Patricia B.; Koopmann, Tamara T.; Sotoodehnia, Nona; Rossin, Elizabeth J.; Morley, Michael; Wang, Xinchen; Johnson, Andrew D.; Lundby, Alicia; Gudbjartsson, Daniel F.; Noseworthy, Peter A.; Eijgelsheim, Mark; Bradford, Yuki; Tarasov, Kirill V.; Dorr, Marcus; Miiller-Nurasyid, Martina; Lahtinen, Annukka M.; Nolte, Ilja M.; Smith, Albert Vernon; Bis, Joshua C.; Isaacs, Aaron; Newhouse, Stephen J.; Evans, Daniel S.; Post, Wendy S.; Waggott, Daryl; Lyytikainen, Leo-Pekka; Hicks, Andrew A.; Eisele, Lewin; Ellinghaus, David; Hayward, Caroline; Navarro, Pau; Ulivi, Sheila; Tanaka, Toshiko; Tester, David J.; Chatel, Stephanie; Gustafsson, Stefan; Kumari, Meena; Morris, Richard W.; Naluai, Asa T.; Padmanabhan, Sandosh; Kluttig, Alexander; Strohmer, Bernhard; Panayiotou, Andrie G.; Torres, Maria; Knoflach, Michael; Hubacek, Jaroslav A.; Slowikowski, Kamil; Raychaudhuri, Soumya; Kumar, Runjun D.; Harris, Tamara B.; Launer, Lenore J.; Shuldiner, Alan R.; Alonso, Alvaro; Bader, Joel S.; EhreT, Georg; Huang, Hailiang; Kao, W. H. Linda; Strait, James B.; Macfarlane, Peter W.; Brown, Morris; Caulfield, Mark J.; Samani, Nilesh J.; Kronenberg, Florian; Willeit, Johann; Smith, J. Gustav; Greiser, Karin H.; Schwabedissen, Henriette Meyer Zu; Werdan, Karl; Carella, Massimo; Zelante, Leopoldo; Heckbert, Susan R.; Psaty, Bruce M.; Rotter, Jerome I.; Kolcic, Ivana; Poagek, Ozren; Wright, Alan F.; Griffin, Maura; Daly, Mark J.; Arnar, David O.; Holm, Hilma; Thorsteinsdottir, Unnur; Denny, Joshua C.; Roden, Dan M.; Zuvich, Rebecca L.; Emilsson, Valur; Plump, Andrew S.; Larson, Martin G.; O'Donnell, Christopher J.; Yin, Xiaoyan; Bobboll, Marco; D'Adamo, Adamo P.; Iorio, Annamaria; Sinagra, Gianfranco; Carracedo, Angel; Cummings, Steven R.; Nalls, Michael A.; Jula, Antti; Kontula, Kimmo K.; Marjamaa, Annukka; Oikarinen, Lasse; Perola, Markus; Porthan, Kimmo; Erbe, Raimund; Hoffmann, Per; Jockel, Karl-Heinz; Kalsch, Hagen; Nothen, Markus M.; Den Hoed, Marcel; Loos, Ruth J. F.; Thelle, Dag S.; Gieger, Christian; Meitinger, Thomas; Perz, Siegfried; Peters, Annette; Pruchal, Hanna; Sinner, Moritz F.; Waldenberger, Melanie; De Boer, Rudolf A.; Franke, Lude; Van der Vleuten, Pieter A.; Beckmann, Britt Maria; Martens, Eimo; Bardail, Abdennasser; Hofman, Nynke; Wilde, Arthur A. M.; Behr, Elijah R.; Dalageorgou, Chrysoula; Giudicessi, John R.; Medeiros-Domingo, Argelia; Barc, Julien; Kyndt, Florence; Probst, Vincent; Ghidoni, Alice; Insolia, Roberto; Hamilton, Robert M.; Scherer, Stephen W.; Brandimarto, Jeffrey; Margulies, Kenneth; Moravec, Christine E.; Del Greco, Fabiola; Fuchsberger, Christian; O'Connell, Jeffrey R.; Lee, Wai K.; Watt, Graham C. M.; Campbell, Harry; Wild, Sarah H.; El Mokhtari, Nour E.; Frey, Norbert; Asselbergs, Folkert W.; Mateo Leach, Irene; Navis, Gerjan; Van den Berg, Maarten P.; Van Veldhuisen, Dirk J.; Kellis, Manolis; Krijthe, Bouwe P.; Franco, Oscar H.; Hofman, Albert; Kors, Jan A.; Uitterlinden, Andre G.; Witteman, Jacqueline C. M.; Kedenko, Lyudmyla; Lamina, Claudia; Oostra, Ben A.; Abecasis, Goncalo R.; Lakatta, Edward G.; Mulas, Antonella; Orru, Marco; Schlessinger, David; Uda, Manuela; Markus, Marcello R. P.; Volker, Uwe; Snieder, Harold; Spector, Timothy D.; Arnlov, Johan; Lind, Lars; Sundstrom, Johan; Syvanen, Ann-Christine; Kivimaki, Mika; Kahonen, Mika; Mononen, Nina; Raitakari, I. T.; Viikari, Jorma S.; Adamkova, Vera; Kiech, Stefan; Brion, Maria; Nicolaides, Andrew N.; Paulweber, Bernhard; Haerting, Johannes; Dominiczak, Anna F.; Nyberg, Fredrik; Whincup, Peter H.; Hingorani, Aroon D.; Schott, Jean-Jacques; Bezzina, Connie R.; Ingelsson, Erik; Ferrucci, Luigi; Gaspariniin, Paolo; Wilson, James F.; Rudan, Igor; Franke, Andre; Miihleisen, Thomas W.; Pramstaller, Peter P.; Lehtimaki, Terho J.; Paterson, Andrew D.; Parsa, Afshin; Liu, Yongmei; Van Duijn, Cornelia M.; Siscovick, David S.; Gudnason, Vilmundur; Jamshidi, Yalda; Salomaa, Veikko; Felix, Stephan B.; Sanna, Serena; Ritchie, Marylyn D.; Stricker, Bruno H.; Stefansson, Karl; Boyer, Laurie A.; Cappola, Thomas P.; Olsen, Jesper V.; Lage, Kasper; Schwartz, Peter J.; Kaab, Stefan; Chakravarti, Aravinda; Ackerman, Michael J.; Pfeufer, Arne; De Bakker, Paul I. W.; Newton-Cheh, Christopher

    2014-01-01

    The QT interval, an electrocardiographic measure reflecting myocardial repolarization, is a heritable trait. QT prolongation is a risk factor for ventricular arrhythmias and sudden cardiac death (SCD) and could indicate the presence of the potentially lethal mendelian long-QT syndrome (LQTS). Using

  19. Plasma catecholamine, corticosterone and glucose responses to repeated stress in rats : Effect of interstressor interval length

    NARCIS (Netherlands)

    de Boer, S.F.; Koopmans, S.J.; Slangen, J L; Van der Gugten, J

    1990-01-01

    Plasma noradrenaline (NA), adrenaline (A), corticosterone (CS) and glucose concentrations were determined in blood frequently sampled via a cardiac catheter from freely behaving rats exposed to five successive trials of water-immersion stress (WIS) with an interval between successive trials (interst

  20. Almost primes in short intervals

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    In this paper,we prove that the short interval(x-x101/232,x] contains at least an almost prime P2 for sufficiently large x,where P2 denotes an integer having at most two prime factors counted with multiplicity.

  1. Haemostatic reference intervals in pregnancy

    DEFF Research Database (Denmark)

    Szecsi, Pal Bela; Jørgensen, Maja; Klajnbard, Anna

    2010-01-01

    Haemostatic reference intervals are generally based on samples from non-pregnant women. Thus, they may not be relevant to pregnant women, a problem that may hinder accurate diagnosis and treatment of haemostatic disorders during pregnancy. In this study, we establish gestational age-specific refe......Haemostatic reference intervals are generally based on samples from non-pregnant women. Thus, they may not be relevant to pregnant women, a problem that may hinder accurate diagnosis and treatment of haemostatic disorders during pregnancy. In this study, we establish gestational age......-specific reference intervals for coagulation tests during normal pregnancy. Eight hundred one women with expected normal pregnancies were included in the study. Of these women, 391 had no complications during pregnancy, vaginal delivery, or postpartum period. Plasma samples were obtained at gestational weeks 13......-20, 21-28, 29-34, 35-42, at active labor, and on postpartum days 1 and 2. Reference intervals for each gestational period using only the uncomplicated pregnancies were calculated in all 391 women for activated partial thromboplastin time (aPTT), fibrinogen, fibrin D-dimer, antithrombin, free protein S...

  2. Robust misinterpretation of confidence intervals

    NARCIS (Netherlands)

    Hoekstra, Rink; Morey, Richard; Rouder, Jeffrey N.; Wagenmakers, Eric-Jan

    2014-01-01

    Null hypothesis significance testing (NHST) is undoubtedly the most common inferential technique used to justify claims in the social sciences. However, even staunch defenders of NHST agree that its outcomes are often misinterpreted. Confidence intervals (CIs) have frequently been proposed as a more

  3. Robust misinterpretation of confidence intervals

    NARCIS (Netherlands)

    Hoekstra, R.; Morey, R.D.; Rouder, J.N.; Wagenmakers, E.-J.

    2014-01-01

    Null hypothesis significance testing (NHST) is undoubtedly the most common inferential technique used to justify claims in the social sciences. However, even staunch defenders of NHST agree that its outcomes are often misinterpreted. Confidence intervals (CIs) have frequently been proposed as a more

  4. Prolonged QT interval in a man with anorexia nervosa

    Science.gov (United States)

    Macías-Robles, María Dolores; Perez-Clemente, Ana María; Maciá-Bobes, Carmen; Alvarez-Rueda, María Asunción; Pozo-Nuevo, Sergio

    2009-01-01

    Anorexia nervosa is an eating disorder characterized by the avoidance of food intake, which usually leads to a weight loss. Cardiac co-morbility is common and we can find sometimes a mass loss from the left ventricle, which can be seen by echocardiography. But the commonest complications are rhythm variations, typically bradycardia with a prolonged QT interval in up to a 40% of the cases, which altogether elevates ventricular tachycardia and sudden death risk. We present the case of a male who was diagnosed with anorexia nervosa and developed asthenia, a long QT interval and also a severe both hypokalaemia and hypomagnesaemia. We intend to discuss the pathogenic paths as well as prophylactic and therapeutic measures to this potentially-lethal pathology. PMID:19646241

  5. Systolic time intervals after a seven-day orbital flight

    Science.gov (United States)

    Groza, P.; Vrâncianu, R.; Lazǎr, M.; Baevski, R. M.; Funtova, V. L.

    Heart rate, systolic time intervals (pre-ejection period, left ventricular ejection time), ejection fraction, stroke volume and QT interval of two cosmonauts (Leonid Popov - L.P. and Dumitru Prunariu - D.P.) were studied before, during, and after an ergometric bicycle exercise test performed before and after the seven-day Soviet-Romanian orbital flight on the Soyuz 40 - Salyut 6 Complex in May 1981. For this purpose one precordial electrocardiogram (ecg) and the ear photodensitogram (den) were recorded stimulaneously. The method used permitted recording even during exercise, Ecg and den signals were stored on magnetic tape, processed in an analogue device and in a digital computer. The data obtained after landing suggest a slight cardiac deconditioning in L.P., demonstrated especially by augmentation of the pre-ejection period, which was unchanged in D.P. corresponding to a sympathoadrenergic hypertonia. The seven-day orbital flight has not produced important cardiovascular changes.

  6. The definition of exertion-related cardiac events.

    Science.gov (United States)

    Rai, M; Thompson, P D

    2011-02-01

    Vigorous physical activity increases the risk of sudden cardiac death (SCD) and acute myocardial infarction (AMI) but there is no standard definition as to what constitutes an exertion-related cardiac event, specifically the time interval between physical exertion and cardiac event. A systematic review of studies related to exertion-related cardiac events was performed and the time interval between exertion and the event or the symptoms leading to the event was looked for in all the articles selected for inclusion. A total of 12 of 26 articles "suggested" or "defined" exertion-related events as those events whose symptoms started during or within 1 h of exertion. Others used definitions of 0.5 h, 2 h, "during exertion", "during or immediately post exertion" and "during or within several hours after exertion". It is suggested, therefore, that the definition of an exertion-related cardiac event be established as a cardiac event in which symptoms started during or within 1 h of physical exertion.

  7. Cardiac tumors: echo assessment.

    Science.gov (United States)

    Mankad, Rekha; Herrmann, Joerg

    2016-12-01

    Cardiac tumors are exceedingly rare (0.001-0.03% in most autopsy series). They can be present anywhere within the heart and can be attached to any surface or be embedded in the myocardium or pericardial space. Signs and symptoms are nonspecific and highly variable related to the localization, size and composition of the cardiac mass. Echocardiography, typically performed for another indication, may be the first imaging modality alerting the clinician to the presence of a cardiac mass. Although echocardiography cannot give the histopathology, certain imaging features and adjunctive tools such as contrast imaging may aid in the differential diagnosis as do the adjunctive clinical data and the following principles: (1) thrombus or vegetations are the most likely etiology, (2) cardiac tumors are mostly secondary and (3) primary cardiac tumors are mostly benign. Although the finding of a cardiac mass on echocardiography may generate confusion, a stepwise approach may serve well practically. Herein, we will review such an approach and the role of echocardiography in the assessment of cardiac masses.

  8. Cardiac tumors: echo assessment

    Directory of Open Access Journals (Sweden)

    Rekha Mankad MD

    2016-12-01

    Full Text Available Cardiac tumors are exceedingly rare (0.001–0.03% in most autopsy series. They can be present anywhere within the heart and can be attached to any surface or be embedded in the myocardium or pericardial space. Signs and symptoms are nonspecific and highly variable related to the localization, size and composition of the cardiac mass. Echocardiography, typically performed for another indication, may be the first imaging modality alerting the clinician to the presence of a cardiac mass. Although echocardiography cannot give the histopathology, certain imaging features and adjunctive tools such as contrast imaging may aid in the differential diagnosis as do the adjunctive clinical data and the following principles: (1 thrombus or vegetations are the most likely etiology, (2 cardiac tumors are mostly secondary and (3 primary cardiac tumors are mostly benign. Although the finding of a cardiac mass on echocardiography may generate confusion, a stepwise approach may serve well practically. Herein, we will review such an approach and the role of echocardiography in the assessment of cardiac masses.

  9. BIRTH INTERVAL AMONG NOMAD WOMEN

    Directory of Open Access Journals (Sweden)

    E.Keyvan

    1976-06-01

    Full Text Available To have an, idea about the relation between the length of birth interval and lactation, and birth control program this study have been done. The material for such analysis was nomad women's fertility history that was in their reproductive period (15-44. The material itself was gathered through a health survey. The main sample was composed of 2,165 qualified women, of whom 49 due to previous or presently using contraceptive methods and 10 for the lack of enough data were excluded from 'this study. Purpose of analysis was to find a relation between No. of live births and pregnancies with total duration of married life (in other word, total months which the women were at risk of pregnancy. 2,106 women which their fertility history was analyzed had a totally of272, 502 months married life. During this time 8,520 live births did occurred which gave a birth interval of 32 months. As pregnancy termination could be through either live birth, still birth or abortion (induced or spontaneous, bringing all together will give No. of pregnancies which have occurred during this period (8,520 + 124 + 328 = 8,972 with an average of interpregnancy interval of 30.3 months. Considering the length of components of birth interval: Post partum amenorrhea which depends upon lactation. - Anovulatory cycles (2 month - Ooulatory exposure, in the absence of contraceptive methods (5 months - Pregnancy (9 months.Difference between the length, of birth interval from the sum of the mentioned period (except the first component, (2 + 5+ 9 = 16 will be duration of post partum amenorrhea (32 - 16 = 16, or in other word duration of breast feeding among nomad women. In this study it was found that, in order to reduce birth by 50% a contraceptive method with 87% effectiveness is needed.

  10. Cesium-induced QT-interval prolongation in an adolescent.

    Science.gov (United States)

    O'Brien, Catherine E; Harik, Nada; James, Laura P; Seib, Paul M; Stowe, Cindy D

    2008-08-01

    Alternative medicine is becoming increasingly popular, especially with terminally ill patients. Most alternative remedies have not been adequately studied or proven effective for the diseases for which they are promoted. In the worst cases, these therapies are harmful. We describe a 16-year-old girl with metastatic hepatocellular carcinoma who experienced cesium-induced QT-interval prolongation after the start of a cesium chloride-based alternative treatment regimen. She had received seven courses of chemotherapy, with a cumulative doxorubicin dose of 500 mg/m(2) over 5 months, resulting in minimal tumor regression. Against the advice of her oncologist, she abandoned traditional therapy and started an alternative regimen that included cesium chloride supplements. Two weeks later, the patient went to a local emergency department after experiencing two brief syncopal episodes. An electrocardiogram revealed occasional premature ventricular contractions, a QTc interval of 683 msec (normal range for females 450-460 msec), and R on T phenomenon. She was admitted to the hospital and later experienced monomorphic ventricular tachycardia, which resolved spontaneously. Lidocaine therapy was started, and the patient was transferred to a cardiac intensive care unit at our hospital. Her plasma cesium level was 2400 microg/dl (normal cesium level was 1800 microg/dl, and her QTc interval was 494 msec. According to the Naranjo adverse drug reaction probability scale, cesium was the probable cause of the patient's arrhythmia. In animal models, cesium chloride has induced cardiac arrhythmias, including torsade de pointes. It inhibits delayed rectifier potassium channels in the myocardium, causing delayed repolarization and QT-interval prolongation. Patients with cancer should be aware that alternative remedies may be harmful and ineffective. Because patients may be unlikely to self-report alternative remedies, health care providers should specifically ask their patients about any

  11. Cardiac Tamponade Revisited

    Science.gov (United States)

    Ariyarajah, Vignendra; Spodick, David H.

    2007-01-01

    Cardiac tamponade is a life-threatening clinical syndrome that requires timely diagnosis. Herein, we present an instructive case of a patient who had cardiac tamponade. The condition went undiagnosed and resulted in the patient's death because almost all of the pathognomonic clinical findings of tamponade were unrecognized or not manifest. To better prepare health care professionals for similar challenges, we discuss the symptoms and clinical signs typical of cardiac tamponade, review the medical literature, and highlight current investigative methods that enable quick, efficient diagnosis and treatment. PMID:17948086

  12. Major rapid weight loss induces changes in cardiac repolarization

    DEFF Research Database (Denmark)

    Vedel-Larsen, Esben; Iepsen, Eva Winning; Lundgren, Julie

    2016-01-01

    INTRODUCTION: Obesity is associated with increased all-cause mortality, but weight loss may not decrease cardiovascular events. In fact, very low calorie diets have been linked to arrhythmias and sudden death. The QT interval is the standard marker for cardiac repolarization, but T-wave morphology...... analysis has been suggested as a more sensitive method to identify changes in cardiac repolarization. We examined the effect of a major and rapid weight loss on T-wave morphology. METHODS AND RESULTS: Twenty-six individuals had electrocardiograms (ECG) taken before and after eight weeks of weight loss......A1c (pweight loss induces changes in cardiac repolarization. Monitoring of MCS during calorie restriction makes it possible to detect repolarization changes with higher discriminative power than the QT-interval during major rapid weight...

  13. Sex-Based Differences in Cardiac Arrhythmias, ICD Utilisation and Cardiac Resynchronisation Therapy.

    Science.gov (United States)

    Ghani, A; Maas, A H E M; Delnoy, P P H M; Ramdat Misier, A R; Ottervanger, J P; Elvan, A

    2011-01-01

    Many important differences in the presentation and clinical course of cardiac arrhythmias are present between men and women that should be accounted for in clinical practice. In this paper, we review published data on gender differences in cardiac excitable properties, supraventricular tachycardias, ventricular tachycardias, sudden cardiac death, and the utilisation of implantable defibrillators and cardiac resynchronisation therapy. Women have a higher heart rate at rest, and a longer QT interval than men. They further have a narrower QRS complex and lower QRS voltages on the 12-lead ECG with more often non-specific repolarisation abnormalities at rest. Supraventricular tachycardias, such as AV nodal reentrant tachycardia, are twice as frequent in women compared with men. Atrial fibrillation, however, has a 1.5-fold higher prevalence in men. The triggers for idiopathic right ventricular outflow tract tachycardia (VT) initiation are gender specific, i.e. hormonal changes play an important role in the occurrence of these VTs in women. There are clear-cut gender differences in acquired and congenital LQTS. Brugada syndrome affects men more commonly and severely than women. Sudden cardiac death is less prevalent in women at all ages and occurs 10 years later in women than in men. This may be related to the later onset of clinically manifest coronary heart disease in women. Among patients who receive ICDs and CRT devices, women appear to be under-represented, while they may benefit even more from these novel therapies.

  14. Molecular Basis of Cardiac Myxomas

    Directory of Open Access Journals (Sweden)

    Pooja Singhal

    2014-01-01

    Full Text Available Cardiac tumors are rare, and of these, primary cardiac tumors are even rarer. Metastatic cardiac tumors are about 100 times more common than the primary tumors. About 90% of primary cardiac tumors are benign, and of these the most common are cardiac myxomas. Approximately 12% of primary cardiac tumors are completely asymptomatic while others present with one or more signs and symptoms of the classical triad of hemodynamic changes due to intracardiac obstruction, embolism and nonspecific constitutional symptoms. Echocardiography is highly sensitive and specific in detecting cardiac tumors. Other helpful investigations are chest X-rays, magnetic resonance imaging and computerized tomography scan. Surgical excision is the treatment of choice for primary cardiac tumors and is usually associated with a good prognosis. This review article will focus on the general features of benign cardiac tumors with an emphasis on cardiac myxomas and their molecular basis.

  15. Modulation of the QT interval duration in hypertension with antihypertensive treatment.

    Science.gov (United States)

    Klimas, Jan; Kruzliak, Peter; Rabkin, Simon W

    2015-07-01

    The duration of the QT interval as measured by 12-lead electrocardiography is a measure of myocardial repolarization and is widely used to describe cardiac abnormalities, to determine the presence of cardiac toxicity and to evaluate drug safety. In hypertension, the QT interval is a predictor of the risk of both coronary events and cardiovascular death, after adjusting for the effects of additional risk factors. The mechanism of QT interval prolongation is multifactorial and includes cardiomyocyte hypertrophy and increased left ventricular mass, with accompanying changes in left ventricular transmural dispersion of repolarization, as well as changes in the tone of the autonomic nervous system of some patients with hypertension and mechano-electrical feedback, although this mechanism is less likely. Antihypertensive drugs vary in their effect on QT interval duration. The mechanisms underlying their effect depend on changes in left ventricular mass and autonomic nervous system tone, as well as changes in the activity of cardiac ion channels. Although blood pressure reduction is the primary goal of antihypertensive drug therapy and although the choice of antihypertensive drug treatment regimens varies among different individuals, the data regarding the disparate effects of antihypertensive drugs on the duration of the QT interval warrant consideration when implementing long-term pharmacotherapy for hypertension.

  16. Cardiac Tumors; Tumeurs cardiaques

    Energy Technology Data Exchange (ETDEWEB)

    Laissy, J.P.; Fernandez, P. [Centre Hospitalier Universitaire Bichat Claude Bernard, Service d' Imagerie, 76 - Rouen (France); Mousseaux, E. [Hopital Europeen Georges Pompidou (HEGP), Service de Radiologie Cardio Vasculaire et Interventionnelle, 75 - Paris (France); Dacher, J.N. [Centre Hospitalier Universitaire Charles Nicolle, 75 - Rouen (France); Crochet, D. [Centre Hospitalier Universitaire, Hopital Laennec, Centre Hemodynamique, Radiologie Thoracique et Vasculaire, 44 - Nantes (France)

    2004-04-01

    Metastases are the most frequent tumors of the heart even though they seldom are recognized. Most primary cardiac tumors are benign. The main role of imaging is to differentiate a cardiac tumor from thrombus and rare pseudo-tumors: tuberculoma, hydatid cyst. Echocardiography is the fist line imaging technique to detect cardiac tumors, but CT and MRl arc useful for further characterization and differential diagnosis. Myxoma of the left atrium is the most frequent benign cardiac tumor. It usually is pedunculated and sometimes calcified. Sarcoma is the most frequent primary malignant tumor and usually presents as a sessile infiltrative tumor. Lymphoma and metastases are usually recognized by the presence of known tumor elsewhere of by characteristic direct contiguous involvement. Diagnosing primary and secondary pericardial tumors often is difficult. Imaging is valuable for diagnosis, characterization, pre-surgical evaluation and follow-up. (author)

  17. Socially differentiated cardiac rehabilitation

    DEFF Research Database (Denmark)

    Meillier, Lucette Kirsten; Nielsen, Kirsten Melgaard; Larsen, Finn Breinholt;

    2012-01-01

    to a standard rehabilitation programme (SRP). If patients were identified as socially vulnerable, they were offered an extended version of the rehabilitation programme (ERP). Excluded patients were offered home visits by a cardiac nurse. Concordance principles were used in the individualised programme elements......%. Patients were equally distributed to the SRP and the ERP. No inequality was found in attendance and adherence among referred patients. Conclusions: It seems possible to overcome unequal referral, attendance, and adherence in cardiac rehabilitation by organisation of systematic screening and social......Aim: The comprehensive cardiac rehabilitation (CR) programme after myocardial infarction (MI) improves quality of life and results in reduced cardiac mortality and recurrence of MI. Hospitals worldwide face problems with low participation rates in rehabilitation programmes. Inequality...

  18. Transvenous Temporary Cardiac Pacing

    National Research Council Canada - National Science Library

    Emmanouil Poulidakis; Antonis S Manolis

    2014-01-01

      Transvenous temporary cardiac pacing is a rather old but still contemporary life-saving technique, with a unique value in the treatment of critically ill patients suffering from rhythm disturbances...

  19. Interval Valued Neutrosophic Soft Topological Spaces

    Directory of Open Access Journals (Sweden)

    Anjan Mukherjee

    2014-12-01

    Full Text Available In this paper we introduce the concept of interval valued neutrosophic soft topological space together with interval valued neutrosophic soft finer and interval valued neutrosophic soft coarser topology. We also define interval valued neutrosophic interior and closer of an interval valued neutrosophic soft set. Some theorems and examples are cites. Interval valued neutrosophic soft subspace topology are studied. Some examples and theorems regarding this concept are presented.

  20. Statistical intervals a guide for practitioners

    CERN Document Server

    Hahn, Gerald J

    2011-01-01

    Presents a detailed exposition of statistical intervals and emphasizes applications in industry. The discussion differentiates at an elementary level among different kinds of statistical intervals and gives instruction with numerous examples and simple math on how to construct such intervals from sample data. This includes confidence intervals to contain a population percentile, confidence intervals on probability of meeting specified threshold value, and prediction intervals to include observation in a future sample. Also has an appendix containing computer subroutines for nonparametric stati

  1. Cardiac arrest - cardiopulmonary resuscitation

    Institute of Scientific and Technical Information of China (English)

    Basri Lenjani; Besnik Elshani; Nehat Baftiu; Kelmend Pallaska; Kadir Hyseni; Njazi Gashi; Nexhbedin Karemani; Ilaz Bunjaku; Taxhidin Zaimi; Arianit Jakupi

    2014-01-01

    Objective:To investigate application of cardiopulmonary resuscitation(CPR) measures within the golden minutes inEurope.Methods:The material was taken from theUniversityClinical Center ofKosovo -EmergencyCentre inPristina, during the two(2) year period(2010-2011).The collected date belong to the patients with cardiac arrest have been recorded in the patients' log book protocol at the emergency clinic.Results:During the2010 to2011 in the emergency center of theCUCK inPristina have been treated a total of269 patients with cardiac arrest, of whom159 or59.1% have been treated in2010, and110 patients or40.9% in2011.Of the269 patients treated in the emergency centre,93 or34.6% have exited lethally in the emergency centre, and176 or 65.4% have been transferred to other clinics.In the total number of patients with cardiac arrest, males have dominated with186 cases, or69.1%.The average age of patients included in the survey was56.7 year oldSD±16.0 years.Of the269 patients with cardiac arrest, defibrillation has been applied for93 or34.6% of patients.In the outpatient settings defibrillation has been applied for3 or3.2% of patients.Patients were defibrillated with application of one to four shocks. Of27 cases with who have survived cardiac arrest, none of them have suffered cardiac arrest at home,3 or11.1% of them have suffered cardiac arrest on the street, and24 or88.9% of them have suffered cardiac arrest in the hospital.5 out of27 patients survived have ended with neurological impairment.Cardiac arrest cases were present during all days of the week, but frequently most reported cases have been onMonday with32.0% of cases, and onFriday with24.5% of cases. Conclusions:All survivors from cardiac arrest have received appropriate medical assistance within10 min from attack, which implies that if cardiac arrest occurs near an institution health care(with an opportunity to provide the emergent health care) the rate of survival is higher.

  2. Cardiac Aging Detection Using Complexity Measures

    CERN Document Server

    Balasubramanian, Karthi

    2016-01-01

    As we age, our hearts undergo changes which result in reduction in complexity of physiological interactions between different control mechanisms. This results in a potential risk of cardiovascular diseases which are the number one cause of death globally. Since cardiac signals are nonstationary and nonlinear in nature, complexity measures are better suited to handle such data. In this study, non-invasive methods for detection of cardiac aging using complexity measures are explored. Lempel-Ziv (LZ) complexity, Approximate Entropy (ApEn) and Effort-to-Compress (ETC) measures are used to differentiate between healthy young and old subjects using heartbeat interval data. We show that both LZ and ETC complexity measures are able to differentiate between young and old subjects with only 10 data samples while ApEn requires at least 15 data samples.

  3. Cardiac imaging in adults

    Energy Technology Data Exchange (ETDEWEB)

    Jaffe, C.C.

    1987-01-01

    This book approaches adult cardiac disease from the correlative imaging perspective. It includes chest X-rays and angiographs, 2-dimensional echocardiograms with explanatory diagrams for clarity, plus details on digital radiology, nuclear medicine techniques, CT and MRI. It also covers the normal heart, valvular heart disease, myocardial disease, pericardial disease, bacterial endocarditis, aortic aneurysm, cardiac tumors, and congenital heart disease of the adult. It points out those aspects where one imaging technique has significant superiority.

  4. Autonomic cardiac innervation

    OpenAIRE

    Hasan, Wohaib

    2013-01-01

    Autonomic cardiac neurons have a common origin in the neural crest but undergo distinct developmental differentiation as they mature toward their adult phenotype. Progenitor cells respond to repulsive cues during migration, followed by differentiation cues from paracrine sources that promote neurochemistry and differentiation. When autonomic axons start to innervate cardiac tissue, neurotrophic factors from vascular tissue are essential for maintenance of neurons before they reach their targe...

  5. Port Access Cardiac Surgery.

    Science.gov (United States)

    Viganó, Mario; Minzioni, Gaetano; Spreafico, Patrizio; Rinaldi, Mauro; Pasquino, Stefano; Ceriana, Piero; Locatelli, Alessandro

    2000-10-01

    The port-access technique for cardiac surgery was recently developed at Stanford University in California as a less invasive method to perform some cardiac operations. The port-access system has been described in detail elsewhere. It is based on femoral arterial and venous access for cardiopulmonary bypass (CPB) and on the adoption of a specially designed triple-lumen catheter described originally by Peters, and subsequently modified and developed in the definitive configuration called the endoaortic clamp.

  6. Awareness in cardiac anesthesia.

    LENUS (Irish Health Repository)

    Serfontein, Leon

    2010-02-01

    Cardiac surgery represents a sub-group of patients at significantly increased risk of intraoperative awareness. Relatively few recent publications have targeted the topic of awareness in this group. The aim of this review is to identify areas of awareness research that may equally be extrapolated to cardiac anesthesia in the attempt to increase understanding of the nature and significance of this scenario and how to reduce it.

  7. Post cardiac injury syndrome

    DEFF Research Database (Denmark)

    Nielsen, S L; Nielsen, F E

    1991-01-01

    The post-pericardiotomy syndrome is a symptom complex which is similar in many respects to the post-myocardial infarction syndrome and these are summarized under the diagnosis of the Post Cardiac Injury Syndrome (PCIS). This condition, which is observed most frequently after open heart surgery, i...... on the coronary vessels, with cardiac tamponade and chronic pericardial exudate. In the lighter cases, PCIS may be treated with NSAID and, in the more severe cases, with systemic glucocorticoid which has a prompt effect....

  8. Infected cardiac hydatid cyst

    OpenAIRE

    Ceviz, M; Becit, N; Kocak, H.

    2001-01-01

    A 24 year old woman presented with chest pain and palpitation. The presence of a semisolid mass—an echinococcal cyst or tumour—in the left ventricular apex was diagnosed by echocardiography, computed tomography, and magnetic resonance imaging. The infected cyst was seen at surgery. The cyst was removed successfully by using cardiopulmonary bypass with cross clamp.


Keywords: cardiac hydatid cyst; infected cardiac hydatid cyst

  9. Epileptic Patients are at Risk of Cardiac Arrhythmias: A Novel Approach using QT-nomogram, Tachogram, and Cardiac Restitution Plots

    Science.gov (United States)

    Al-Nimer, Marwan S.; Al-Mahdawi, Sura A.; Abdullah, Namir M.; Al-Mahdawi, Akram

    2017-01-01

    Background: Sudden death is reported in patients who had a history of epilepsy and some authors believed that is due to cardiac arrhythmias. Objectives: This study aimed to predict that the epileptic patients are at risk of serious cardiac arrhythmias by QT-nomogram, tachogram (Lorenz), and cardiac restitution plots. Methods: A total number of 71 healthy subjects (Group I) and 64 newly diagnosed epileptic patients (Group II) were recruited from Al-Yarmouk and Baghdad Teaching hospitals in Baghdad from March 2015 to July 2015 and included in this study. The diagnosis of epilepsy achieved clinically, electroencephalograph record and radio-images including computerized tomography and magnetic image resonance. At the time of entry into the study, an electrocardiography (ECG) was done, and the determinants of each ECG record were calculated. The QT-nomogram, tachogram, and cardiac restitution plots were used to identify the patients at risk of cardiac arrhythmias. Results: Significant prolonged corrected QT corrected (QTc) and JT corrected intervals were observed in female compared with male at age ≥50 years while the TQ interval was significantly prolonged in males of Group II. Eight patients of Group II had a significant pathological prolonged QTc interval compared with undetectable finding in Group I. QT nomogram did not disclose significant findings while the plots of Lorenz and restitution steepness disclose that the patients of Group II were vulnerable to cardiac arrhythmias. Abnormal ECG findings were observed in the age extremities (≤18 years and ≥50 years) in Group II compared with Group I. Conclusion: Utilization of QT-nomogram, restitution steepness, and tachogram plots is useful tools for detection subclinical vulnerable epileptic patient with cardiac arrhythmias. PMID:28149075

  10. Epileptic patients are at risk of cardiac arrhythmias: A novel approach using QT-nomogram, tachogram, and cardiac restitution plots

    Directory of Open Access Journals (Sweden)

    Marwan S Al-Nimer

    2017-01-01

    Full Text Available Background: Sudden death is reported in patients who had a history of epilepsy and some authors believed that is due to cardiac arrhythmias. Objectives: This study aimed to predict that the epileptic patients are at risk of serious cardiac arrhythmias by QT-nomogram, tachogram (Lorenz, and cardiac restitution plots. Methods: A total number of 71 healthy subjects (Group I and 64 newly diagnosed epileptic patients (Group II were recruited from Al-Yarmouk and Baghdad Teaching hospitals in Baghdad from March 2015 to July 2015 and included in this study. The diagnosis of epilepsy achieved clinically, electroencephalograph record and radio-images including computerized tomography and magnetic image resonance. At the time of entry into the study, an electrocardiography (ECG was done, and the determinants of each ECG record were calculated. The QT-nomogram, tachogram, and cardiac restitution plots were used to identify the patients at risk of cardiac arrhythmias. Results: Significant prolonged corrected QT corrected (QTc and JT corrected intervals were observed in female compared with male at age ≥50 years while the TQ interval was significantly prolonged in males of Group II. Eight patients of Group II had a significant pathological prolonged QTc interval compared with undetectable finding in Group I. QT nomogram did not disclose significant findings while the plots of Lorenz and restitution steepness disclose that the patients of Group II were vulnerable to cardiac arrhythmias. Abnormal ECG findings were observed in the age extremities (≤18 years and ≥50 years in Group II compared with Group I. Conclusion: Utilization of QT-nomogram, restitution steepness, and tachogram plots is useful tools for detection subclinical vulnerable epileptic patient with cardiac arrhythmias.

  11. Cardiac applications of optogenetics.

    Science.gov (United States)

    Ambrosi, Christina M; Klimas, Aleksandra; Yu, Jinzhu; Entcheva, Emilia

    2014-08-01

    In complex multicellular systems, such as the brain or the heart, the ability to selectively perturb and observe the response of individual components at the cellular level and with millisecond resolution in time, is essential for mechanistic understanding of function. Optogenetics uses genetic encoding of light sensitivity (by the expression of microbial opsins) to provide such capabilities for manipulation, recording, and control by light with cell specificity and high spatiotemporal resolution. As an optical approach, it is inherently scalable for remote and parallel interrogation of biological function at the tissue level; with implantable miniaturized devices, the technique is uniquely suitable for in vivo tracking of function, as illustrated by numerous applications in the brain. Its expansion into the cardiac area has been slow. Here, using examples from published research and original data, we focus on optogenetics applications to cardiac electrophysiology, specifically dealing with the ability to manipulate membrane voltage by light with implications for cardiac pacing, cardioversion, cell communication, and arrhythmia research, in general. We discuss gene and cell delivery methods of inscribing light sensitivity in cardiac tissue, functionality of the light-sensitive ion channels within different types of cardiac cells, utility in probing electrical coupling between different cell types, approaches and design solutions to all-optical electrophysiology by the combination of optogenetic sensors and actuators, and specific challenges in moving towards in vivo cardiac optogenetics.

  12. Relationship between the Initial Systolic Time Interval and RR-interval during an exercise stimulus measured with Impedance Cardiography

    Science.gov (United States)

    Hoekstra, Femke; Habers, Esther; Janssen, Thomas W. J.; Verdaasdonk, Rudolf M.; Meijer, Jan H.

    2010-04-01

    The Initial Systolic Time Interval (ISTI), obtained from the electrocardiogram and impedance cardiogram, is considered to be a measure for the time delay between the electrical and mechanical activity of the heart and reflects an active period of the heart cycle. The relationship between ISTI and the total heart cycle (RR-interval) was studied in three groups of young, healthy volunteers: low, moderately and highly trained subjects. The three groups were exposed to an exercise stimulus on a cycle ergometer with an increasing work load to increase the heart rate. ISTI was decreased with decreasing RR-interval. However, the relative proportion of ISTI, ISTI/RR, was found to increase with decreasing RR-interval. This relationship was found to be inversely proportional. The rate of this increase in ISTI/RR was significantly higher in highly trained subjects. Also, over the whole range of heart rates ISTI was longer in these subjects. It is concluded that ISTI can be used to evaluate cardiac performance during physical exercise non-invasively and in an extramural setting.

  13. Nitrates for the prevention of cardiac morbidity and mortality in patients undergoing non-cardiac surgery.

    Science.gov (United States)

    Zhao, Na; Xu, Jin; Singh, Balwinder; Yu, Xuerong; Wu, Taixiang; Huang, Yuguang

    2016-08-04

    resolved differences by discussion and, when necessary, sought help and suggestions from a third review author. We used a random-effects model for data analysis. We included 27 randomized controlled trials (RCTs) (8244 participants analysed). Investigators reported 12 different comparisons of three different nitrates (nitroglycerin, isosorbide dinitrate and nicorandil) versus no treatment, placebo or other pharmacological interventions. All participants were older than 15 years of age. More than half of the trials used general anaesthesia. Surgical procedures in most trials were at low to moderate risk for perioperative cardiac complications. Only two comparisons including three studies reported the primary outcome - all-cause mortality up to 30 days post operation. Researchers reported other morbidity outcomes and adverse events in a variable and heterogeneous way, resulting in limited available data for inclusion in the meta-analysis. We determined that the overall methodological quality of included studies was fair to low, in accordance with risk of bias in most domains.In summary, we found no difference in the primary outcome - all-cause mortality up to 30 days post operation - when nitroglycerin was compared with no treatment (one study, 60 participants, 0/30 vs 1/30; (risk ratio (RR) 0.33, 95% confidence interval (CI) 0.01 to 7.87, very low-quality evidence based on GRADE criteria) or with placebo (two studies, 89 participants, 1/45 vs 0/44; RR 2.81, 95% CI 0.12 to 63.83, very low-quality evidence). Regarding our secondary outcomes, we noted no statistically significant differences in angina pectoris, acute myocardial infarction, acute heart failure, cardiac arrhythmia or cardiac arrest in any comparisons. In comparisons versus nitroglycerin, although more events of cardiac ischaemia were observed in participants receiving no treatment or placebo, we found no statistically significant differences in any comparisons, except the comparison of nicorandil versus placebo

  14. [Psychosomatic aspects of cardiac arrhythmias].

    Science.gov (United States)

    Siepmann, Martin; Kirch, Wilhelm

    2010-07-01

    Emotional stress facilitates the occurrence of cardiac arrhythmias including sudden cardiac death. The prevalence of anxiety and depression is increased in cardiac patients as compared to the normal population. The risk of cardiovascular mortality is enhanced in patients suffering from depression. Comorbid anxiety disorders worsen the course of cardiac arrhythmias. Disturbance of neurocardiac regulation with predominance of the sympathetic tone is hypothesized to be causative for this. The emotional reaction to cardiac arrhythmias is differing to a large extent between individuals. Emotional stress may result from coping with treatment of cardiac arrhythmias. Emotional stress and cardiac arrhythmias may influence each other in the sense of a vicious circle. Somatoform cardiac arrhythmias are predominantly of psychogenic origin. Instrumental measures and frequent contacts between physicians and patients may facilitate disease chronification. The present review is dealing with the multifaceted relationships between cardiac arrhythmias and emotional stress. The underlying mechanisms and corresponding treatment modalities are discussed.

  15. QTc interval in patients with schizophrenia receiving antipsychotic treatment as monotherapy or polypharmacy

    DEFF Research Database (Denmark)

    Elliott, Anja Friis; Johan Mørk, Thibault; Højlund, Mikkel

    2017-01-01

    Objective: Antipsychotics are associated with a polymorphic ventricular tachycardia, torsades de pointes, which, in the worst case, can lead to sudden cardiac death. The QT interval corrected for heart rate (QTc) is used as a clinical proxy for torsades de pointes. The QTc interval can be prolong...... on monitoring the QTc interval in women with schizophrenia receiving antipsychotics as polypharmacy....... by antipsychotic monotherapy, but it is unknown if the QTc interval is prolonged further with antipsychotic polypharmaceutical treatment. Therefore, this study investigated the associations between QTc interval and antipsychotic monotherapy and antipsychotic polypharmaceutical treatment in schizophrenia......, and measured the frequency of QTc prolongation among patients. Methods: We carried out an observational cohort study of unselected patients with schizophrenia visiting outpatient facilities in the region of Central Jutland, Denmark. Patients were enrolled from January of 2013 to June of 2015, with follow...

  16. Risk of Cardiac Rhythm Problems During Spaceflight

    Science.gov (United States)

    Lee, Stuart M. C.; Stenger, Michael B.; Laurie, Steven S.; Macias, Brandon R.

    2017-01-01

    NASA has concerns regarding the incidence and clinical significance of cardiac arrhythmias that could occur during long-term exposure to the spaceflight environment, such as on the International Space Station (ISS) or during a prolonged (e.g., up to 3 years) sojourn to Mars or on the Moon. There have been some anecdotal reports and a few documented cases of cardiac arrhythmias in space, including one documented episode of non-sustained ventricular tachycardia. The potential catastrophic nature of a sudden cardiac death in the remote space environment has led to concerns from the early days of the space program that spaceflight might be arrhythmogenic. Indeed, there are known and well-defined changes in the cardiovascular system with spaceflight: a) plasma volume is reduced, b) left ventricular mass is decreased, and c) the autonomic nervous system adapts to the weightless environment. Combined, these physiologic adaptations suggest that changes in cardiac structure and neuro-humoral environment during spaceflight could alter electrical conduction, although the evidence supporting this contention consists mostly of minor changes in QT interval (the time between the start of the Q wave and the end of the T wave on an electrocardiogram tracing) in a small number of astronauts after long-duration spaceflight. Concurrent with efforts by NASA Medical Operations to refine and improve screening techniques relevant to arrhythmias and cardiovascular disease, as NASA enters the era of exploration-class missions it will be critical to determine with the highest degree of certainty whether spaceflight by itself alters cardiac structure and function sufficiently to increase the risk of arrhythmias.

  17. Variational collocation on finite intervals

    Energy Technology Data Exchange (ETDEWEB)

    Amore, Paolo [Facultad de Ciencias, Universidad de Colima, Bernal DIaz del Castillo 340, Colima, Colima (Mexico); Cervantes, Mayra [Facultad de Ciencias, Universidad de Colima, Bernal DIaz del Castillo 340, Colima, Colima (Mexico); Fernandez, Francisco M [INIFTA (Conicet, UNLP), Diag. 113 y 64 S/N, Sucursal 4, Casilla de Correo 16, 1900 La Plata (Argentina)

    2007-10-26

    In this paper, we study a set of functions, defined on an interval of finite width, which are orthogonal and which reduce to the sinc functions when the appropriate limit is taken. We show that these functions can be used within a variational approach to obtain accurate results for a variety of problems. We have applied them to the interpolation of functions on finite domains and to the solution of the Schroedinger equation, and we have compared the performance of the present approach with others.

  18. Dijets at large rapidity intervals

    CERN Document Server

    Pope, B G

    2001-01-01

    Inclusive diet production at large pseudorapidity intervals ( Delta eta ) between the two jets has been suggested as a regime for observing BFKL dynamics. We have measured the dijet cross section for large Delta eta in pp collisions at square root s = 1800 and 630 GeV using the DOE detector. The partonic cross section increases strongly with the size of Delta eta . The observed growth is even stronger than expected on the basis of BFKL resummation in the leading logarithmic approximation. The growth of the partonic cross section can be accommodated with an effective BFKL intercept of alpha /sub BFKL/(20 GeV) = 1.65 +or- 0.07.

  19. Some Characterizations of Convex Interval Games

    NARCIS (Netherlands)

    Brânzei, R.; Tijs, S.H.; Alparslan-Gok, S.Z.

    2008-01-01

    This paper focuses on new characterizations of convex interval games using the notions of exactness and superadditivity. We also relate big boss interval games with concave interval games and obtain characterizations of big boss interval games in terms of exactness and subadditivity.

  20. Some Characterizations of Convex Interval Games

    NARCIS (Netherlands)

    Brânzei, R.; Tijs, S.H.; Alparslan-Gok, S.Z.

    2008-01-01

    This paper focuses on new characterizations of convex interval games using the notions of exactness and superadditivity. We also relate big boss interval games with concave interval games and obtain characterizations of big boss interval games in terms of exactness and subadditivity.

  1. Cardiac radiology: centenary review.

    Science.gov (United States)

    de Roos, Albert; Higgins, Charles B

    2014-11-01

    During the past century, cardiac imaging technologies have revolutionized the diagnosis and treatment of acquired and congenital heart disease. Many important contributions to the field of cardiac imaging were initially reported in Radiology. The field developed from the early stages of cardiac imaging, including the use of coronary x-ray angiography and roentgen kymography, to nowadays the widely used echocardiographic, nuclear medicine, cardiac computed tomographic (CT), and magnetic resonance (MR) applications. It is surprising how many of these techniques were not recognized for their potential during their early inception. Some techniques were described in the literature but required many years to enter the clinical arena and presently continue to expand in terms of clinical application. The application of various CT and MR contrast agents for the diagnosis of myocardial ischemia is a case in point, as the utility of contrast agents continues to expand the noninvasive characterization of myocardium. The history of cardiac imaging has included a continuous process of advances in our understanding of the anatomy and physiology of the cardiovascular system, along with advances in imaging technology that continue to the present day.

  2. STABILITY FOR SEVERAL TYPES OF INTERVAL MATRICES

    Institute of Scientific and Technical Information of China (English)

    NianXiaohong; GaoJintai

    1999-01-01

    The robust stability for some types of tlme-varying interval raatrices and nonlineartime-varying interval matrices is considered and some sufficient conditions for robust stability of such interval matrices are given, The main results of this paper are only related to the verticesset of a interval matrices, and therefore, can be easily applied to test robust stability of interval matrices. Finally, some examples are given to illustrate the results.

  3. Interval Arithmetic for Nonlinear Problem Solving

    OpenAIRE

    2013-01-01

    Implementation of interval arithmetic in complex problems has been hampered by the tedious programming exercise needed to develop a particular implementation. In order to improve productivity, the use of interval mathematics is demonstrated using the computing platform INTLAB that allows for the development of interval-arithmetic-based programs more efficiently than with previous interval-arithmetic libraries. An interval-Newton Generalized-Bisection (IN/GB) method is developed in this platfo...

  4. Reviewing EKGs in Thalassemia Patients to Evaluate Their Cardiac Function

    Directory of Open Access Journals (Sweden)

    Abdolhamid Bagheri

    2016-03-01

    Full Text Available Introduction: There are more than 18000 thalassemia patients in Iran. In a current study, a high rate of mortality in these patients due to heart failure, is shown. Main factors for evaluating this disorder in thalassemia patients were their electrocardiograms (EKGs and Serum Ferritin Levels (SFLs.Methods: We studied the cardiac function in 91 patients (73 major and 18 intermediate thalassemia patients treated in Zafar Thalassemia Center, of whom 35 (38.45% were male and 56 (61.55% were female. The Factors in this study contains: EKGs, mean annual serum ferritin (at least, three SFL had been recorded in each patient treatment file in 2009, mean annual hemoglobin (Hb levels and mean annual hematocrit (Hct levels (average, 12 recorded hematocrit levels during 2009.Results: Our findings have shown that Q-T interval did not correlate with ferritin (r = 0.05, P > 0.05. In both patients with LVH and without LVH, there was no significant difference in SFL (P > 0.05. Although, the mean rate among the thalassemia patients was 85.34 ± 12.91, it did not correlate significantly with QRS duration and P-R Interval (r = -0.08, P > 0.05. In addition, ferritin did not correlate significantly with QRS duration and P-R Interval (r = 0.1, r = 0.05 and P > 0.05, P > 0.05. Furthermore, there was no difference in SFL in patients with normal cardiac axis and those with cardiac axis deviation.Conclusion: There is no correlation between SFL and variations in EKG. Although EKG is an available method for checking cardiac function in thalassemic patients, especially in developing countries, physicians cannot rely on it for diagnosis or prognosis of cardiac failure in thalassemia patients. Therefore, other methods such as MRIT2* and Echocardiography are suggested to be used periodically in order to check the cardiac function in thalassemia patients.

  5. Comprehensive cardiac rehabilitation

    DEFF Research Database (Denmark)

    Kruse, Marie; Hochstrasser, Stefan; Zwisler, Ann-Dorthe O;

    2006-01-01

    OBJECTIVES: The costs of comprehensive cardiac rehabilitation are established and compared to the corresponding costs of usual care. The effect on health-related quality of life is analyzed. METHODS: An unprecedented and very detailed cost assessment was carried out, as no guidelines existed...... for the situation at hand. Due to challenging circumstances, the cost assessment turned out to be ex-post and top-down. RESULTS: Cost per treatment sequence is estimated to be approximately euro 976, whereas the incremental cost (compared with usual care) is approximately euro 682. The cost estimate is uncertain...... and may be as high as euro 1.877. CONCLUSIONS: Comprehensive cardiac rehabilitation is more costly than usual care, and the higher costs are not outweighed by a quality of life gain. Comprehensive cardiac rehabilitation is, therefore, not cost-effective....

  6. Pediatric cardiac postoperative care

    Directory of Open Access Journals (Sweden)

    Auler Jr. José Otávio Costa

    2002-01-01

    Full Text Available The Heart Institute of the University of São Paulo, Medical School is a referral center for the treatment of congenital heart diseases of neonates and infants. In the recent years, the excellent surgical results obtained in our institution may be in part due to modern anesthetic care and to postoperative care based on well-structured protocols. The purpose of this article is to review unique aspects of neonate cardiovascular physiology, the impact of extracorporeal circulation on postoperative evolution, and the prescription for pharmacological support of acute cardiac dysfunction based on our cardiac unit protocols. The main causes of low cardiac output after surgical correction of heart congenital disease are reviewed, and methods of treatment and support are proposed as derived from the relevant literature and our protocols.

  7. Toothache of cardiac origin.

    Science.gov (United States)

    Kreiner, M; Okeson, J P

    1999-01-01

    Pain referred to the orofacial structures can sometimes be a diagnostic challenge for the clinician. In some instances, a patient may complain of tooth pain that is completely unrelated to any dental source. This poses a diagnostic and therapeutic problem for the dentist. Cardiac pain most commonly radiates to the left arm, shoulder, neck, and face. In rare instances, angina pectoris may present as dental pain. When this occurs, an improper diagnosis frequently leads to unnecessary dental treatment or, more significantly, a delay of proper treatment. This delay may result in the patient experiencing an acute myocardial infarction. It is the dentist's responsibility to establish a proper diagnosis so that the treatment will be directed toward the source of pain and not to the site of pain. This article reviews the literature concerning referred pain of cardiac origin and presents a case report of toothache of cardiac origin.

  8. The cardiac anxiety questionnaire: cross-validation among cardiac inpatients

    NARCIS (Netherlands)

    Beek, M.H. van; Oude Voshaar, R.C.; Deelen, F.M. van; Balkom, A.J. van; Pop, G.A.; Speckens, A.E.

    2012-01-01

    OBJECTIVE: General anxiety symptoms are common in patients with cardiac disease and considered to have an adverse effect on cardiac prognosis. The role of specific cardiac anxiety, however, is still unknown. The aim of this study is to examine the factor structure, reliability, and validity of the D

  9. THE CARDIAC ANXIETY QUESTIONNAIRE : CROSS-VALIDATION AMONG CARDIAC INPATIENTS

    NARCIS (Netherlands)

    van Beek, M. H. C. T.; Voshaar, R. C. Oude; van Deelen, F. M.; van Balkom, A. J. L. M.; Pop, G.; Speckens, A. E. M.

    2012-01-01

    Objective: General anxiety symptoms are common in patients with cardiac disease and considered to have an adverse effect on cardiac prognosis. The role of specific cardiac anxiety, however, is still unknown. The aim of this study is to examine the factor structure, reliability, and validity of the D

  10. Does it matter if I exercise? What can ``cardiophysics" tell us?

    Science.gov (United States)

    Hart, Gus; Wilson, Benjamin; Parcell, Allen

    2007-10-01

    Lower heart rates are often associated with better cardiovascular health. But there's a lot more to cardiac rhythms than just the average heart rate. Fractal analysis of inter-beat intervals shows a surprising ability to discriminate between healthy and unhealthy, young and old groups. Are the fluctuations in the heartbeat of a healthy heart random, small, periodic, or chaotic? Does exercise make a difference? We discuss our analysis of the cardiac data of two groups of individuals, those that were physically active and those that were sedentary.

  11. Radionuclide assessment of left ventricular function following cardiac surgery

    Energy Technology Data Exchange (ETDEWEB)

    Howe, W.R.; Jones, R.H.; Sabiston, D.C. Jr.

    1976-01-01

    Use of a high count-rate gamma scintillation camera permits the noninvasive assessment of left ventricular function by nuclear angiocardiography. Counts recorded from the region of the left ventricle at 50- or 100-msec intervals during the first transit of an intravenously administered bolus of radioisotope produce a high-fidelity indicator-dilution curve. Count fluctuations reflect left ventricular volume changes during the cardiac cycle and permit measurement of dv/dt, ejection fraction, mean transit time, and wall motion of this chamber. The present study evaluates (1) the accuracy of this technique compared to standard biplane cineangiography and (2) its usefulness in evaluating patients after cardiac surgery.

  12. Cardiac output measurement

    Directory of Open Access Journals (Sweden)

    Andreja Möller Petrun

    2014-02-01

    Full Text Available In recent years, developments in the measuring of cardiac output and other haemodynamic variables are focused on the so-called minimally invasive methods. The aim of these methods is to simplify the management of high-risk and haemodynamically unstable patients. Due to the need of invasive approach and the possibility of serious complications the use of pulmonary artery catheter has decreased. This article describes the methods for measuring cardiac output, which are based on volume measurement (Fick method, indicator dilution method, pulse wave analysis, Doppler effect, and electrical bioimpedance.

  13. Oxygen Delivery and Muscle Deoxygenation during Continuous, Long- and Short-Interval Exercise.

    Science.gov (United States)

    Zafeiridis, A; Kounoupis, A; Dipla, K; Kyparos, A; Nikolaidis, M G; Smilios, I; Vrabas, I S

    2015-11-01

    This study compared the O2 delivery (a central determinant of VO2) and muscle deoxygenation (reflecting a peripheral determinant of VO2) during intense continuous, long-interval, and short-interval exercise protocols. Twelve young men completed the 3 protocols with equal overall effort. Simultaneous and continuous recordings of central hemodynamics, muscle oxygenation/deoxygenation and VO2 were performed. Peak responses for stroke volume and peripheral resistance did not differ among protocols, whereas peak cardiac output and VO2 were higher in long-interval vs. continuous and short-interval protocols with inactive rest phases (pexercise (pexercise-time above 80% VO2max were also higher in continuous and long-interval vs. short-interval protocol (pprotocols. In conclusion, all 3 protocols resulted in a great activation of central and peripheral determinants of VO2. When performed with equal overall effort, the intense continuous and interval modalities reveal similarities in muscle O2-utilization response, but differences in central hemodynamic and VO2 responses. Intense continuous and long-interval protocols exert a more commanding role on the cardiovascular system and VO2 response compared to short-interval exercise with inactive rest phases.

  14. High-intensity interval training with vibration as rest intervals attenuates fiber atrophy and prevents decreases in anaerobic performance.

    Directory of Open Access Journals (Sweden)

    Sandro Manuel Mueller

    Full Text Available Aerobic high-intensity interval training (HIT improves cardiovascular capacity but may reduce the finite work capacity above critical power (W' and lead to atrophy of myosin heavy chain (MyHC-2 fibers. Since whole-body vibration may enhance indices of anaerobic performance, we examined whether side-alternating whole-body vibration as a replacement for the active rest intervals during a 4 x 4 min HIT prevents decreases in anaerobic performance and capacity without compromising gains in aerobic function. Thirty-three young recreationally active men were randomly assigned to conduct either conventional 4 x 4 min HIT, HIT with 3 min of WBV at 18 Hz (HIT+VIB18 or 30 Hz (HIT+VIB30 in lieu of conventional rest intervals, or WBV at 30 Hz (VIB30. Pre and post training, critical power (CP, W', cellular muscle characteristics, as well as cardiovascular and neuromuscular variables were determined. W' (-14.3%, P = 0.013, maximal voluntary torque (-8.6%, P = 0.001, rate of force development (-10.5%, P = 0.018, maximal jumping power (-6.3%, P = 0.007 and cross-sectional areas of MyHC-2A fibers (-6.4%, P = 0.044 were reduced only after conventional HIT. CP, V̇O2peak, peak cardiac output, and overall capillary-to-fiber ratio were increased after HIT, HIT+VIB18, and HIT+VIB30 without differences between groups. HIT-specific reductions in anaerobic performance and capacity were prevented by replacing active rest intervals with side-alternating whole-body vibration, notably without compromising aerobic adaptations. Therefore, competitive cyclists (and potentially other endurance-oriented athletes may benefit from replacing the active rest intervals during aerobic HIT with side-alternating whole-body vibration.ClinicalTrials.gov Identifier: NCT01875146.

  15. Perioperative management of cardiac disease.

    Science.gov (United States)

    Aresti, N A; Malik, A A; Ihsan, K M; Aftab, S M E; Khan, W S

    2014-01-01

    Pre-existing cardiac disease contributes significantly to morbidity and mortality amongst patients undergoing non cardiac surgery. Patients with pre-existing cardiac disease or with risk factors for it, have as much as a 3.9% risk of suffering a major perioperative cardiac event (Lee et al 1999, Devereaux 2005). Furthermore, the incidence of perioperative myocardial infarction (MI) is increased 10 to 50 fold in patients with previous coronary events (Jassal 2008).

  16. Data analysis in cardiac arrhythmias.

    Science.gov (United States)

    Rodrigo, Miguel; Pedrón-Torecilla, Jorge; Hernández, Ismael; Liberos, Alejandro; Climent, Andreu M; Guillem, María S

    2015-01-01

    Cardiac arrhythmias are an increasingly present in developed countries and represent a major health and economic burden. The occurrence of cardiac arrhythmias is closely linked to the electrical function of the heart. Consequently, the analysis of the electrical signal generated by the heart tissue, either recorded invasively or noninvasively, provides valuable information for the study of cardiac arrhythmias. In this chapter, novel cardiac signal analysis techniques that allow the study and diagnosis of cardiac arrhythmias are described, with emphasis on cardiac mapping which allows for spatiotemporal analysis of cardiac signals.Cardiac mapping can serve as a diagnostic tool by recording cardiac signals either in close contact to the heart tissue or noninvasively from the body surface, and allows the identification of cardiac sites responsible of the development or maintenance of arrhythmias. Cardiac mapping can also be used for research in cardiac arrhythmias in order to understand their mechanisms. For this purpose, both synthetic signals generated by computer simulations and animal experimental models allow for more controlled physiological conditions and complete access to the organ.

  17. Biosynthesis of cardiac natriuretic peptides

    DEFF Research Database (Denmark)

    Goetze, Jens Peter

    2010-01-01

    Cardiac-derived peptide hormones were identified more than 25 years ago. An astonishing amount of clinical studies have established cardiac natriuretic peptides and their molecular precursors as useful markers of heart disease. In contrast to the clinical applications, the biogenesis of cardiac...

  18. Cardiac troponins and high-sensitivity cardiac troponin assays.

    Science.gov (United States)

    Conrad, Michael J; Jarolim, Petr

    2014-03-01

    Measurement of circulating cardiac troponins I and T has become integral to the diagnosis of myocardial infarction. This article discusses the structure and function of the troponin complex and the release of cardiac troponin molecules from the injured cardiomyocyte into the circulation. An overview of current cardiac troponin assays and their classification according to sensitivity is presented. The diagnostic criteria, role, and usefulness of cardiac troponin for myocardial infarction are discussed. In addition, several examples are given of the usefulness of high-sensitivity cardiac troponin assays for short-term and long-term prediction of adverse events.

  19. Hepato-cardiac disorders

    Institute of Scientific and Technical Information of China (English)

    Yasser; Mahrous; Fouad; Reem; Yehia

    2014-01-01

    Understanding the mutual relationship between the liver and the heart is important for both hepatologists and cardiologists. Hepato-cardiac diseases can be classified into heart diseases affecting the liver, liver diseases affecting the heart, and conditions affecting the heart and the liver at the same time. Differential diagnoses of liver injury are extremely important in a cardiologist’s clinical practice calling for collaboration between cardiologists and hepatologists due to the many other diseases that can affect the liver and mimic haemodynamic injury. Acute and chronic heart failure may lead to acute ischemic hepatitis or chronic congestive hepatopathy. Treatment in these cases should be directed to the primary heart disease. In patients with advanced liver disease, cirrhotic cardiomyopathy may develop including hemodynamic changes, diastolic and systolic dysfunctions, reduced cardiac performance and electrophysiological abnormalities. Cardiac evaluation is important for patients with liver diseases especially before and after liver transplantation. Liver transplantation may lead to the improvement of all cardiac changes and the reversal of cirrhotic cardiomyopathy. There are systemic diseases that may affect both the liver and the heart concomitantly including congenital, metabolic and inflammatory diseases as well as alcoholism. This review highlights these hepatocardiac diseases

  20. The cardiac malpositions.

    Science.gov (United States)

    Perloff, Joseph K

    2011-11-01

    Dextrocardia was known in the 17th century and was 1 of the first congenital malformations of the heart to be recognized. Fifty years elapsed before Matthew Baillie published his account of complete transposition in a human of the thoracic and abdominal viscera to the opposite side from what is natural. In 1858, Thomas Peacock stated that "the heart may be congenitally misplaced in various ways, occupying either an unusual position within the thorax, or being situated external to that cavity." In 1915, Maude Abbott described ectopia cordis, and Richard Paltauf's remarkable illustrations distinguished the various types of dextrocardia. In 1928, the first useful classification of the cardiac malpositions was proposed, and in 1966, Elliott et al's radiologic classification set the stage for clinical recognition. The first section of this review deals with the 3 basic cardiac malpositions in the presence of bilateral asymmetry. The second section deals with cardiac malpositions in the presence of bilateral left-sidedness or right-sidedness. Previous publications on cardiac malpositions are replete with an arcane vocabulary that confounds rather than clarifies. Even if the terms themselves are understood, inherent complexity weighs against clarity. This review was designed as a guided tour of an unfamiliar subject.

  1. Sudden cardiac death

    DEFF Research Database (Denmark)

    Hougen, H P; Valenzuela, Antonio Jesus Sanchez; Lachica, E

    1992-01-01

    The study deals with the comparison of morphological, histochemical and biochemical methods applied to the detection of myocardial infarction in 150 medico-legal autopsies performed at the Institute of Forensic Pathology in Copenhagen. The study also included an NBT (formazan) test of cardiac cro...

  2. Cardiac Risk Assessment

    Science.gov (United States)

    ... Risk Assessment Related tests: Lipid Profile , VLDL Cholesterol , hs-CRP , Lp(a) Overview | Common Questions | Related Pages What ... cardiac risk include: High-sensitivity C-reactive protein (hs-CRP) : Studies have shown that measuring CRP with a ...

  3. Cardiac Catheterization (For Teens)

    Science.gov (United States)

    ... once a day. Avoid baths, hot tubs, and swimming for 1 week after the catheterization. Don't use any creams, lotions, or ointments on the site. The doctor will tell you when it's safe to go back to your normal activities after a cardiac catheterization. ...

  4. Direct Interval Forecasting of Wind Power

    DEFF Research Database (Denmark)

    Wan, Can; Xu, Zhao; Pinson, Pierre

    2013-01-01

    This letter proposes a novel approach to directly formulate the prediction intervals of wind power generation based on extreme learning machine and particle swarm optimization, where prediction intervals are generated through direct optimization of both the coverage probability and sharpness...

  5. Robust misinterpretation of confidence intervals.

    Science.gov (United States)

    Hoekstra, Rink; Morey, Richard D; Rouder, Jeffrey N; Wagenmakers, Eric-Jan

    2014-10-01

    Null hypothesis significance testing (NHST) is undoubtedly the most common inferential technique used to justify claims in the social sciences. However, even staunch defenders of NHST agree that its outcomes are often misinterpreted. Confidence intervals (CIs) have frequently been proposed as a more useful alternative to NHST, and their use is strongly encouraged in the APA Manual. Nevertheless, little is known about how researchers interpret CIs. In this study, 120 researchers and 442 students-all in the field of psychology-were asked to assess the truth value of six particular statements involving different interpretations of a CI. Although all six statements were false, both researchers and students endorsed, on average, more than three statements, indicating a gross misunderstanding of CIs. Self-declared experience with statistics was not related to researchers' performance, and, even more surprisingly, researchers hardly outperformed the students, even though the students had not received any education on statistical inference whatsoever. Our findings suggest that many researchers do not know the correct interpretation of a CI. The misunderstandings surrounding p-values and CIs are particularly unfortunate because they constitute the main tools by which psychologists draw conclusions from data.

  6. Scaling of light and dark time intervals.

    Science.gov (United States)

    Marinova, J

    1978-01-01

    Scaling of light and dark time intervals of 0.1 to 1.1 s is performed by the mehtod of magnitude estimation with respect to a given standard. The standards differ in duration and type (light and dark). The light intervals are subjectively estimated as longer than the dark ones. The relation between the mean interval estimations and their magnitude is linear for both light and dark intervals.

  7. Generalised Interval-Valued Fuzzy Soft Set

    OpenAIRE

    Shawkat Alkhazaleh; Abdul Razak Salleh

    2012-01-01

    We introduce the concept of generalised interval-valued fuzzy soft set and its operations and study some of their properties. We give applications of this theory in solving a decision making problem. We also introduce a similarity measure of two generalised interval-valued fuzzy soft sets and discuss its application in a medical diagnosis problem: fuzzy set; soft set; fuzzy soft set; generalised fuzzy soft set; generalised interval-valued fuzzy soft set; interval-valued fuzz...

  8. Cardiac rehabilitation in the Navy.

    Science.gov (United States)

    Bruzek-Kohler, C M; Love, V; Hendrickson, R; Branford, M; Gates, A; Telvick, C

    1994-10-01

    Cardiac rehabilitation has been effective in the management and recovery of the post-myocardial infarction population for almost 40 years. During that time, the fundamental components of rehabilitation have changed to reflect a growing complexity and number of cardiac patients. Great Lakes Naval Hospital has instituted a structured outpatient cardiac rehabilitation program. It is based on the needs of a large cardiac population with modifiable risk factors identified through quality improvement studies. Future implications and research in the area of cardiac rehabilitation include measurements of self-efficacy, long-term risk factor modification, cost effectiveness, gender-related differences, or morbidity and mortality.

  9. Targeted deletion of the 9p21 noncoding coronary artery disease risk interval in mice

    Energy Technology Data Exchange (ETDEWEB)

    Visel, Axel; Zhu, Yiwen; May, Dalit; Afzal, Veena; Gong, Elaine; Attanasio, Catia; Blow, Matthew J.; Cohen, Jonathan C.; Rubin, Edward M.; Pennacchio, Len A.

    2010-01-01

    Sequence polymorphisms in a 58kb interval on chromosome 9p21 confer a markedly increased risk for coronary artery disease (CAD), the leading cause of death worldwide 1,2. The variants have a substantial impact on the epidemiology of CAD and other life?threatening vascular conditions since nearly a quarter of Caucasians are homozygous for risk alleles. However, the risk interval is devoid of protein?coding genes and the mechanism linking the region to CAD risk has remained enigmatic. Here we show that deletion of the orthologous 70kb noncoding interval on mouse chromosome 4 affects cardiac expression of neighboring genes, as well as proliferation properties of vascular cells. Chr4delta70kb/delta70kb mice are viable, but show increased mortality both during development and as adults. Cardiac expression of two genes near the noncoding interval, Cdkn2a and Cdkn2b, is severely reduced in chr4delta70kb/delta70kb mice, indicating that distant-acting gene regulatory functions are located in the noncoding CAD risk interval. Allelespecific expression of Cdkn2b transcripts in heterozygous mice revealed that the deletion affects expression through a cis-acting mechanism. Primary cultures of chr4delta70kb/delta70kb aortic smooth muscle cells exhibited excessive proliferation and diminished senescence, a cellular phenotype consistent with accelerated CAD pathogenesis. Taken together, our results provide direct evidence that the CAD risk interval plays a pivotal role in regulation of cardiac Cdkn2a/b expression and suggest that this region affects CAD progression by altering the dynamics of vascular cell proliferation.

  10. The Fuzzy Set by Fuzzy Interval

    OpenAIRE

    Dr.Pranita Goswami

    2011-01-01

    Fuzzy set by Fuzzy interval is atriangular fuzzy number lying between the two specified limits. The limits to be not greater than 2 and less than -2 by fuzzy interval have been discussed in this paper. Through fuzzy interval we arrived at exactness which is a fuzzymeasure and fuzzy integral

  11. The Fundamental Theorems of Interval Analysis

    OpenAIRE

    van Emden, M. H.; Moa, B.

    2007-01-01

    Expressions are not functions. Confusing the two concepts or failing to define the function that is computed by an expression weakens the rigour of interval arithmetic. We give such a definition and continue with the required re-statements and proofs of the fundamental theorems of interval arithmetic and interval analysis. Revision Feb. 10, 2009: added reference to and acknowledgement of P. Taylor.

  12. An Adequate First Order Logic of Intervals

    DEFF Research Database (Denmark)

    Chaochen, Zhou; Hansen, Michael Reichhardt

    1998-01-01

    This paper introduces left and right neighbourhoods as primitive interval modalities to define other unary and binary modalities of intervals in a first order logic with interval length. A complete first order logic for the neighbourhood modalities is presented. It is demonstrated how the logic c...

  13. Consistency and Refinement for Interval Markov Chains

    DEFF Research Database (Denmark)

    Delahaye, Benoit; Larsen, Kim Guldstrand; Legay, Axel;

    2012-01-01

    Interval Markov Chains (IMC), or Markov Chains with probability intervals in the transition matrix, are the base of a classic specification theory for probabilistic systems [18]. The standard semantics of IMCs assigns to a specification the set of all Markov Chains that satisfy its interval...

  14. [Drug-induced QT interval prolongation: do we know the risks?].

    Science.gov (United States)

    Villamañán, Elena; Armada, Eduardo; Ruano, Margarita

    2015-03-15

    Sudden cardiac death is an important cause of mortality in developed countries, most of them being consequence of acute ventricular arrhythmias. These arrhythmias, in some cases, owe to QT interval prolongation. A major risk factor for this condition is the use of drugs that prolong the QT interval. In fact, in recent years, one of the most common reasons for drug withdrawal or usage restrictions has been drug induced QT interval prolongation that involves both cardiovascular and non-cardiovascular drugs. Taking into account the severity that the occurrence of such an event may have, it is important for clinicians to know the risks of these drugs in certain patients. In this review we analyze the drugs that prolong the QT interval, the risk factors that can enhance QT prolongation and the drug interactions that can increase these risks. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  15. Electrocardiographic Tpeak-Tend interval and risk of cardiovascular morbidity and mortality

    DEFF Research Database (Denmark)

    Bachmann, Troels N.; Skov, Morten W.; Rasmussen, P. V.;

    2016-01-01

    the association between these groups and the risk of the selected outcomes. RESULTS: Compared with the reference groups (104-115 ms for all-cause mortality and 98-103 ms for all other outcomes), individuals with a Tpeak-Tend interval in lead V5 ...BACKGROUND: The electrocardiographic Tpeak-Tend interval is considered a novel risk marker of cardiac arrhythmias and cardiovascular death; however, results to date have been conflicting. OBJECTIVE: The purpose of this study was to investigate the association between this interval and the risk...... of all-cause and cardiovascular mortality, atrial fibrillation, and heart failure, allowing for nonlinear relationships. METHODS: From primary care, 138,404 individuals were included and categorized into seven groups based on Tpeak-Tend interval. Cox regression models were used to describe...

  16. Automatic Identification of Systolic Time Intervals in Seismocardiogram

    Science.gov (United States)

    Shafiq, Ghufran; Tatinati, Sivanagaraja; Ang, Wei Tech; Veluvolu, Kalyana C.

    2016-11-01

    Continuous and non-invasive monitoring of hemodynamic parameters through unobtrusive wearable sensors can potentially aid in early detection of cardiac abnormalities, and provides a viable solution for long-term follow-up of patients with chronic cardiovascular diseases without disrupting the daily life activities. Electrocardiogram (ECG) and siesmocardiogram (SCG) signals can be readily acquired from light-weight electrodes and accelerometers respectively, which can be employed to derive systolic time intervals (STI). For this purpose, automated and accurate annotation of the relevant peaks in these signals is required, which is challenging due to the inter-subject morphological variability and noise prone nature of SCG signal. In this paper, an approach is proposed to automatically annotate the desired peaks in SCG signal that are related to STI by utilizing the information of peak detected in the sliding template to narrow-down the search for the desired peak in actual SCG signal. Experimental validation of this approach performed in conventional/controlled supine and realistic/challenging seated conditions, containing over 5600 heart beat cycles shows good performance and robustness of the proposed approach in noisy conditions. Automated measurement of STI in wearable configuration can provide a quantified cardiac health index for long-term monitoring of patients, elderly people at risk and health-enthusiasts.

  17. Genetic association study of QT interval highlights role for calcium signaling pathways in myocardial repolarization

    Science.gov (United States)

    Arking, Dan E.; Pulit, Sara L.; Crotti, Lia; van der Harst, Pim; Munroe, Patricia B.; Koopmann, Tamara T.; Sotoodehnia, Nona; Rossin, Elizabeth J.; Morley, Michael; Wang, Xinchen; Johnson, Andrew D.; Lundby, Alicia; Gudbjartsson, Daníel F.; Noseworthy, Peter A.; Eijgelsheim, Mark; Bradford, Yuki; Tarasov, Kirill V.; Dörr, Marcus; Müller-Nurasyid, Martina; Lahtinen, Annukka M.; Nolte, Ilja M.; Smith, Albert Vernon; Bis, Joshua C.; Isaacs, Aaron; Newhouse, Stephen J.; Evans, Daniel S.; Post, Wendy S.; Waggott, Daryl; Lyytikäinen, Leo-Pekka; Hicks, Andrew A.; Eisele, Lewin; Ellinghaus, David; Hayward, Caroline; Navarro, Pau; Ulivi, Sheila; Tanaka, Toshiko; Tester, David J.; Chatel, Stéphanie; Gustafsson, Stefan; Kumari, Meena; Morris, Richard W.; Naluai, Åsa T.; Padmanabhan, Sandosh; Kluttig, Alexander; Strohmer, Bernhard; Panayiotou, Andrie G.; Torres, Maria; Knoflach, Michael; Hubacek, Jaroslav A.; Slowikowski, Kamil; Raychaudhuri, Soumya; Kumar, Runjun D.; Harris, Tamara B.; Launer, Lenore J.; Shuldiner, Alan R.; Alonso, Alvaro; Bader, Joel S.; Ehret, Georg; Huang, Hailiang; Kao, W.H. Linda; Strait, James B.; Macfarlane, Peter W.; Brown, Morris; Caulfield, Mark J.; Samani, Nilesh J.; Kronenberg, Florian; Willeit, Johann; Smith, J. Gustav; Greiser, Karin H.; zu Schwabedissen, Henriette Meyer; Werdan, Karl; Carella, Massimo; Zelante, Leopoldo; Heckbert, Susan R.; Psaty, Bruce M.; Rotter, Jerome I.; Kolcic, Ivana; Polašek, Ozren; Wright, Alan F.; Griffin, Maura; Daly, Mark J.; Arnar, David O.; Hólm, Hilma; Thorsteinsdottir, Unnur; Denny, Joshua C.; Roden, Dan M.; Zuvich, Rebecca L.; Emilsson, Valur; Plump, Andrew S.; Larson, Martin G.; O'Donnell, Christopher J.; Yin, Xiaoyan; Bobbo, Marco; D'Adamo, Adamo P.; Iorio, Annamaria; Sinagra, Gianfranco; Carracedo, Angel; Cummings, Steven R.; Nalls, Michael A.; Jula, Antti; Kontula, Kimmo K.; Marjamaa, Annukka; Oikarinen, Lasse; Perola, Markus; Porthan, Kimmo; Erbel, Raimund; Hoffmann, Per; Jöckel, Karl-Heinz; Kälsch, Hagen; Nöthen, Markus M.; consortium, HRGEN; den Hoed, Marcel; Loos, Ruth J.F.; Thelle, Dag S.; Gieger, Christian; Meitinger, Thomas; Perz, Siegfried; Peters, Annette; Prucha, Hanna; Sinner, Moritz F.; Waldenberger, Melanie; de Boer, Rudolf A.; Franke, Lude; van der Vleuten, Pieter A.; Beckmann, Britt Maria; Martens, Eimo; Bardai, Abdennasser; Hofman, Nynke; Wilde, Arthur A.M.; Behr, Elijah R.; Dalageorgou, Chrysoula; Giudicessi, John R.; Medeiros-Domingo, Argelia; Barc, Julien; Kyndt, Florence; Probst, Vincent; Ghidoni, Alice; Insolia, Roberto; Hamilton, Robert M.; Scherer, Stephen W.; Brandimarto, Jeffrey; Margulies, Kenneth; Moravec, Christine E.; Fabiola Del, Greco M.; Fuchsberger, Christian; O'Connell, Jeffrey R.; Lee, Wai K.; Watt, Graham C.M.; Campbell, Harry; Wild, Sarah H.; El Mokhtari, Nour E.; Frey, Norbert; Asselbergs, Folkert W.; Leach, Irene Mateo; Navis, Gerjan; van den Berg, Maarten P.; van Veldhuisen, Dirk J.; Kellis, Manolis; Krijthe, Bouwe P.; Franco, Oscar H.; Hofman, Albert; Kors, Jan A.; Uitterlinden, André G.; Witteman, Jacqueline C.M.; Kedenko, Lyudmyla; Lamina, Claudia; Oostra, Ben A.; Abecasis, Gonçalo R.; Lakatta, Edward G.; Mulas, Antonella; Orrú, Marco; Schlessinger, David; Uda, Manuela; Markus, Marcello R.P.; Völker, Uwe; Snieder, Harold; Spector, Timothy D.; Ärnlöv, Johan; Lind, Lars; Sundström, Johan; Syvänen, Ann-Christine; Kivimaki, Mika; Kähönen, Mika; Mononen, Nina; Raitakari, Olli T.; Viikari, Jorma S.; Adamkova, Vera; Kiechl, Stefan; Brion, Maria; Nicolaides, Andrew N.; Paulweber, Bernhard; Haerting, Johannes; Dominiczak, Anna F.; Nyberg, Fredrik; Whincup, Peter H.; Hingorani, Aroon; Schott, Jean-Jacques; Bezzina, Connie R.; Ingelsson, Erik; Ferrucci, Luigi; Gasparini, Paolo; Wilson, James F.; Rudan, Igor; Franke, Andre; Mühleisen, Thomas W.; Pramstaller, Peter P.; Lehtimäki, Terho J.; Paterson, Andrew D.; Parsa, Afshin; Liu, Yongmei; van Duijn, Cornelia; Siscovick, David S.; Gudnason, Vilmundur; Jamshidi, Yalda; Salomaa, Veikko; Felix, Stephan B.; Sanna, Serena; Ritchie, Marylyn D.; Stricker, Bruno H.; Stefansson, Kari; Boyer, Laurie A.; Cappola, Thomas P.; Olsen, Jesper V.; Lage, Kasper; Schwartz, Peter J.; Kääb, Stefan; Chakravarti, Aravinda; Ackerman, Michael J.; Pfeufer, Arne; de Bakker, Paul I.W.; Newton-Cheh, Christopher

    2014-01-01

    The QT interval, an electrocardiographic measure reflecting myocardial repolarization, is a heritable trait. QT prolongation is a risk factor for ventricular arrhythmias and sudden cardiac death (SCD) and could indicate the presence of the potentially lethal Mendelian Long QT Syndrome (LQTS). Using a genome-wide association and replication study in up to 100,000 individuals we identified 35 common variant QT interval loci, that collectively explain ∼8-10% of QT variation and highlight the importance of calcium regulation in myocardial repolarization. Rare variant analysis of 6 novel QT loci in 298 unrelated LQTS probands identified coding variants not found in controls but of uncertain causality and therefore requiring validation. Several newly identified loci encode for proteins that physically interact with other recognized repolarization proteins. Our integration of common variant association, expression and orthogonal protein-protein interaction screens provides new insights into cardiac electrophysiology and identifies novel candidate genes for ventricular arrhythmias, LQTS,and SCD. PMID:24952745

  18. Reference intervals for transthoracic echocardiography in the English springer spaniel: a prospective, longitudinal study.

    Science.gov (United States)

    Dickson, D; Shave, R; Rishniw, M; Harris, J; Patteson, M

    2016-10-01

    To establish transthoracic echocardiographic reference intervals in adult English springer spaniel dogs. Forty-two healthy adult English springer spaniels were prospectively recruited from a general practice population in the UK. Animals were examined twice, at least 12 months apart, to exclude dogs with progressive cardiac disease. Reference intervals were calculated using Box-Cox transformations and specific variables were depicted within an expert consensus range. Relationships of body mass, age and heart rate with cardiac structure and function were examined and functional assessments were compared with previous reports. Reference intervals were compared against published ratiometric indices and allometric scaling models. Thirty-nine dogs contributed to create the reference intervals. Significant relationships with bodyweight, age and heart rate were detected, although low coefficients of determination were found. Fractional shortening values were lower than has been reported in many breeds but Simpson-derived ejection fractions were similar to previously published breed-specific values. Breed-specific reference intervals are reported allowing for more appropriate interpretation of echocardiographic assessments in the English springer spaniel. © 2016 British Small Animal Veterinary Association.

  19. A question about the potential cardiac toxicity of escitalopram.

    Science.gov (United States)

    Howland, Robert H

    2012-04-01

    Previous reviews have focused on the potential cardiac toxicity of the racemic drug citalopram (Celexa(®)). Evaluating the safety of escitalopram (Lexapro(®)) is an important issue to consider, since it is the S-enantiomer of citalopram. Escitalopram has a small effect on the QTc interval. A prolonged QTc was seen in 2% to 14% of escitalopram overdose cases, without serious cardiac sequelae. The QTc prolongation effect of citalopram in beagle dogs has been attributed to the minor metabolite racemic didemethylcitalopram (DDCT). Whether the escitalopram minor metabolite S-DDCT has this effect is not known. Concentrations of S-DDCT are lower than DDCT, but for a broad range of doses of escitalopram and citalopram, the S-DDCT and DDCT concentrations are well below the QTc prolonging concentrations reported in dogs. There is no strong evidence from human and animal studies that the cardiac safety of escitalopram is significantly superior to that of citalopram.

  20. Time delay between cardiac and brain activity during sleep transitions

    Science.gov (United States)

    Long, Xi; Arends, Johan B.; Aarts, Ronald M.; Haakma, Reinder; Fonseca, Pedro; Rolink, Jérôme

    2015-04-01

    Human sleep consists of wake, rapid-eye-movement (REM) sleep, and non-REM (NREM) sleep that includes light and deep sleep stages. This work investigated the time delay between changes of cardiac and brain activity for sleep transitions. Here, the brain activity was quantified by electroencephalographic (EEG) mean frequency and the cardiac parameters included heart rate, standard deviation of heartbeat intervals, and their low- and high-frequency spectral powers. Using a cross-correlation analysis, we found that the cardiac variations during wake-sleep and NREM sleep transitions preceded the EEG changes by 1-3 min but this was not the case for REM sleep transitions. These important findings can be further used to predict the onset and ending of some sleep stages in an early manner.

  1. QTc-prolonging drugs and hospitalizations for cardiac arrhythmias

    DEFF Research Database (Denmark)

    De Bruin, Marie L; Hoes, Arno W; Leufkens, Hubert G M

    2003-01-01

    Cardiac arrhythmia as an adverse effect of noncardiac drugs has been an issue of growing importance during the past few years. In this population-based study, we evaluated the risk for serious cardiac arrhythmias during the use of several noncardiac QTc-prolonging drugs in day-to-day practice......, and subsequently focused on several specific groups of patients who could be extremely vulnerable for drug-induced arrhythmias. We performed a case-control study in which patients (cases), hospitalized for nonatrial cardiac arrhythmias from 1987 to 1998, were compared with their matched controls regarding current...... use of QTc-prolonging drugs. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using multivariate conditional logistic regression, adjusting for potential confounding factors. Data were obtained from the PHARMO record linkage system. We identified 501 cases, 39 of whom used QTc...

  2. Effects of bilastine on T-wave morphology and the QTc interval

    DEFF Research Database (Denmark)

    Graff, Claus; Struijk, Johannes; Kanters, Jørgen K.;

    2012-01-01

    The International Conference of Harmonisation (ICH) E14 guideline for thorough QT studies requires assessing the propensity of new non-antiarrhythmic drugs to affect cardiac repolarization. The present study investigates whether a composite ECG measure of T-wave morphology (Morphology Combination...... Score [MCS]) can be used together with the heart rate corrected QT interval (QTc) in a fully ICH E14-compliant thorough QT study to exclude clinically relevant repolarization effects of bilastine, a novel antihistamine....

  3. Cardiac fusion and complex congenital cardiac defects in thoracopagus twins: diagnostic value of cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Goo, Hyun Woo [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Seoul (Korea, Republic of); Park, Jeong-Jun [University of Ulsan College of Medicine, Asan Medical Center, Department of Pediatric Cardiac Surgery, Seoul (Korea, Republic of); Kim, Ellen Ai-Rhan [University of Ulsan College of Medicine, Asan Medical Center, Division of Neonatology, Department of Pediatrics, Seoul (Korea, Republic of); Won, Hye-Sung [University of Ulsan College of Medicine, Asan Medical Center, Department of Obstetrics and Gynecology, Seoul (Korea, Republic of)

    2014-09-15

    Most thoracopagus twins present with cardiac fusion and associated congenital cardiac defects, and assessment of this anatomy is of critical importance in determining patient care and outcome. Cardiac CT with electrocardiographic triggering provides an accurate and quick morphological assessment of both intracardiac and extracardiac structures in newborns, making it the best imaging modality to assess thoracopagus twins during the neonatal period. In this case report, we highlight the diagnostic value of cardiac CT in thoracopagus twins with an interatrial channel and complex congenital cardiac defects. (orig.)

  4. Dexamethasone reduces gut permeability in pediatric cardiac surgery.

    Science.gov (United States)

    Malagon, Ignacio; Onkenhout, Willem; Klok, Margreet; Linthorst, Lisa; van der Poel, Petrus F H; Bovill, James G; Hazekamp, Mark G

    2005-08-01

    Little attention has been paid to the effect of the systemic inflammatory response syndrome on intestinal dysfunction in the postoperative period. Several proinflammatory cytokines have been reported to increase the permeability of intestinal mucosa in vitro. We investigated the effect of dexamethasone on gut permeability in pediatric patients undergoing cardiac surgery by using the dual sugar permeability test and absorption of 2 other saccharides. Thirty-four patients scheduled for cardiac surgery with cardiopulmonary bypass were prospectively randomized to either act as control subjects or to receive dexamethasone (1 mg . kg -1) during induction of anesthesia. Intestinal permeability was measured with 3-O-methyl-D-glucose, D-xylose, L-rhamnose, and lactulose administered orally after induction of anesthesia and 12 and 24 hours later. Lactulose/rhamnose ratios were increased from the outset in both groups (mean 0.57 [95% confidence interval, 0.24-0.91] for the control group and 0.76 [95% confidence interval, 0.35-1.17] for patients receiving dexamethasone). Although the ratios decreased 12 hours (0.29 [95% confidence interval, 0.17-0.42]) and 24 hours later (0.17 [95% confidence interval, 0.08-0.15]) in the dexamethasone group, in the control group there was a rise at 12 hours (0.77 [95% confidence interval, 0-1.64]), with a slight reduction 24 hours later (0.46 [95% confidence interval, 0.06-0.85]). Infants and children undergoing cardiac surgery with cardiopulmonary bypass show a significant reduction in gut permeability when dexamethasone is used during induction of anesthesia. Dexamethasone does not affect the intestinal barrier at the functional level, as assessed on the basis of 3-O-methyl-D-glucose and D-xylose absorption.

  5. Sudden Cardiac Death

    Directory of Open Access Journals (Sweden)

    Yipsy María Gutiérrez Báez

    2015-09-01

    Full Text Available Since the second half of the twentieth century, dying suddenly due to heart-related problems has become the main health issue in all countries where infectious diseases are not prevalent. Sudden death from cardiac causes is an important global health problem. Major databases were searched for the leading causes of sudden cardiac death. It has been demonstrated that there is a group of hereditary diseases with structural alterations or without apparent organic cause that explains many cases of sudden death in young people, whether related or not to physical exertion. Certain population groups are at higher risk for this disease. They are relatively easy to identify and can be the target of primary prevention measures.

  6. Cardiac nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)

    Gerson, M.C.

    1987-01-01

    The book begins with a review of the radionuclide methods available for evaluating cardiac perfusion and function. The authors discuss planar and tomographic thallium myocardial imaging, first-pass and equilibrium radionuclide angiography, and imaging with infarct-avid tracers. Several common but more specialized procedures are then reviewed: nonogemetric measurement of left ventricular volume, phase (Fourier) analysis, stroke volume ratio, right ventricular function, and diastolic function. A separate chapter is devoted to drug interventions and in particular the use of radionuclide ventriculography to monitor doxorubicin toxicity and therapy of congestive heart failure. The subsequent chapters provide a comprehensive guide to test selection, accuracy, and results in acute myocardial infarction, in postmyocardial infarction, in chronic coronary artery disease, before and after medical or surgical revascularization, in valvular heart disease, in cardiomyopathies, and in cardiac trauma.

  7. Cardiac arrest in children

    Directory of Open Access Journals (Sweden)

    Tress Erika

    2010-01-01

    Full Text Available Major advances in the field of pediatric cardiac arrest (CA were made during the last decade, starting with the publication of pediatric Utstein guidelines, the 2005 recommendations by the International Liaison Committee on Resuscitation, and culminating in multicenter collaborations. The epidemiology and pathophysiology of in-hospital and out-of-hospital CA are now well described. Four phases of CA are described and the term "post-cardiac arrest syndrome" has been proposed, along with treatment goals for each of its four phases: immediate post-arrest, early post-arrest, intermediate and recovery phase. Hypothermia is recommended to be considered as a therapy for post-CA syndrome in comatose patients after CA, and large multicenter prospective studies are underway. We reviewed landmark articles related to pediatric CA published during the last decade. We present the current knowledge of epidemiology, pathophysiology and treatment of CA relevant to pre-hospital and acute care health practitioners.

  8. Cardiac arrhythmias in pregnancy.

    Science.gov (United States)

    Knotts, Robert J; Garan, Hasan

    2014-08-01

    As more women with repaired congenital heart disease survive to their reproductive years and many other women are delaying pregnancy until later in life, a rising concern is the risk of cardiac arrhythmias during pregnancy. Naturally occurring cardiovascular changes during pregnancy increase the likelihood that a recurrence of a previously experienced cardiac arrhythmia or a de novo arrhythmia will occur. Arrhythmias should be thoroughly investigated to determine if there is a reversible etiology, and risks/benefits of treatment options should be fully explored. We discuss the approach to working up and treating various arrhythmias during pregnancy with attention to fetal and maternal risks as well as treatment of fetal arrhythmias. Acute management in stable patients includes close monitoring and intravenous pharmacologic therapy, while DC cardioversion should be used to terminate arrhythmias in hemodynamically unstable patients. Long-term management may require continued oral antiarrhythmic therapy, with particular attention to fetal safety, to prevent complications associated with arrhythmias.

  9. The Role of Cardiac Side Population Cells in Cardiac Regeneration

    Science.gov (United States)

    Yellamilli, Amritha; van Berlo, Jop H.

    2016-01-01

    The heart has a limited ability to regenerate. It is important to identify therapeutic strategies that enhance cardiac regeneration in order to replace cardiomyocytes lost during the progression of heart failure. Cardiac progenitor cells are interesting targets for new regenerative therapies because they are self-renewing, multipotent cells located in the heart. Cardiac side population cells (cSPCs), the first cardiac progenitor cells identified in the adult heart, have the ability to differentiate into cardiomyocytes, endothelial cells, smooth muscle cells, and fibroblasts. They become activated in response to cardiac injury and transplantation of cSPCs into the injured heart improves cardiac function. In this review, we will discuss the current literature on the progenitor cell properties and therapeutic potential of cSPCs. This body of work demonstrates the great promise cSPCs hold as targets for new regenerative strategies. PMID:27679798

  10. Cardiac hybrid imaging

    Energy Technology Data Exchange (ETDEWEB)

    Gaemperli, Oliver [University Hospital Zurich, Cardiac Imaging, Zurich (Switzerland); University Hospital Zurich, Nuclear Cardiology, Cardiovascular Center, Zurich (Switzerland); Kaufmann, Philipp A. [University Hospital Zurich, Cardiac Imaging, Zurich (Switzerland); Alkadhi, Hatem [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland)

    2014-05-15

    Hybrid cardiac single photon emission computed tomography (SPECT)/CT imaging allows combined assessment of anatomical and functional aspects of cardiac disease. In coronary artery disease (CAD), hybrid SPECT/CT imaging allows detection of coronary artery stenosis and myocardial perfusion abnormalities. The clinical value of hybrid imaging has been documented in several subsets of patients. In selected groups of patients, hybrid imaging improves the diagnostic accuracy to detect CAD compared to the single imaging techniques. Additionally, this approach facilitates functional interrogation of coronary stenoses and guidance with regard to revascularization procedures. Moreover, the anatomical information obtained from CT coronary angiography or coronary artery calcium scores (CACS) adds prognostic information over perfusion data from SPECT. The use of cardiac hybrid imaging has been favoured by the dissemination of dedicated hybrid systems and the release of dedicated image fusion software, which allow simple patient throughput for hybrid SPECT/CT studies. Further technological improvements such as more efficient detector technology to allow for low-radiation protocols, ultra-fast image acquisition and improved low-noise image reconstruction algorithms will be instrumental to further promote hybrid SPECT/CT in research and clinical practice. (orig.)

  11. Cardiac tissue engineering

    Directory of Open Access Journals (Sweden)

    MILICA RADISIC

    2005-03-01

    Full Text Available We hypothesized that clinically sized (1-5 mm thick,compact cardiac constructs containing physiologically high density of viable cells (~108 cells/cm3 can be engineered in vitro by using biomimetic culture systems capable of providing oxygen transport and electrical stimulation, designed to mimic those in native heart. This hypothesis was tested by culturing rat heart cells on polymer scaffolds, either with perfusion of culture medium (physiologic interstitial velocity, supplementation of perfluorocarbons, or with electrical stimulation (continuous application of biphasic pulses, 2 ms, 5 V, 1 Hz. Tissue constructs cultured without perfusion or electrical stimulation served as controls. Medium perfusion and addition of perfluorocarbons resulted in compact, thick constructs containing physiologic density of viable, electromechanically coupled cells, in contrast to control constructs which had only a ~100 mm thick peripheral region with functionally connected cells. Electrical stimulation of cultured constructs resulted in markedly improved contractile properties, increased amounts of cardiac proteins, and remarkably well developed ultrastructure (similar to that of native heart as compared to non-stimulated controls. We discuss here the state of the art of cardiac tissue engineering, in light of the biomimetic approach that reproduces in vitro some of the conditions present during normal tissue development.

  12. Molecular nuclear cardiac imaging

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Dong Soo; Paeng, Jin Chul [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    2004-04-01

    Molecular nuclear cardiac imaging has included Tc-99m Annexin imaging to visualize myocardial apoptosis, but is now usually associated with gene therapy and cell-based therapy. Cardiac gene therapy was not successful so far but cardiac reporter gene imaging was made possible using HSV-TK (herpes simplex virus thymidine kinase) and F-18 FHBG (fluoro-hydroxymethylbutyl guanine) or I-124 FIAU (fluoro-deoxyiodo-arabino-furanosyluracil). Gene delivery was performed by needle injection with or without catheter guidance. TK expression did not last longer than 2 weeks in myocardium. Cell-based therapy of ischemic heart or failing heart looks promising, but biodistribution and differentiation of transplanted cells are not known. Reporter genes can be transfected to the stem/progenitor cells and cells containing these genes can be transplanted to the recipients using catheter-based purging or injection. Repeated imaging should be available and if promoter are varied to let express reporter transgenes, cellular (trans)differentiation can be studied. NIS (sodium iodide symporter) or D2R receptor genes are promising in this aspect.

  13. Cardiac surgery 2015 reviewed.

    Science.gov (United States)

    Doenst, Torsten; Strüning, Constanze; Moschovas, Alexandros; Gonzalez-Lopez, David; Essa, Yasin; Kirov, Hristo; Diab, Mahmoud; Faerber, Gloria

    2016-10-01

    For the year 2015, almost 19,000 published references can be found in PubMed when entering the search term "cardiac surgery". The last year has been again characterized by lively discussions in the fields where classic cardiac surgery and modern interventional techniques overlap. Lacking evidence in the field of coronary revascularization with either percutaneous coronary intervention or bypass surgery has been added. As in the years before, CABG remains the gold standard for the revascularization of complex stable triple-vessel disease. Plenty of new information has been presented comparing the conventional to transcatheter aortic valve implantation (TAVI) demonstrating similar short- and mid-term outcomes at high and low risk, but even a survival advantage with transfemoral TAVI at intermediate risk. In addition, there were many relevant and interesting other contributions from the purely operative arena. This review article will summarize the most pertinent publications in the fields of coronary revascularization, surgical treatment of valve disease, heart failure (i.e., transplantation and ventricular assist devices), and aortic surgery. While the article does not have the expectation of being complete and cannot be free of individual interpretation, it provides a condensed summary that is intended to give the reader "solid ground" for up-to-date decision-making in cardiac surgery.

  14. Minimally interrupted cardiac resuscitation by emergency medical services for out-of-hospital cardiac arrest.

    Science.gov (United States)

    Bobrow, Bentley J; Clark, Lani L; Ewy, Gordon A; Chikani, Vatsal; Sanders, Arthur B; Berg, Robert A; Richman, Peter B; Kern, Karl B

    2008-03-12

    Out-of-hospital cardiac arrest is a major public health problem. To investigate whether the survival of patients with out-of-hospital cardiac arrest would improve with minimally interrupted cardiac resuscitation (MICR), an alternate emergency medical services (EMS) protocol. A prospective study of survival-to-hospital discharge between January 1, 2005, and November 22, 2007. Patients with out-of-hospital cardiac arrests in 2 metropolitan cities in Arizona before and after MICR training of fire department emergency medical personnel were assessed. In a second analysis of protocol compliance, patients from the 2 metropolitan cities and 60 additional fire departments in Arizona who actually received MICR were compared with patients who did not receive MICR but received standard advanced life support. Instruction for EMS personnel in MICR, an approach that includes an initial series of 200 uninterrupted chest compressions, rhythm analysis with a single shock, 200 immediate postshock chest compressions before pulse check or rhythm reanalysis, early administration of epinephrine, and delayed endotracheal intubation. Survival-to-hospital discharge. Among the 886 patients in the 2 metropolitan cities, survival-to-hospital discharge increased from 1.8% (4/218) before MICR training to 5.4% (36/668) after MICR training (odds ratio [OR], 3.0; 95% confidence interval [CI], 1.1-8.9). In the subgroup of 174 patients with witnessed cardiac arrest and ventricular fibrillation, survival increased from 4.7% (2/43) before MICR training to 17.6% (23/131) after MICR training (OR, 8.6; 95% CI, 1.8-42.0). In the analysis of MICR protocol compliance involving 2460 patients with cardiac arrest, survival was significantly better among patients who received MICR than those who did not (9.1% [60/661] vs 3.8% [69/1799]; OR, 2.7; 95% CI, 1.9-4.1), as well as patients with witnessed ventricular fibrillation (28.4% [40/141] vs 11.9% [46/387]; OR, 3.4; 95% CI, 2.0-5.8). Survival

  15. Cardiac assessment prior to non-cardiac surgery.

    Science.gov (United States)

    Mooney, J F; Hillis, G S; Lee, V W; Halliwell, R; Vicaretti, M; Moncrieff, C; Chow, C K

    2016-08-01

    Increasingly, patients undergoing non-cardiac surgery are older and have more comorbidities yet preoperative cardiac assessment appears haphazard and unsystematic. We hypothesised that patients at high cardiac risk were not receiving adequate cardiac assessment, and patients with low-cardiac risk were being over-investigated. To compare in a representative sample of patients undergoing non-cardiac surgery the use of cardiac investigations in patients at high and low preoperative cardiac risk. We examined cardiac assessment patterns prior to elective non-cardiac surgery in a representative sample of patients. Cardiac risk was calculated using the Revised Cardiac Risk Index. Of 671 patients, 589 (88%) were low risk and 82 (12%) were high risk. We found that nearly 14% of low-risk and 45% of high-risk patients had investigations for coronary ischaemia prior to surgery. Vascular surgery had the highest rate of investigation (38%) and thoracic patients the lowest rate (14%). Whilst 78% of high-risk patients had coronary disease, only 46% were on beta-blockers, 49% on aspirin and 77% on statins. For current smokers (17.3% of cohort, n = 98), 60% were advised to quit pre-op. Practice patterns varied across surgical sub-types with low-risk patients tending to be over-investigated and high-risk patients under-investigated. A more systemised approach to this large group of patients could improve clinical outcomes, and more judicious use of investigations could lower healthcare costs and increase efficiency in managing this cohort. © 2016 Royal Australasian College of Physicians.

  16. Intervals in evolutionary algorithms for global optimization

    Energy Technology Data Exchange (ETDEWEB)

    Patil, R.B.

    1995-05-01

    Optimization is of central concern to a number of disciplines. Interval Arithmetic methods for global optimization provide us with (guaranteed) verified results. These methods are mainly restricted to the classes of objective functions that are twice differentiable and use a simple strategy of eliminating a splitting larger regions of search space in the global optimization process. An efficient approach that combines the efficient strategy from Interval Global Optimization Methods and robustness of the Evolutionary Algorithms is proposed. In the proposed approach, search begins with randomly created interval vectors with interval widths equal to the whole domain. Before the beginning of the evolutionary process, fitness of these interval parameter vectors is defined by evaluating the objective function at the center of the initial interval vectors. In the subsequent evolutionary process the local optimization process returns an estimate of the bounds of the objective function over the interval vectors. Though these bounds may not be correct at the beginning due to large interval widths and complicated function properties, the process of reducing interval widths over time and a selection approach similar to simulated annealing helps in estimating reasonably correct bounds as the population evolves. The interval parameter vectors at these estimated bounds (local optima) are then subjected to crossover and mutation operators. This evolutionary process continues for predetermined number of generations in the search of the global optimum.

  17. AV interval optimization using pressure volume loops in dual chamber pacemaker patients with maintained systolic left ventricular function.

    Science.gov (United States)

    Eberhardt, Frank; Hanke, Thorsten; Fitschen, Joern; Heringlake, Matthias; Bode, Frank; Schunkert, Heribert; Wiegand, Uwe K H

    2012-08-01

    Atrioventricular (AV) interval optimization is often deemed too time-consuming in dual-chamber pacemaker patients with maintained LV function. Thus the majority of patients are left at their default AV interval. To quantify the magnitude of hemodynamic improvement following AV interval optimization in chronically paced dual chamber pacemaker patients. A pressure volume catheter was placed in the left ventricle of 19 patients with chronic dual chamber pacing and an ejection fraction >45 % undergoing elective coronary angiography. AV interval was varied in 10 ms steps from 80 to 300 ms, and pressure volume loops were recorded during breath hold. The average optimal AV interval was 152 ± 39 ms compared to 155 ± 8 ms for the average default AV interval (range 100-240 ms). The average improvement in stroke work following AV interval optimization was 935 ± 760 mmHg/ml (range 0-2,908; p AV interval changes the average stroke work by 207 ± 162 mmHg/ml. AV interval optimization also leads to improved systolic dyssynchrony indices (17.7 ± 7.0 vs. 19.4 ± 7.1 %; p = 0.01). The overall hemodynamic effect of AV interval optimization in patients with maintained LV function is in the same range as for patients undergoing cardiac resynchronization therapy for several parameters. The positive effect of AV interval optimization also applies to patients who have been chronically paced for years.

  18. Restricted Interval Valued Neutrosophic Sets and Restricted Interval Valued Neutrosophic Topological Spaces

    Directory of Open Access Journals (Sweden)

    Anjan Mukherjee

    2016-08-01

    Full Text Available In this paper we introduce the concept of restricted interval valued neutrosophic sets (RIVNS in short. Some basic operations and properties of RIVNS are discussed. The concept of restricted interval valued neutrosophic topology is also introduced together with restricted interval valued neutrosophic finer and restricted interval valued neutrosophic coarser topology. We also define restricted interval valued neutrosophic interior and closer of a restricted interval valued neutrosophic set. Some theorems and examples are cites. Restricted interval valued neutrosophic subspace topology is also studied.

  19. Indeterminacy of Spatiotemporal Cardiac Alternans

    CERN Document Server

    Zhao, Xiaopeng

    2007-01-01

    Cardiac alternans, a beat-to-beat alternation in action potential duration (at the cellular level) or in ECG morphology (at the whole heart level), is a marker of ventricular fibrillation, a fatal heart rhythm that kills hundreds of thousands of people in the US each year. Investigating cardiac alternans may lead to a better understanding of the mechanisms of cardiac arrhythmias and eventually better algorithms for the prediction and prevention of such dreadful diseases. In paced cardiac tissue, alternans develops under increasingly shorter pacing period. Existing experimental and theoretical studies adopt the assumption that alternans in homogeneous cardiac tissue is exclusively determined by the pacing period. In contrast, we find that, when calcium-driven alternans develops in cardiac fibers, it may take different spatiotemporal patterns depending on the pacing history. Because there coexist multiple alternans solutions for a given pacing period, the alternans pattern on a fiber becomes unpredictable. Usin...

  20. Epidural catheterization in cardiac surgery: The 2012 risk assessment

    Directory of Open Access Journals (Sweden)

    Thomas M Hemmerling

    2013-01-01

    Full Text Available Aims and Objectives: The risk assessment of epidural hematoma due to catheter placement in patients undergoing cardiac surgery is essential since its benefits have to be weighed against risks, such as the risk of paraplegia. We determined the risk of the catheter-related epidural hematoma in cardiac surgery based on the cases reported in the literature up to September 2012. Materials and Methods: We included all reported cases of epidural catheter placement for cardiac surgery in web and in literature from 1966 to September 2012. Risks of other medical and non-medical activities were retrieved from recent reviews or national statistical reports. Results: Based on our analysis the risk of catheter-related epidural hematoma is 1 in 5493 with a 95% confidence interval (CI of 1/970-1/31114. The risk of catheter-related epidural hematoma in cardiac surgery is similar to the risk in the general surgery population at 1 in 6,628 (95% CI 1/1,170-1/37,552. Conclusions: The present risk calculation does not justify not offering epidural analgesia as part of a multimodal analgesia protocol in cardiac surgery.

  1. Case report: isolated cardiac amyloidosis: an enigma unravelled.

    Science.gov (United States)

    Khalid, Umair; Awar, Omar; Verstovsek, Gordana; Cheong, Benjamin; Yellapragada, Sarvari Venkata; Jneid, Hani; Deswal, Anita; Virani, Salim S

    2015-01-01

    Amyloidosis is a rare, multisystem disease characterized by deposition of fibrils in extracellular tissue involving kidney, liver, heart, autonomic nervous system, and several other organs. This report discusses a 75-year-old male who presented with worsening dyspnea on exertion, orthopnea, and lower-extremity edema. On physical exam, he had elevated jugular venous pressure and lower-extremity edema. Electrocardiogram depicted low voltage in limb leads and a prolonged PR interval. Echocardiogram revealed left ventricular hypertrophy, severe biatrial dilatation, and restrictive filling physiology. Coronary angiography showed absence of significant epicardial coronary artery disease. On right heart catheterization, a "dip-and-plateau sign" was noted on right ventricular pressure tracings. A diagnosis of cardiac amyloidosis was considered, but a complete hematology work-up for systemic amyloidosis was negative. Cardiac magnetic resonance imaging was pursued, showing delayed gadolinium enhancement, and this ultimately led to the myocardial biopsy confirming the diagnosis of isolated cardiac amyloidosis. Further genetic analyses confirmed isolated cardiac amyloid caused by mutant transthyretin protein (Val-122-Ile). Isolated cardiac amyloidosis is an extremely rare entity, and diagnosis may be difficult despite the use of multimodality imaging. If the index of suspicion is high, then myocardial biopsy should be considered.

  2. [The QT interval: standardization, limits and interpretation].

    Science.gov (United States)

    Ouali, S; Ben Salem, H; Gribaa, R; Kacem, S; Hammas, S; Fradi, S; Neffeti, E; Remedi, F; Boughzela, E

    2012-02-01

    Despite clinical importance of ventricular repolarisation, it remains difficult to analyse. Conventionally, quantification of the electrocardiographic ventricular repolarization is usually performed with reference to axis of the T wave and QT interval duration. A variety of factors can prolong the QT interval, such as drug effects, electrolyte imbalances, and myocardial ischemia. The biggest risk with prolongation of the QT interval is the development of torsades de pointes. Commonly accepted reference ranges for the electrocardiogram (ECG) have been in use, with little change, for many years. Populations throughout the world present several differences: age, ethnic compositions, and are exposed to different environmental factors. Recent studies have reported reference data for QT interval in healthy population and have evaluated the influence of age, gender, QRS duration and heart rate on this interval. In this review, we address several issues relative to the measurement, and interpretation of QT interval and its adjustment for rate, age, gender and QRS duration.

  3. Normal range of Atlanta-dental interval

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Y. L.; Lee, S. C.; Lee, K. H.; Sung, J. H.; Joo, K. B.; Lee, S. R.; Hahm, C. K. [Hanyang University School of Medicine, Seoul (Korea, Republic of)

    1986-08-15

    The roentgenologic diagnosis of lateral subluxation of the atlanto-axial joint is very difficult because the only presentation is increase of the atlanto-dental interval. This study was carried out with 70 volunteers for normal value of atlanto-dental interval. We measured these intervals from lateral roentgenograms of cervical spine in neutral, flexion, and extension position of the neck. The results were as follows: 1. The mean value of atlanto-dental interval in all subjects was 1.54+-0.52mm in neutral, 1.59+-0.62mm in flexion, and 1.46+-0.48mm in extension position. 2. After thirty years of age the atlanto-dental interval was getting narrower according to aging. 3. In neutral and flexion positions there is no difference in atlanto-dental intervals, but in extension position it was significantly narrowed.

  4. Design of optimized Interval Arithmetic Multiplier

    Directory of Open Access Journals (Sweden)

    Rajashekar B.Shettar

    2011-07-01

    Full Text Available Many DSP and Control applications that require the user to know how various numericalerrors(uncertainty affect the result. This uncertainty is eliminated by replacing non-interval values withintervals. Since most DSPs operate in real time environments, fast processors are required to implementinterval arithmetic. The goal is to develop a platform in which Interval Arithmetic operations areperformed at the same computational speed as present day signal processors. So we have proposed thedesign and implementation of Interval Arithmetic multiplier, which operates with IEEE 754 numbers. Theproposed unit consists of a floating point CSD multiplier, Interval operation selector. This architectureimplements an algorithm which is faster than conventional algorithm of Interval multiplier . The costoverhead of the proposed unit is 30% with respect to a conventional floating point multiplier. Theperformance of proposed architecture is better than that of a conventional CSD floating-point multiplier,as it can perform both interval multiplication and floating-point multiplication as well as Intervalcomparisons

  5. Capacitated max -Batching with Interval Graph Compatibilities

    Science.gov (United States)

    Nonner, Tim

    We consider the problem of partitioning interval graphs into cliques of bounded size. Each interval has a weight, and the weight of a clique is the maximum weight of any interval in the clique. This natural graph problem can be interpreted as a batch scheduling problem. Solving a long-standing open problem, we show NP-hardness, even if the bound on the clique sizes is constant. Moreover, we give a PTAS based on a novel dynamic programming technique for this case.

  6. Increasing the Confidence in Student's $t$ Interval

    OpenAIRE

    Goutis, Constantinos; Casella, George

    1992-01-01

    The usual confidence interval, based on Student's $t$ distribution, has conditional confidence that is larger than the nominal confidence level. Although this fact is known, along with the fact that increased conditional confidence can be used to improve a confidence assertion, the confidence assertion of Student's $t$ interval has never been critically examined. We do so here, and construct a confidence estimator that allows uniformly higher confidence in the interval and is closer (than $1 ...

  7. Increasing the Confidence in Student's $t$ Interval

    OpenAIRE

    Goutis, Constantinos; Casella, George

    1992-01-01

    The usual confidence interval, based on Student's $t$ distribution, has conditional confidence that is larger than the nominal confidence level. Although this fact is known, along with the fact that increased conditional confidence can be used to improve a confidence assertion, the confidence assertion of Student's $t$ interval has never been critically examined. We do so here, and construct a confidence estimator that allows uniformly higher confidence in the interval and is closer (than $1 ...

  8. An Optimization-Based Approach to Calculate Confidence Interval on Mean Value with Interval Data

    Directory of Open Access Journals (Sweden)

    Kais Zaman

    2014-01-01

    Full Text Available In this paper, we propose a methodology for construction of confidence interval on mean values with interval data for input variable in uncertainty analysis and design optimization problems. The construction of confidence interval with interval data is known as a combinatorial optimization problem. Finding confidence bounds on the mean with interval data has been generally considered an NP hard problem, because it includes a search among the combinations of multiple values of the variables, including interval endpoints. In this paper, we present efficient algorithms based on continuous optimization to find the confidence interval on mean values with interval data. With numerical experimentation, we show that the proposed confidence bound algorithms are scalable in polynomial time with respect to increasing number of intervals. Several sets of interval data with different numbers of intervals and type of overlap are presented to demonstrate the proposed methods. As against the current practice for the design optimization with interval data that typically implements the constraints on interval variables through the computation of bounds on mean values from the sampled data, the proposed approach of construction of confidence interval enables more complete implementation of design optimization under interval uncertainty.

  9. Confidence intervals for the MMPI-2.

    Science.gov (United States)

    Munley, P H

    1991-08-01

    The confidence intervals for the Minnesota Multiphasic Personality Inventory (MMPI-2) clinical scales were investigated. Based on the clinical scale reliabilities published in the MMPI-2 manual, estimated true scores, standard errors of measurement for estimated true scores, and 95% confidence intervals centered around estimated true scores were calculated at 5-point MMPI-2 T-score intervals. The relationships between obtained T-scores, estimated true T-scores, scale reliabilities, and confidence intervals are discussed. The possible role of error measurement in defining scale high point and code types is noted.

  10. A note on the path interval distance.

    Science.gov (United States)

    Coons, Jane Ivy; Rusinko, Joseph

    2016-06-01

    The path interval distance accounts for global congruence between locally incongruent trees. We show that the path interval distance provides a lower bound for the nearest neighbor interchange distance. In contrast to the Robinson-Foulds distance, random pairs of trees are unlikely to be maximally distant from one another under the path interval distance. These features indicate that the path interval distance should play a role in phylogenomics where the comparison of trees on a fixed set of taxa is becoming increasingly important.

  11. Spectral Statistics of RR Intervals in ECG

    CERN Document Server

    Martinis, M; Knezevic, A; Crnugelj, J

    2003-01-01

    The statistical properties (fluctuations) of heartbeat intervals (RR intervals) in ECG are studied and compared with the predictions of Random Matrix Theory (RMT). It is found that heartbeat intervals only locally exhibit the fluctuation patterns (universality) predicted by the RMT. This finding shows that heartbeat dynamics is of the mixed type where regular and irregular (chaotic) regimes coexist and the Berry-Robnik theory can be applied. It is also observed that the distribution of heartbeat intervals is well described by the one-parameter Brody distribution. The parameter $\\beta $ of the Brody distribution is seen to be connected with the dynamical state of the heart.

  12. Confidence Intervals from One One Observation

    CERN Document Server

    Rodriguez, Carlos C

    2008-01-01

    Robert Machol's surprising result, that from a single observation it is possible to have finite length confidence intervals for the parameters of location-scale models, is re-produced and extended. Two previously unpublished modifications are included. First, Herbert Robbins nonparametric confidence interval is obtained. Second, I introduce a technique for obtaining confidence intervals for the scale parameter of finite length in the logarithmic metric. Keywords: Theory/Foundations , Estimation, Prior Distributions, Non-parametrics & Semi-parametrics Geometry of Inference, Confidence Intervals, Location-Scale models

  13. Case Report: Penetrating Cardiac Injury

    Directory of Open Access Journals (Sweden)

    Adem Grbolar

    2013-10-01

    Full Text Available Summary: Penetrating cardiac injurys caused by gunshots and penetrating tools have high mortality rates. The way of injury, how the cardiac area is effected and the presence of cardiac tamponadecauses mortality in different rates. However the better treatment quality of hospitals, increasingoperative techniques, and internel care unit quality has not been change during the years. Searching the literature, we want to present a 42 years old male patient whowas injured by knife and had a 1 cm skin wound on chest with cardiac tamponade. After sternotomy a 7 cm laseration was observed in heart. Cardioraphy was performed.

  14. Cardiac surgery for Kartagener syndrome.

    Science.gov (United States)

    Tkebuchava, T; von Segesser, L K; Niederhäuser, U; Bauersfeld, U; Turina, M

    1997-01-01

    Two patients (one girl, one boy) with Kartagener syndrome (situs inversus, bronchiectasis, sinusitis), despite pulmonary problems and associated congenital cardiac anomalies, were operated on at the ages of 4 years and 7 years, respectively. They had had previous palliative treatment at the age of 3 months and 1.3 years, respectively. Both postoperative periods after total correction were without significant complications. Long-term follow-up was available for 9 and 19 years, respectively, with no manifestations of heart insufficiency. Both patients are physically active, and neither requires cardiac medication. Patients with Kartagener syndrome and associated congenital cardiac anomalies can successfully undergo multiple cardiac operations with good long-term outcome.

  15. CSI cardiac prevent 2015

    Directory of Open Access Journals (Sweden)

    S Ramakrishnan

    2015-01-01

    Full Text Available The CSI Cardiac Prevent 2015 was held at Hotel Taj Palace, New Delhi, on September 25-27, 2015. The major challenge was to create interest among cardiologists and physicians on preventive cardiology, a neglected area. The theme of the conference was "Innovations in Heart Disease Prevention.′′ This conference included "CSI at WHF Roadmap Workshop, Inauguration Ceremony, scientific program, plenary sessions, Nursing/Dietician track, Industry Exhibition, Social Events," Great India blood pressure Survey, and CSI Smart Heart App. A total of 848 delegates/faculties attended this conference against a total of 1140 people registered for the meeting.

  16. Clique-width of unit interval graphs

    OpenAIRE

    Lozin, Vadim V.

    2007-01-01

    The clique-width is known to be unbounded in the class of unit interval graphs. In this paper, we show that this is a minimal hereditary class of unbounded clique-width, i.e., in every hereditary subclass of unit interval graphs the clique-width is bounded by a constant.

  17. Breastfeeding, birth intervals and child survival:

    African Journals Online (AJOL)

    short birth intervals are associated with inceased mortality rates in the ages 1-12 months, and to ... and early childhood mortality in Ethiopia is ... factors linking birth intervals and child survival ... and women in their reproductive ages. ... and 2,550 women of reproductive age. ..... to Ecological Degradation and Food Insecurity:.

  18. Bayesian credible interval construction for Poisson statistics

    Institute of Scientific and Technical Information of China (English)

    ZHU Yong-Sheng

    2008-01-01

    The construction of the Bayesian credible (confidence) interval for a Poisson observable including both the signal and background with and without systematic uncertainties is presented.Introducing the conditional probability satisfying the requirement of the background not larger than the observed events to construct the Bayesian credible interval is also discussed.A Fortran routine,BPOCI,has been developed to implement the calculation.

  19. Nonparametric confidence intervals for monotone functions

    NARCIS (Netherlands)

    Groeneboom, P.; Jongbloed, G.

    2015-01-01

    We study nonparametric isotonic confidence intervals for monotone functions. In [Ann. Statist. 29 (2001) 1699–1731], pointwise confidence intervals, based on likelihood ratio tests using the restricted and unrestricted MLE in the current status model, are introduced. We extend the method to the trea

  20. Nonparametric confidence intervals for monotone functions

    NARCIS (Netherlands)

    Groeneboom, P.; Jongbloed, G.

    2015-01-01

    We study nonparametric isotonic confidence intervals for monotone functions. In [Ann. Statist. 29 (2001) 1699–1731], pointwise confidence intervals, based on likelihood ratio tests using the restricted and unrestricted MLE in the current status model, are introduced. We extend the method to the

  1. Optimal Approximation of Quadratic Interval Functions

    Science.gov (United States)

    Koshelev, Misha; Taillibert, Patrick

    1997-01-01

    Measurements are never absolutely accurate, as a result, after each measurement, we do not get the exact value of the measured quantity; at best, we get an interval of its possible values, For dynamically changing quantities x, the additional problem is that we cannot measure them continuously; we can only measure them at certain discrete moments of time t(sub 1), t(sub 2), ... If we know that the value x(t(sub j)) at a moment t(sub j) of the last measurement was in the interval [x-(t(sub j)), x + (t(sub j))], and if we know the upper bound D on the rate with which x changes, then, for any given moment of time t, we can conclude that x(t) belongs to the interval [x-(t(sub j)) - D (t - t(sub j)), x + (t(sub j)) + D (t - t(sub j))]. This interval changes linearly with time, an is, therefore, called a linear interval function. When we process these intervals, we get an expression that is quadratic and higher order w.r.t. time t, Such "quadratic" intervals are difficult to process and therefore, it is necessary to approximate them by linear ones. In this paper, we describe an algorithm that gives the optimal approximation of quadratic interval functions by linear ones.

  2. Iyengar Yoga Increases Cardiac Parasympathetic Nervous Modulation among Healthy Yoga Practitioners

    Directory of Open Access Journals (Sweden)

    Kerstin Khattab

    2007-01-01

    Full Text Available Relaxation techniques are established in managing of cardiac patients during rehabilitation aiming to reduce future adverse cardiac events. It has been hypothesized that relaxation-training programs may significantly improve cardiac autonomic nervous tone. However, this has not been proven for all available relaxation techniques. We tested this assumption by investigating cardiac vagal modulation during yoga.We examined 11 healthy yoga practitioners (7 women and 4 men, mean age: 43 ± 11; range: 26–58 years. Each individual was subjected to training units of 90 min once a week over five successive weeks. During two sessions, they practiced a yoga program developed for cardiac patients by B.K.S. Iyengar. On three sessions, they practiced a placebo program of relaxation. On each training day they underwent ambulatory 24 h Holter monitoring. The group of yoga practitioners was compared to a matched group of healthy individuals not practicing any relaxation techniques. Parameters of heart rate variability (HRV were determined hourly by a blinded observer. Mean RR interval (interval between two R-waves of the ECG was significantly higher during the time of yoga intervention compared to placebo and to control (P < 0.001 for both. The increase in HRV parameters was significantly higher during yoga exercise than during placebo and control especially for the parameters associated with vagal tone, i.e. mean standard deviation of NN (Normal Beat to Normal Beat of the ECG intervals for all 5-min intervals (SDNNi, P < 0.001 for both and root mean square successive difference (rMSSD, P < 0.01 for both. In conclusion, relaxation by yoga training is associated with a significant increase of cardiac vagal modulation. Since this method is easy to apply with no side effects, it could be a suitable intervention in cardiac rehabilitation programs.

  3. Diagnostic interval and mortality in colorectal cancer

    DEFF Research Database (Denmark)

    Tørring, Marie Louise; Frydenberg, Morten; Hamilton, William;

    2012-01-01

    Objective To test the theory of a U-shaped association between time from the first presentation of symptoms in primary care to the diagnosis (the diagnostic interval) and mortality after diagnosis of colorectal cancer (CRC). Study Design and Setting Three population-based studies in Denmark...... presentation, the association between the length of the diagnostic interval and 5-year mortality rate after the diagnosis of CRC was the same for all three types of data: displaying a U-shaped association with decreasing and subsequently increasing mortality with longer diagnostic intervals. Conclusion Unknown...... confounding and in particular confounding by indication is likely to explain the counterintuitive findings of higher mortality among patients with very short diagnostic intervals, but cannot explain the increasing mortality with longer diagnostic intervals. The results support the theory that longer...

  4. Generation interval contraction and epidemic data analysis

    CERN Document Server

    Kenah, Eben; Robins, James M

    2008-01-01

    The generation interval is the time between the infection time of an infected person and the infection time of his or her infector. Probability density functions for generation intervals have been an important input for epidemic models and epidemic data analysis. In this paper, we specify a general stochastic SIR epidemic model and prove that the mean generation interval decreases when susceptible persons are at risk of infectious contact from multiple sources. The intuition behind this is that when a susceptible person has multiple potential infectors, there is a ``race'' to infect him or her in which only the first infectious contact leads to infection. In an epidemic, the mean generation interval contracts as the prevalence of infection increases. We call this global competition among potential infectors. When there is rapid transmission within clusters of contacts, generation interval contraction can be caused by a high local prevalence of infection even when the global prevalence is low. We call this loc...

  5. Hysteresis of electrocardiographic depolarization-repolarization intervals during dynamic physical exercise and subsequent recovery.

    Science.gov (United States)

    Lewis, M J; Short, A L

    2006-02-01

    The post-exercise electrocardiographic QT interval is shortened relative to that at similar heart rates during exercise or pre-exercise rest. This lag in QT adaptation to the recovering heart rate is described as "hysteresis". No previous studies have quantified the influence of ECG electrode placement on hysteresis following physical exercise. Six males and six females of similar age, mass and aerobic fitness undertook progressive sub-maximal bicycle exercise. A three-channel ECG was recorded continuously during pre-exercise, exercise and recovery. Beat-to-beat NN (cardiac interval) and QT(a) interval (Q wave onset to T wave apex) data were measured for each sinus heart beat. QT(a)-NN hysteresis was calculated as the difference in QT(a) magnitude at identical heart rates during the rest/exercise and post-exercise recovery periods. There were some significant (p ECG electrode placement in future investigations.

  6. Sequencing of SCN5A Identifies Rare and Common Variants Associated With Cardiac Conduction : Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium

    NARCIS (Netherlands)

    Magnani, Jared W.; Brody, Jennifer A.; Prins, Bram P.; Arking, Dan E.; Lin, Honghuang; Yin, Xiaoyan; Liu, Ching-Ti; Morrison, Alanna C.; Zhang, Feng; Spector, Tim D.; Alonso, Alvaro; Bis, Joshua C.; Heckbert, Susan R.; Lumley, Thomas; Sitlani, Colleen M.; Cupples, Adrienne; Lubitz, Steven A.; Soliman, Elsayed Z.; Pulit, Sara L.; Newton-Cheh, Christopher; O'Donnell, Christopher J.; Ellinor, Patrick T.; Benjamin, Emelia J.; Muzny, Donna M.; Gibbs, Richard A.; Santibanez, Jireh; Taylor, Herman A.; Rotter, Jerome I.; Lange, Leslie A.; Psaty, Bruce M.; Jackson, Rebecca; Rich, Stephen S.; Boerwinkle, Eric; Jamshidi, Yalda; Sotoodehnia, Nona

    2014-01-01

    Background-The cardiac sodium channel SCN5A regulates atrioventricular and ventricular conduction. Genetic variants in this gene are associated with PR and QRS intervals. We sought to characterize further the contribution of rare and common coding variation in SCN5A to cardiac conduction. Methods an

  7. Common genetic variation near the phospholamban gene is associated with cardiac repolarisation : Meta-analysis of three genome-wide association studies

    NARCIS (Netherlands)

    I.M. Nolte (Ilja); C. Wallace (Chris); S.J. Newhouse (Stephen); D. Waggott (Daryl); J. Fu (Jingyuan); N. Soranzo (Nicole); R. Gwilliam (Rhian); S. Demissie (Serkalem); I. Savelieva (Irina); D. Zheng (Dongling); C. Dalageorgou (Chrysoula); M. Farrall (Martin); N.J. Samani (Nilesh); J. Connell (John); M.J. Brown (Morris); A. Dominiczak (Anna); M. Lathrop (Mark); E. Zeggini (Eleftheria); L.V. Wain (Louise); C. Newton-Cheh (Christopher); M. Eijgelsheim (Mark); K. Rice (Kenneth); P.I.W. de Bakker (Paul); A. Pfeufer (Arne); S. Sanna (Serena); D.E. Arking (Dan); F.W. Asselbergs (Folkert); T.D. Spector (Tim); N.D. Carter (Nicholas); S. Jeffery (Steve); M. Tobin (Martin); M. Caulfield (Mark); H. Snieder (Harold); A.D. Paterson (Andrew); P. Munroe (Patricia); Y. Jamshidi (Yalda)

    2009-01-01

    textabstractTo identify loci affecting the electrocardiographic QT interval, a measure of cardiac repolarisation associated with risk of ventricular arrhythmias and sudden cardiac death, we conducted a meta-analysis of three genome-wide association studies (GWAS) including 3,558 subjects from the Tw

  8. Common Genetic Variation Near the Phospholamban Gene Is Associated with Cardiac Repolarisation : Meta-Analysis of Three Genome-Wide Association Studies

    NARCIS (Netherlands)

    Nolte, Ilja M.; Wallace, Chris; Newhouse, Stephen J.; Waggott, Daryl; Fu, Jingyuan; Soranzo, Nicole; Gwilliam, Rhian; Deloukas, Panos; Savelieva, Irina; Zheng, Dongling; Dalageorgou, Chrysoula; Farrall, Martin; Samani, Nilesh J.; Connell, John; Brown, Morris; Dominiczak, Anna; Lathrop, Mark; Zeggini, Eleftheria; Wain, Louise V.; Newton-Cheh, Christopher; Eijgelsheim, Mark; Rice, Kenneth; de Bakker, Paul I. W.; Pfeufer, Arne; Sanna, Serena; Arking, Dan E.; Asselbergs, Folkert W.; Spector, Tim D.; Carter, Nicholas D.; Jeffery, Steve; Tobin, Martin; Caulfield, Mark; Snieder, Harold; Paterson, Andrew D.; Munroe, Patricia B.; Jamshidi, Yalda

    2009-01-01

    To identify loci affecting the electrocardiographic QT interval, a measure of cardiac repolarisation associated with risk of ventricular arrhythmias and sudden cardiac death, we conducted a meta-analysis of three genome-wide association studies (GWAS) including 3,558 subjects from the TwinsUK and BR

  9. Common genetic variation near the phospholamban gene is associated with cardiac repolarisation : Meta-analysis of three genome-wide association studies

    NARCIS (Netherlands)

    I.M. Nolte (Ilja); C. Wallace (Chris); S.J. Newhouse (Stephen); D. Waggott (Daryl); J. Fu (Jingyuan); N. Soranzo (Nicole); R. Gwilliam (Rhian); S. Demissie (Serkalem); I. Savelieva (Irina); D. Zheng (Dongling); C. Dalageorgou (Chrysoula); M. Farrall (Martin); N.J. Samani (Nilesh); J. Connell (John); M.J. Brown (Morris); A. Dominiczak (Anna); M. Lathrop (Mark); E. Zeggini (Eleftheria); L.V. Wain (Louise); C. Newton-Cheh (Christopher); M. Eijgelsheim (Mark); K. Rice (Kenneth); P.I.W. de Bakker (Paul); A. Pfeufer (Arne); S. Sanna (Serena); D.E. Arking (Dan); F.W. Asselbergs (Folkert); T.D. Spector (Tim); N.D. Carter (Nicholas); S. Jeffery (Steve); M. Tobin (Martin); M. Caulfield (Mark); H. Snieder (Harold); A.D. Paterson (Andrew); P. Munroe (Patricia); Y. Jamshidi (Yalda)

    2009-01-01

    textabstractTo identify loci affecting the electrocardiographic QT interval, a measure of cardiac repolarisation associated with risk of ventricular arrhythmias and sudden cardiac death, we conducted a meta-analysis of three genome-wide association studies (GWAS) including 3,558 subjects from the

  10. Common Genetic Variation Near the Phospholamban Gene Is Associated with Cardiac Repolarisation : Meta-Analysis of Three Genome-Wide Association Studies

    NARCIS (Netherlands)

    Nolte, Ilja M.; Wallace, Chris; Newhouse, Stephen J.; Waggott, Daryl; Fu, Jingyuan; Soranzo, Nicole; Gwilliam, Rhian; Deloukas, Panos; Savelieva, Irina; Zheng, Dongling; Dalageorgou, Chrysoula; Farrall, Martin; Samani, Nilesh J.; Connell, John; Brown, Morris; Dominiczak, Anna; Lathrop, Mark; Zeggini, Eleftheria; Wain, Louise V.; Newton-Cheh, Christopher; Eijgelsheim, Mark; Rice, Kenneth; de Bakker, Paul I. W.; Pfeufer, Arne; Sanna, Serena; Arking, Dan E.; Asselbergs, Folkert W.; Spector, Tim D.; Carter, Nicholas D.; Jeffery, Steve; Tobin, Martin; Caulfield, Mark; Snieder, Harold; Paterson, Andrew D.; Munroe, Patricia B.; Jamshidi, Yalda

    2009-01-01

    To identify loci affecting the electrocardiographic QT interval, a measure of cardiac repolarisation associated with risk of ventricular arrhythmias and sudden cardiac death, we conducted a meta-analysis of three genome-wide association studies (GWAS) including 3,558 subjects from the TwinsUK and

  11. Total lymphoid irradiation and discordant cardiac xenografts

    Energy Technology Data Exchange (ETDEWEB)

    Kaplan, E.; Dresdale, A.R.; Diehl, J.T.; Katzen, N.A.; Aronovitz, M.J.; Konstam, M.A.; Payne, D.D.; Cleveland, R.J. (Tufts Univ. School of Medicine, Boston, MA (USA))

    1990-01-01

    Total lymphoid irradiation can prolong concordant cardiac xenografts. The effects of total lymphoid irradiation in a discordant xenograft model (guinea pig to rat) were studied with and without adjuvant pharmacologic immunosuppression. Inbred Lewis rats were randomly allocated to one of four groups. Group 1 (n = 6) served as a control group and rats received no immunosuppression. Group 2 (n = 5) received triple-drug therapy that consisted of intraperitoneal azathioprine (2 mg/kg), cyclosporine (20 mg/kg), and methylprednisolone (1 mg/kg) for 1 week before transplantation. Group 3 animals (n = 5) received 15 Gy of total lymphoid irradiation in 12 divided doses over a 3-week period. Group 4 (n = 6) received both triple-drug therapy and total lymphoid irradiation as described for groups 2 and 3. Complement-dependent cytotoxicity assay was performed to determine if a correlation between complement-dependent cytotoxicity and rejection-free interval existed. Rejection was defined as cessation of graft pulsation and was confirmed by histologic test results. Only groups 1 and 2 showed a difference in survival (group 1, 6.9 +/- 1.0 minutes; group 2, 14.2 +/- 2.7 minutes, p = 0.02). Although total lymphoid irradiation did decrease complement-dependent cytotoxicity, linear regression revealed no correlation between complement-dependent cytotoxicity and graft survival (coefficient of correlation, 0.30). Unlike concordant cardiac xenografts, total lymphoid irradiation with or without triple-drug therapy does not prolong graft survival.

  12. Leadership in cardiac surgery.

    Science.gov (United States)

    Rao, Christopher; Patel, Vanash; Ibrahim, Michael; Ahmed, Kamran; Wong, Kathie A; Darzi, Ara; von Segesser, Ludwig K; Athanasiou, Thanos

    2011-06-01

    Despite the efficacy of cardiac surgery, less invasive interventions with more uncertain long-term outcomes are increasingly challenging surgery as first-line treatment for several congenital, degenerative and ischemic cardiac diseases. The specialty must evolve if it is to ensure its future relevance. More importantly, it must evolve to ensure that future patients have access to treatments with proven long-term effectiveness. This cannot be achieved without dynamic leadership; however, our contention is that this is not enough. The demands of a modern surgical career and the importance of the task at hand are such that the serendipitous emergence of traditional charismatic leadership cannot be relied upon to deliver necessary change. We advocate systematic analysis and strategic leadership at a local, national and international level in four key areas: Clinical Care, Research, Education and Training, and Stakeholder Engagement. While we anticipate that exceptional individuals will continue to shape the future of our specialty, the creation of robust structures to deliver collective leadership in these key areas is of paramount importance.

  13. [Cardiac myxoma with cerebral metastases].

    Science.gov (United States)

    Bazin, A; Peruzzi, P; Baudrillard, J C; Pluot, M; Rousseaux, P

    1987-01-01

    A 56 year old woman developed multiple metastases in the cerebrum and cerebellum, four years after cardiac intervention on a left atrial myxoma. The absence of stroke is noteworthy. Multiple high density lesions with contrast enhancement were seen by CT scan, suggesting metastatic neoplasms. Histological examination confirmed the diagnosis of metastases of cardiac myxoma. Only four cases were recorded in the literature.

  14. Cardiac arrest – cardiopulmonary resuscitation

    Directory of Open Access Journals (Sweden)

    Basri Lenjani

    2014-01-01

    Conclusions: All survivors from cardiac arrest have received appropriate medical assistance within 10 min from attack, which implies that if cardiac arrest occurs near an institution health care (with an opportunity to provide the emergent health care the rate of survival is higher.

  15. Health Instruction Packages: Cardiac Anatomy.

    Science.gov (United States)

    Phillips, Gwen; And Others

    Text, illustrations, and exercises are utilized in these five learning modules to instruct nurses, students, and other health care professionals in cardiac anatomy and functions and in fundamental electrocardiographic techniques. The first module, "Cardiac Anatomy and Physiology: A Review" by Gwen Phillips, teaches the learner to draw…

  16. Health Instruction Packages: Cardiac Anatomy.

    Science.gov (United States)

    Phillips, Gwen; And Others

    Text, illustrations, and exercises are utilized in these five learning modules to instruct nurses, students, and other health care professionals in cardiac anatomy and functions and in fundamental electrocardiographic techniques. The first module, "Cardiac Anatomy and Physiology: A Review" by Gwen Phillips, teaches the learner to draw…

  17. The Danish Cardiac Rehabilitation Database

    DEFF Research Database (Denmark)

    Zwisler, Ann-Dorthe; Rossau, Henriette Knold; Nakano, Anne

    2016-01-01

    AIM OF DATABASE: The Danish Cardiac Rehabilitation Database (DHRD) aims to improve the quality of cardiac rehabilitation (CR) to the benefit of patients with coronary heart disease (CHD). STUDY POPULATION: Hospitalized patients with CHD with stenosis on coronary angiography treated with percutane...

  18. Mitochondrial biogenesis in cardiac pathophysiology.

    Science.gov (United States)

    Rimbaud, Stéphanie; Garnier, Anne; Ventura-Clapier, Renée

    2009-01-01

    Cardiac performance depends on a fine balance between the work the heart has to perform to satisfy the needs of the body and the energy that it is able to produce. Thus, energy production by oxidative metabolism, the main energy source of the cardiac muscle, has to be strictly regulated to adapt to cardiac work. Mitochondrial biogenesis is the mechanism responsible for mitochondrial component synthesis and assembly. This process controls mitochondrial content and thus correlates with energy production that, in turn, sustains cardiac contractility. Mitochondrial biogenesis should be finely controlled to match cardiac growth and cardiac work. When the heart is subjected to an increase in work in response to physiological and pathological challenges, it adapts by increasing its mass and expressing a new genetic program. In response to physiological stimuli such as endurance training, mitochondrial biogenesis seems to follow a program involving increased cardiac mass. But in the context of pathological hypertrophy, the modifications of this mechanism remain unclear. What appears clear is that mitochondrial biogenesis is altered in heart failure, and the imbalance between cardiac work demand and energy production represents a major factor in the development of heart failure.

  19. Biosynthesis of cardiac natriuretic peptides

    DEFF Research Database (Denmark)

    Goetze, Jens Peter

    2010-01-01

    . An inefficient post-translational prohormone maturation will also affect the biology of the cardiac natriuretic peptide system. This review aims at summarizing the myocardial synthesis of natriuretic peptides focusing on B-type natriuretic peptide, where new data has disclosed cardiac myocytes as highly...

  20. Cardiac Repolarization Abnormalities and Potential Evidence for Loss of Cardiac Sodium Currents on ECGs of Patients with Chagas' Heart Disease

    Science.gov (United States)

    Schlegel, T. T.; Medina, R.; Jugo, D.; Nunez, T. J.; Borrego, A.; Arellano, E.; Arenare, B.; DePalma, J. L.; Greco, E. C.; Starc, V.

    2007-01-01

    Some individuals with Chagas disease develop right precordial lead ST segment elevation in response to an ajmaline challenge test, and the prevalence of right bundle branch block (RBBB) is also high in Chagas disease. Because these same electrocardiographic abnormalities occur in the Brugada syndrome, which involves genetically defective cardiac sodium channels, acquired damage to cardiac sodium channels may also occur in Chagas disease. We studied several conventional and advanced resting 12-lead/derived Frank-lead ECG parameters in 34 patients with Chagas -related heart disease (mean age 39 14 years) and in 34 age-/gender-matched healthy controls. All ECG recordings were of 5-10 min duration, obtained in the supine position using high fidelity hardware/software (CardioSoft, Houston, TX). Even after excluding those Chagas patients who had resting BBBs, tachycardia and/or pathologic arrhythmia (n=8), significant differences remained in multiple conventional and advanced ECG parameters between the Chagas and control groups (n=26/group), especially in their respective QT interval variability indices, maximal spatial QRS-T angles and low frequency HRV powers (p=0.0006, p=0.0015 and p=0.0314 respectively). In relation to the issue of potential damage to cardiac sodium channels, the Chagas patients had: 1) greater than or equal to twice the incidence of resting ST segment elevation in leads V1-V3 (n=10/26 vs. n=5/26) and of both leftward (n=5/26 versus n=0/26) and rightward (n=7/26 versus n=3/26) QRS axis deviation than controls; 2) significantly increased filtered (40-250 Hz) QRS interval durations (92.1 8.5 versus 85.3 plus or minus 9.0 ms, p=0.022) versus controls; and 3) significantly decreased QT and especially JT interval durations versus controls (QT interval: 387.5 plus or minus 26.4 versus 408.9 plus or minus 34.6 ms, p=0.013; JT interval: 290.5 plus or minus 26.3 versus 314.8 plus or minus 31.3 ms; p=0.0029). Heart rates and Bazett-corrected QTc/JTc intervals

  1. [Chronic surplus of Japanese cardiac surgeon--ideal nurse practitioner for cardiac surgery, cardiac surgeon's attitude toward the future].

    Science.gov (United States)

    Ikegami, Hirohisa

    2014-03-01

    It is chronically surplus of doctors in the world of cardiac surgery. There are too many cardiac surgeons because cardiac surgery requires a large amount of manpower resources to provide adequate medical services. Many Japanese cardiac surgeons do not have enough opportunity to perform cardiac surgery operations, and many Japanese cardiac surgery residents do not have enough opportunity to learn cardiac surgery operations. There are physician assistants and nurse practitioners in the US. Because they provide a part of medical care to cardiac surgery patients, American cardiac surgeons can focus more energy on operative procedures. Introduction of cardiac surgery specialized nurse practitioner is essential to deliver a high quality medical service as well as to solve chronic problems that Japanese cardiac surgery has had for a long time.

  2. HCN channelopathy and cardiac electrophysiologic dysfunction in genetic and acquired rat epilepsy models.

    Science.gov (United States)

    Powell, Kim L; Jones, Nigel C; Kennard, Jeremy T; Ng, Caroline; Urmaliya, Vijay; Lau, Shannen; Tran, Adora; Zheng, Thomas; Ozturk, Ezgi; Dezsi, Gabi; Megatia, Ika; Delbridge, Lea M; Pinault, Didier; Reid, Christopher A; White, Paul J; O'Brien, Terence J

    2014-04-01

    Evidence from animal and human studies indicates that epilepsy can affect cardiac function, although the molecular basis of this remains poorly understood. Hyperpolarization-activated cyclic nucleotide-gated (HCN) channels generate pacemaker activity and modulate cellular excitability in the brain and heart, with altered expression and function associated with epilepsy and cardiomyopathies. Whether HCN expression is altered in the heart in association with epilepsy has not been investigated previously. We studied cardiac electrophysiologic properties and HCN channel subunit expression in rat models of genetic generalized epilepsy (Genetic Absence Epilepsy Rats from Strasbourg, GAERS) and acquired temporal lobe epilepsy (post-status epilepticus SE). We hypothesized that the development of epilepsy is associated with altered cardiac electrophysiologic function and altered cardiac HCN channel expression. Electrocardiography studies were recorded in vivo in rats and in vitro in isolated hearts. Cardiac HCN channel messenger RNA (mRNA) and protein expression were measured using quantitative PCR and Western blotting respectively. Cardiac electrophysiology was significantly altered in adult GAERS, with slower heart rate, shorter QRS duration, longer QTc interval, and greater standard deviation of RR intervals compared to control rats. In the post-SE model, we observed similar interictal changes in several of these parameters, and we also observed consistent and striking bradycardia associated with the onset of ictal activity. Molecular analysis demonstrated significant reductions in cardiac HCN2 mRNA and protein expression in both models, providing a molecular correlate of these electrophysiologic abnormalities. These results demonstrate that ion channelopathies and cardiac dysfunction can develop as a secondary consequence of chronic epilepsy, which may have relevance for the pathophysiology of cardiac dysfunction in patients with epilepsy. Wiley Periodicals, Inc.

  3. Heart block and prolonged Q-Tc interval following muscle relaxant reversal: a case report.

    Science.gov (United States)

    Shields, John A

    2008-02-01

    Heart block and Q-Tc interval prolongation have been reported with several agents used in anesthesia, and the US Food and Drug Administration mandates evaluation of the Q-T interval with new drugs. Drug-induced Q-T interval prolongation may precipitate life-threatening arrhythmias, is considered a precursor for torsades de pointes, and may predict cardiovascular complications. In the patient described in this article, heart block occurred and the Q-Tc interval became prolonged after muscle relaxant reversal with neostigmine; both were considered to be related to the combination of agents used in the case, as well as to other predisposing factors such as morbid obesity. The agents used that affected cardiac conduction were neostigmine, desflurane, droperidol, dolasetron, and dexmedetomidine. Although the heart block was resolved after 2 doses of atropine, prolonged P-R and Q-Tc intervals persisted into the immediate postoperative period but returned to baseline within 4 hours. Clinical implications of this report include increasing awareness of the multitude of factors affecting Q-T interval prolongation during anesthesia.

  4. Circadian rhythm in QT interval is preserved in mice deficient of potassium channel interacting protein 2

    DEFF Research Database (Denmark)

    Gottlieb, Lisa A; Lubberding, Anniek; Larsen, Anders Peter;

    2016-01-01

    Potassium Channel Interacting Protein 2 (KChIP2) is suggested to be responsible for the circadian rhythm in repolarization duration, ventricular arrhythmias, and sudden cardiac death. We investigated the hypothesis that there is no circadian rhythm in QT interval in the absence of KChIP2. Implanted...... telemetric devices recorded electrocardiogram continuously for 5 days in conscious wild-type mice (WT, n = 9) and KChIP2(-/-) mice (n = 9) in light:dark periods and in complete darkness. QT intervals were determined from all RR intervals and corrected for heart rate (QT100 = QT/(RR/100)(1/2)). Moreover, QT...... intervals were determined from complexes within the RR range of mean-RR ± 1% in the individual mouse (QTmean-RR). We find that RR intervals are 125 ± 5 ms in WT and 123 ± 4 ms in KChIP2(-/-) (p = 0.81), and QT intervals are 52 ± 1 and 52 ± 1 ms, respectively(p = 0.89). No ventricular arrhythmias or sudden...

  5. Ventricular Cycle Length Characteristics Estimative of Prolonged RR Interval during Atrial Fibrillation

    Science.gov (United States)

    CIACCIO, EDWARD J.; BIVIANO, ANGELO B.; GAMBHIR, ALOK; EINSTEIN, ANDREW J.; GARAN, HASAN

    2014-01-01

    Background When atrial fibrillation (AF) is incessant, imaging during a prolonged ventricular RR interval may improve image quality. It was hypothesized that long RR intervals could be predicted from preceding RR values. Methods From the PhysioNet database, electrocardiogram RR intervals were obtained from 74 persistent AF patients. An RR interval lengthened by at least 250 ms beyond the immediately preceding RR interval (termed T0 and T1, respectively) was considered prolonged. A two-parameter scatterplot was used to predict the occurrence of a prolonged interval T0. The scatterplot parameters were: (1) RR variability (RRv) estimated as the average second derivative from 10 previous pairs of RR differences, T13–T2, and (2) Tm–T1, the difference between Tm, the mean from T13 to T2, and T1. For each patient, scatterplots were constructed using preliminary data from the first hour. The ranges of parameters 1 and 2 were adjusted to maximize the proportion of prolonged RR intervals within range. These constraints were used for prediction of prolonged RR in test data collected during the second hour. Results The mean prolonged event was 1.0 seconds in duration. Actual prolonged events were identified with a mean positive predictive value (PPV) of 80% in the test set. PPV was >80% in 36 of 74 patients. An average of 10.8 prolonged RR intervals per 60 minutes was correctly identified. Conclusions A method was developed to predict prolonged RR intervals using two parameters and prior statistical sampling for each patient. This or similar methodology may help improve cardiac imaging in many longstanding persistent AF patients. PMID:23998759

  6. INTERVAL OBSERVER FOR A BIOLOGICAL REACTOR MODEL

    Directory of Open Access Journals (Sweden)

    T. A. Kharkovskaia

    2014-05-01

    Full Text Available The method of an interval observer design for nonlinear systems with parametric uncertainties is considered. The interval observer synthesis problem for systems with varying parameters consists in the following. If there is the uncertainty restraint for the state values of the system, limiting the initial conditions of the system and the set of admissible values for the vector of unknown parameters and inputs, the interval existence condition for the estimations of the system state variables, containing the actual state at a given time, needs to be held valid over the whole considered time segment as well. Conditions of the interval observers design for the considered class of systems are shown. They are: limitation of the input and state, the existence of a majorizing function defining the uncertainty vector for the system, Lipschitz continuity or finiteness of this function, the existence of an observer gain with the suitable Lyapunov matrix. The main condition for design of such a device is cooperativity of the interval estimation error dynamics. An individual observer gain matrix selection problem is considered. In order to ensure the property of cooperativity for interval estimation error dynamics, a static transformation of coordinates is proposed. The proposed algorithm is demonstrated by computer modeling of the biological reactor. Possible applications of these interval estimation systems are the spheres of robust control, where the presence of various types of uncertainties in the system dynamics is assumed, biotechnology and environmental systems and processes, mechatronics and robotics, etc.

  7. Circadian modulation of interval timing in mice.

    Science.gov (United States)

    Agostino, Patricia V; do Nascimento, Micaela; Bussi, Ivana L; Eguía, Manuel C; Golombek, Diego A

    2011-01-25

    Temporal perception is fundamental to environmental adaptation in humans and other animals. To deal with timing and time perception, organisms have developed multiple systems that are active over a broad range of order of magnitude, the most important being circadian timing, interval timing and millisecond timing. The circadian pacemaker is located in the suprachiasmatic nuclei (SCN) of the hypothalamus, and is driven by a self-sustaining oscillator with a period close to 24h. Time estimation in the second-to-minutes range--known as interval timing--involves the interaction of the basal ganglia and the prefrontal cortex. In this work we tested the hypothesis that interval timing in mice is sensitive to circadian modulations. Animals were trained following the peak-interval (PI) procedure. Results show significant differences in the estimation of 24-second intervals at different times of day, with a higher accuracy in the group trained at night, which were maintained under constant dark (DD) conditions. Interval timing was also studied in animals under constant light (LL) conditions, which abolish circadian rhythmicity. Mice under LL conditions were unable to acquire temporal control in the peak interval procedure. Moreover, short time estimation in animals subjected to circadian desynchronizations (modeling jet lag-like situations) was also affected. Taken together, our results indicate that short-time estimation is modulated by the circadian clock. Copyright © 2010 Elsevier B.V. All rights reserved.

  8. [Non-cardiac surgery in patients with cardiac disease].

    Science.gov (United States)

    Sellevold, Olav F Münter; Stenseth, Roar

    2010-03-25

    Patients with cardiac disease have a higher incidence of cardiovascular events after non-cardiac surgery than those without such disease. This paper provides an overview of perioperative examinations and treatment. Own experience and systematic literature search through work with European guidelines constitute the basis for recommendations given in this article. Beta-blockers should not be discontinued before surgery. High-risk patients may benefit from beta-blockers administered before major non-cardiac surgery. Slow dose titration is recommended. Echocardiography should be performed before preoperative beta-blockade to exclude latent heart failure. Statins should be considered before elective surgery and coronary intervention (stenting or surgery) before high-risk surgery. Otherwise, interventions should be evaluated irrespective of planned non-cardiac surgery. Patients with unstable coronary syndrome should only undergo non-cardiac surgery on vital indications. Neuraxial techniques are optimal for postoperative pain relief and thus for postoperative mobilization. Thromboprophylaxis is important, but increases the risk of epidural haematoma and requires systematic follow-up with respect to diagnostics and treatment. Little evidence supports the use of different anaesthetic methods in cardiac patients that undergo non-cardiac surgery than in other patients. Stable circulation, sufficient oxygenation, good pain relief, thromboprophylaxis, enteral nutrition and early mobilization are important factors for improving the perioperative course. Close cooperation between anaesthesiologist, surgeon and cardiologist improves logistics and treatment.

  9. Fast transfer of crossmodal time interval training.

    Science.gov (United States)

    Chen, Lihan; Zhou, Xiaolin

    2014-06-01

    Sub-second time perception is essential for many important sensory and perceptual tasks including speech perception, motion perception, motor coordination, and crossmodal interaction. This study investigates to what extent the ability to discriminate sub-second time intervals acquired in one sensory modality can be transferred to another modality. To this end, we used perceptual classification of visual Ternus display (Ternus in Psychol Forsch 7:81-136, 1926) to implicitly measure participants' interval perception in pre- and posttests and implemented an intra- or crossmodal sub-second interval discrimination training protocol in between the tests. The Ternus display elicited either an "element motion" or a "group motion" percept, depending on the inter-stimulus interval between the two visual frames. The training protocol required participants to explicitly compare the interval length between a pair of visual, auditory, or tactile stimuli with a standard interval or to implicitly perceive the length of visual, auditory, or tactile intervals by completing a non-temporal task (discrimination of auditory pitch or tactile intensity). Results showed that after fast explicit training of interval discrimination (about 15 min), participants improved their ability to categorize the visual apparent motion in Ternus displays, although the training benefits were mild for visual timing training. However, the benefits were absent for implicit interval training protocols. This finding suggests that the timing ability in one modality can be rapidly acquired and used to improve timing-related performance in another modality and that there may exist a central clock for sub-second temporal processing, although modality-specific perceptual properties may constrain the functioning of this clock.

  10. Magnetic Resonance Fingerprinting with short relaxation intervals.

    Science.gov (United States)

    Amthor, Thomas; Doneva, Mariya; Koken, Peter; Sommer, Karsten; Meineke, Jakob; Börnert, Peter

    2017-09-01

    The aim of this study was to investigate a technique for improving the performance of Magnetic Resonance Fingerprinting (MRF) in repetitive sampling schemes, in particular for 3D MRF acquisition, by shortening relaxation intervals between MRF pulse train repetitions. A calculation method for MRF dictionaries adapted to short relaxation intervals and non-relaxed initial spin states is presented, based on the concept of stationary fingerprints. The method is applicable to many different k-space sampling schemes in 2D and 3D. For accuracy analysis, T1 and T2 values of a phantom are determined by single-slice Cartesian MRF for different relaxation intervals and are compared with quantitative reference measurements. The relevance of slice profile effects is also investigated in this case. To further illustrate the capabilities of the method, an application to in-vivo spiral 3D MRF measurements is demonstrated. The proposed computation method enables accurate parameter estimation even for the shortest relaxation intervals, as investigated for different sampling patterns in 2D and 3D. In 2D Cartesian measurements, we achieved a scan acceleration of more than a factor of two, while maintaining acceptable accuracy: The largest T1 values of a sample set deviated from their reference values by 0.3% (longest relaxation interval) and 2.4% (shortest relaxation interval). The largest T2 values showed systematic deviations of up to 10% for all relaxation intervals, which is discussed. The influence of slice profile effects for multislice acquisition is shown to become increasingly relevant for short relaxation intervals. In 3D spiral measurements, a scan time reduction of 36% was achieved, maintaining the quality of in-vivo T1 and T2 maps. Reducing the relaxation interval between MRF sequence repetitions using stationary fingerprint dictionaries is a feasible method to improve the scan efficiency of MRF sequences. The method enables fast implementations of 3D spatially resolved

  11. Advanced Interval Management: A Benefit Analysis

    Science.gov (United States)

    Timer, Sebastian; Peters, Mark

    2016-01-01

    This document is the final report for the NASA Langley Research Center (LaRC)- sponsored task order 'Possible Benefits for Advanced Interval Management Operations.' Under this research project, Architecture Technology Corporation performed an analysis to determine the maximum potential benefit to be gained if specific Advanced Interval Management (AIM) operations were implemented in the National Airspace System (NAS). The motivation for this research is to guide NASA decision-making on which Interval Management (IM) applications offer the most potential benefit and warrant further research.

  12. Dynamics of Non-Classical Interval Exchanges

    CERN Document Server

    Gadre, Vaibhav S

    2009-01-01

    Train tracks with a single vertex are a generalization of interval exchange maps. Here, we consider non-classical interval exchanges: complete train tracks with a single vertex. These can be studied as a dynamical system by considering Rauzy induction in this context. This gives a refinement process on the parameter space similar to Kerckhoff's simplicial systems. We show that the refinement process gives an expansion that has a key dynamical property called uniform distortion. We use uniform distortion to prove normality of the expansion. Consequently we prove an analog of Keane's conjecture: almost every non-classical interval exchange is uniquely ergodic.

  13. Linear chord diagrams on two intervals

    DEFF Research Database (Denmark)

    Andersen, Jørgen Ellegaard; Penner, Robert; Reidys, Christian

    Consider all possible ways of attaching disjoint chords to two ordered and oriented disjoint intervals so as to produce a connected graph. Taking the intervals to lie in the real axis with the induced orientation and the chords to lie in the upper half plane canonically determines a corresponding...... generating function ${\\bf C}_g(z)=z^{2g}R_g(z)/(1-4z)^{3g-{1\\over 2}}$ for chords attached to a single interval is algebraic, for $g\\geq 1$, where the polynomial $R_g(z)$ with degree at most $g-1$ has integer coefficients and satisfies $R_g(1/4)\

  14. Fundamental relations between short-term RR interval and arterial pressure oscillations in humans

    Science.gov (United States)

    Taylor, J. A.; Eckberg, D. L.

    1996-01-01

    BACKGROUND: One of the principal explanations for respiratory sinus arrhythmia is that it reflects arterial baroreflex buffering of respiration-induced arterial pressure fluctuations. If this explanation is correct, then elimination of RR interval fluctuations should increase respiratory arterial pressure fluctuations. METHODS AND RESULTS: We measured RR interval and arterial pressure fluctuations during normal sinus rhythm and fixed-rate atrial pacing at 17.2+/-1.8 (SEM) beats per minute greater than the sinus rate in 16 healthy men and 4 healthy women, 20 to 34 years of age. Measurements were made during controlled-frequency breathing (15 breaths per minute or 0.25 Hz) with subjects in the supine and 40 degree head-up tilt positions. We characterized RR interval and arterial pressure variabilities in low-frequency (0.05 to 0.15 Hz) and respiratory-frequency (0.20 to 0.30 Hz) ranges with fast Fourier transform power spectra and used cross-spectral analysis to determine the phase relation between the two signals. As expected, cardiac pacing eliminated beat-to-beat RR interval variability. Against expectations, however, cardiac pacing in the supine position significantly reduced arterial pressure oscillations in the respiratory frequency (systolic, 6.8+/-1.8 to 2.9 +/-0.6 mm Hg2/Hz, P=.017). In contrast, cardiac pacing in the 40 degree tilt position increased arterial pressure variability (systolic, 8.0+/-1.8 to 10.8 +/-2.6, P=.027). Cross-spectral analysis showed that 40 degree tilt shifted the phase relation between systolic pressure and RR interval at the respiratory frequency from positive to negative (9 +/-7 degrees versus -17+/-11 degrees, P=.04); that is, in the supine position, RR interval changes appeared to lead arterial pressure changes, and in the upright position, RR interval changes appeared to follow arterial pressure changes. CONCLUSIONS: These results demonstrate that respiratory sinus arrhythmia can actually contribute to respiratory arterial

  15. Physics of Cardiac Arrhythmogenesis

    Science.gov (United States)

    Karma, Alain

    2013-04-01

    A normal heartbeat is orchestrated by the stable propagation of an excitation wave that produces an orderly contraction. In contrast, wave turbulence in the ventricles, clinically known as ventricular fibrillation (VF), stops the heart from pumping and is lethal without prompt defibrillation. I review experimental, computational, and theoretical studies that have shed light on complex dynamical phenomena linked to the initiation, maintenance, and control of wave turbulence. I first discuss advances made to understand the precursor state to a reentrant arrhythmia where the refractory period of cardiac tissue becomes spatiotemporally disordered; this is known as an arrhythmogenic tissue substrate. I describe observed patterns of transmembrane voltage and intracellular calcium signaling that can contribute to this substrate, and symmetry breaking instabilities to explain their formation. I then survey mechanisms of wave turbulence and discuss novel methods that exploit electrical pacing stimuli to control precursor patterns and low-energy pulsed electric fields to control turbulence.

  16. Cardiac potassium channel subtypes

    DEFF Research Database (Denmark)

    Schmitt, Nicole; Grunnet, Morten; Olesen, Søren-Peter

    2014-01-01

    that they could constitute targets for new pharmacological treatment of atrial fibrillation. The interplay between the different K(+) channel subtypes in both atria and ventricle is dynamic, and a significant up- and downregulation occurs in disease states such as atrial fibrillation or heart failure......About 10 distinct potassium channels in the heart are involved in shaping the action potential. Some of the K(+) channels are primarily responsible for early repolarization, whereas others drive late repolarization and still others are open throughout the cardiac cycle. Three main K(+) channels...... drive the late repolarization of the ventricle with some redundancy, and in atria this repolarization reserve is supplemented by the fairly atrial-specific KV1.5, Kir3, KCa, and K2P channels. The role of the latter two subtypes in atria is currently being clarified, and several findings indicate...

  17. Mediastinitis after cardiac transplantation

    Directory of Open Access Journals (Sweden)

    Noedir A. G. Stolf

    2000-05-01

    Full Text Available OBJECTIVE: Assessment of incidence and behavior of mediastinitis after cardiac transplantation. METHODS: From 1985 to 1999, 214 cardiac transplantations were performed, 12 (5.6% of the transplanted patients developed confirmed mediastinitis. Patient's ages ranged from 42 to 66 years (mean of 52.3±10.0 years and 10 (83.3% patients were males. Seven (58.3% patients showed sternal stability on palpation, 4 (33.3% patients had pleural empyema, and 2 (16.7% patients did not show purulent secretion draining through the wound. RESULTS: Staphylococcus aureus was the infectious agent identified in the wound secretion or in the mediastinum, or both, in 8 (66.7% patients. Staphylococcus epidermidis was identified in 2 (16.7% patients, Enterococcus faecalis in 1 (8.3% patient, and the cause of mediastinitis could not be determined in 1 (8.3% patient. Surgical treatment was performed on an emergency basis, and the extension of the débridement varied with local conditions. In 2 (16.7% patients, we chose to leave the surgical wound open and performed daily dressings with granulated sugar. Total sternal resection was performed in only 1 (8.3% patient. Out of this series, 5 (41.7% patients died, and the causes of death were related to the infection. Autopsy revealed persistence of mediastinitis in 1 (8.3% patient. CONCLUSION: Promptness in diagnosing mediastinitis and precocious surgical drainage have changed the natural evolution of this disease. Nevertheless, observance of the basic precepts of prophylaxis of infection is still the best way to treat mediastinitis.

  18. Platelets and cardiac arrhythmia

    Directory of Open Access Journals (Sweden)

    Jonas S De Jong

    2010-12-01

    Full Text Available Sudden cardiac death remains one of the most prevalent modes of death in industrialized countries, and myocardial ischemia due to thrombotic coronary occlusion is its primary cause. The role of platelets in the occurrence of SCD extends beyond coronary flow impairment by clot formation. Here we review the substances released by platelets during clot formation and their arrhythmic properties. Platelet products are released from three types of platelet granules: dense core granules, alpha-granules, and platelet lysosomes. The physiologic properties of dense granule products are of special interest as a potential source of arrhythmic substances. They are released readily upon activation and contain high concentrations of serotonin, histamine, purines, pyrimidines, and ions such as calcium and magnesium. Potential arrhythmic mechanisms of these substances, e.g. serotonin and high energy phosphates, include induction of coronary constriction, calcium overloading, and induction of delayed after-depolarizations. Alpha-granules produce thromboxanes and other arachidonic acid products with many potential arrhythmic effects mediated by interference with cardiac sodium, calcium and potassium channels. Alpha-granules also contain hundreds of proteins that could potentially serve as ligands to receptors on cardiomyocytes. Lysosomal products probably do not have an important arrhythmic effect. Platelet products and ischemia can induce coronary permeability, thereby enhancing interaction with surrounding cardiomyocytes. Antiplatelet therapy is known to improve survival after myocardial infarction. Although an important part of this effect results from prevention of coronary clot formation, there is evidence to suggest that antiplatelet therapy also induces anti-arrhythmic effects during ischemia by preventing the release of platelet activation products.

  19. Finite Element Model of Cardiac Electrical Conduction.

    Science.gov (United States)

    Yin, John Zhihao

    1994-01-01

    In this thesis, we develop mathematical models to study electrical conduction of the heart. One important pattern of wave propagation of electrical excitation in the heart is reentry which is believed to be the underlying mechanism of some dangerous cardiac arhythmias such as ventricular tachycardia and ventricular fibrillation. We present in this thesis a new ionic channel model of the ventricular cardiac cell membrane to study the microscopic electrical properties of myocardium. We base our model on recent single channel experiment data and a simple physical diffusion model of the calcium channel. Our ionic channel model of myocardium has simpler differential equations and fewer parameters than previous models. Further more, our ionic channel model achieves better results in simulating the strength-interval curve when we connect the membrane patch model to form a one dimensional cardiac muscle strand. We go on to study a finite element model which uses multiple states and non-nearest neighbor interactions to include curvature and dispersion effects. We create a generalized lattice randomization to overcome the artifacts generated by the interaction between the local dynamics and the regularities of the square lattice. We show that the homogeneous model does not display spontaneous wavefront breakup in a reentrant wave propagation once the lattice artifacts have been smoothed out by lattice randomization with a randomization scale larger than the characteristic length of the interaction. We further develop a finite 3-D 3-state heart model which employs a probability interaction rule. This model is applied to the simulation of Body Surface Laplacian Mapping (BSLM) using a cylindrical volume conductor as the torso model. We show that BSLM has a higher spatial resolution than conventional mapping methods in revealing the underlying electrical activities of the heart. The results of these studies demonstrate that mathematical modeling and computer simulation are very

  20. Combination of structural reliability and interval analysis

    Institute of Scientific and Technical Information of China (English)

    Zhiping Qiu; Di Yang; saac Elishakoff

    2008-01-01

    In engineering applications,probabilistic reliability theory appears to be presently the most important method,however,in many cases precise probabilistic reliability theory cannot be considered as adequate and credible model of the real state of actual affairs.In this paper,we developed a hybrid of probabilistic and non-probabilistic reliability theory,which describes the structural uncertain parameters as interval variables when statistical data are found insufficient.By using the interval analysis,a new method for calculating the interval of the structural reliability as well as the reliability index is introduced in this paper,and the traditional probabilistic theory is incorporated with the interval analysis.Moreover,the new method preserves the useful part of the traditional probabilistic reliability theory,but removes the restriction of its strict requirement on data acquisition.Example is presented to demonstrate the feasibility and validity of the proposed theory.

  1. Application of Interval Analysis to Error Control.

    Science.gov (United States)

    1976-09-01

    We give simple examples of ways in which interval arithmetic can be used to alert instabilities in computer algorithms , roundoff error accumulation, and even the effects of hardware inadequacies. This paper is primarily tutorial. (Author)

  2. Classifying and ranking DMUs in interval DEA

    Institute of Scientific and Technical Information of China (English)

    GUO Jun-peng; WU Yu-hua; LI Wen-hua

    2005-01-01

    During efficiency evaluating by DEA, the inputs and outputs of DMUs may be intervals because of insufficient information or measure error. For this reason, interval DEA is proposed. To make the efficiency scores more discriminative, this paper builds an Interval Modified DEA (IMDEA) model based on MDEA.Furthermore, models of obtaining upper and lower bounds of the efficiency scores for each DMU are set up.Based on this, the DMUs are classified into three types. Next, a new order relation between intervals which can express the DM' s preference to the three types is proposed. As a result, a full and more eonvietive ranking is made on all the DMUs. Finally an example is given.

  3. Conditional prediction intervals of wind power generation

    DEFF Research Database (Denmark)

    Pinson, Pierre; Kariniotakis, Georges

    2010-01-01

    A generic method for the providing of prediction intervals of wind power generation is described. Prediction intervals complement the more common wind power point forecasts, by giving a range of potential outcomes for a given probability, their so-called nominal coverage rate. Ideally they inform...... on the characteristics of prediction errors for providing conditional interval forecasts. By simultaneously generating prediction intervals with various nominal coverage rates, one obtains full predictive distributions of wind generation. Adapted resampling is applied here to the case of an onshore Danish wind farm......, for which three point forecasting methods are considered as input. The probabilistic forecasts generated are evaluated based on their reliability and sharpness, while compared to forecasts based on quantile regression and the climatology benchmark. The operational application of adapted resampling...

  4. Trends in Cardiac Pacemaker Batteries

    Directory of Open Access Journals (Sweden)

    Venkateswara Sarma Mallela

    2004-10-01

    Full Text Available Batteries used in Implantable cardiac pacemakers-present unique challenges to their developers and manufacturers in terms of high levels of safety and reliability. In addition, the batteries must have longevity to avoid frequent replacements. Technological advances in leads/electrodes have reduced energy requirements by two orders of magnitude. Micro-electronics advances sharply reduce internal current drain concurrently decreasing size and increasing functionality, reliability, and longevity. It is reported that about 600,000 pacemakers are implanted each year worldwide and the total number of people with various types of implanted pacemaker has already crossed 3 million. A cardiac pacemaker uses half of its battery power for cardiac stimulation and the other half for housekeeping tasks such as monitoring and data logging. The first implanted cardiac pacemaker used nickel-cadmium rechargeable battery, later on zinc-mercury battery was developed and used which lasted for over 2 years. Lithium iodine battery invented and used by Wilson Greatbatch and his team in 1972 made the real impact to implantable cardiac pacemakers. This battery lasts for about 10 years and even today is the power source for many manufacturers of cardiac pacemakers. This paper briefly reviews various developments of battery technologies since the inception of cardiac pacemaker and presents the alternative to lithium iodine battery for the near future.

  5. Haematological Reference Intervals in a Multiethnic Population

    OpenAIRE

    Angeli Ambayya; Anselm Ting Su; Nadila Haryani Osman; Nik Rosnita Nik-Samsudin; Khadijah Khalid; Kian Meng Chang; Jameela Sathar; Jay Suriar Rajasuriar; Subramanian Yegappan

    2014-01-01

    INTRODUCTION: Similar to other populations, full blood count reference (FBC) intervals in Malaysia are generally derived from non-Malaysian subjects. However, numerous studies have shown significant differences between and within populations supporting the need for population specific intervals. METHODS: Two thousand seven hundred twenty five apparently healthy adults comprising all ages, both genders and three principal races were recruited through voluntary participation. FBC was performed ...

  6. Conditional prediction intervals of wind power generation

    OpenAIRE

    Pinson, Pierre; Kariniotakis, Georges

    2010-01-01

    A generic method for the providing of prediction intervals of wind power generation is described. Prediction intervals complement the more common wind power point forecasts, by giving a range of potential outcomes for a given probability, their so-called nominal coverage rate. Ideally they inform of the situation-specific uncertainty of point forecasts. In order to avoid a restrictive assumption on the shape of forecast error distributions, focus is given to an empirical and nonparametric app...

  7. Optimal prediction intervals of wind power generation

    OpenAIRE

    Wan, Can; Wu, Zhao; Pinson, Pierre; Dong, Zhao Yang; Wong, Kit Po

    2014-01-01

    Accurate and reliable wind power forecasting is essential to power system operation. Given significant uncertainties involved in wind generation, probabilistic interval forecasting provides a unique solution to estimate and quantify the potential impacts and risks facing system operation with wind penetration beforehand. This paper proposes a novel hybrid intelligent algorithm approach to directly formulate optimal prediction intervals of wind power generation based on extreme learning machin...

  8. Better Confidence Intervals for Importance Sampling

    OpenAIRE

    HALIS SAK; WOLFGANG HÖRMANN; JOSEF LEYDOLD

    2010-01-01

    It is well known that for highly skewed distributions the standard method of using the t statistic for the confidence interval of the mean does not give robust results. This is an important problem for importance sampling (IS) as its final distribution is often skewed due to a heavy tailed weight distribution. In this paper, we first explain Hall's transformation and its variants to correct the confidence interval of the mean and then evaluate the performance of these methods for two numerica...

  9. Surveillance intervals for small abdominal aortic aneurysms

    DEFF Research Database (Denmark)

    Bown, Matthew J; Sweeting, Michael J; Brown, Louise C

    2013-01-01

    Small abdominal aortic aneurysms (AAAs [3.0 cm-5.4 cm in diameter]) are monitored by ultrasound surveillance. The intervals between surveillance scans should be chosen to detect an expanding aneurysm prior to rupture.......Small abdominal aortic aneurysms (AAAs [3.0 cm-5.4 cm in diameter]) are monitored by ultrasound surveillance. The intervals between surveillance scans should be chosen to detect an expanding aneurysm prior to rupture....

  10. Fetal cardiac rhabdomyoma: case report

    Directory of Open Access Journals (Sweden)

    Seyed Mostafa Ghavami

    2016-07-01

    Full Text Available Background: The primary manifestation of cardiac tumors in embryonic period is a very rare condition. Cardiac rhabdomyomas most frequently arise in the ventricular myocardium, they may also occur in the atria and the epicardial surface. In spite of its benign nature, the critical location of the tumor inside the heart can lead to lethal arrhythmias and chamber obstruction. Multiple rhabdomyomas are strongly associated with tuberous sclerosis which is associated with mental retardation and epilepsy of variable severity. Ultrasonography as a part of routine prenatal screening, is the best method for the diagnosis of cardiac rhabdomyomas. In the review of articles published in Iran, fetal cardiac rhabdomyoma was not reported. Case presentation: We report a case of cardiac rhabdomyoma on a 24-year-old gravid 1, referred to Day Medical Imaging Center for routine evaluation of fetal abnormalities at 31 weeks of her gestational age. Ultrasonographic examination displayed a homogenous echogenic mass (13×9mm, originating from the left ventricle of the fetal heart. It was a normal pregnancy without any specific complications. Other organs of the fetus were found normal and no cardiac abnormalities were appeared. No Pericardial fluid effusion was found. The parents did not have consanguineous marriage. They did not also have any specific disease such as tuberous sclerosis. Conclusion: The clinical features of cardiac rhabdomyomas vary widely, depending on the location, size, and number of tumors in the heart. Although cardiac rhabdomyoma is a benign tumor in many affected fetuses, an early prenatal diagnosis of the tumor is of great significance in making efficient planning and providing adequate follow up visits of the patients and the complications such as, heart failure and outlet obstruction of cardiac chambers.

  11. Metoclopramide-induced cardiac arrest

    Directory of Open Access Journals (Sweden)

    Martha M. Rumore

    2011-11-01

    Full Text Available The authors report a case of cardiac arrest in a patient receiving intravenous (IV metoclopramide and review the pertinent literature. A 62-year-old morbidly obese female admitted for a gastric sleeve procedure, developed cardiac arrest within one minute of receiving metoclopramide 10 mg via slow intravenous (IV injection. Bradycardia at 4 beats/min immediately appeared, progressing rapidly to asystole. Chest compressions restored vital function. Electrocardiogram (ECG revealed ST depression indicative of myocardial injury. Following intubation, the patient was transferred to the intensive care unit. Various cardiac dysrrhythmias including supraventricular tachycardia (SVT associated with hypertension and atrial fibrillation occurred. Following IV esmolol and metoprolol, the patient reverted to normal sinus rhythm. Repeat ECGs revealed ST depression resolution without pre-admission changes. Metoclopramide is a non-specific dopamine receptor antagonist. Seven cases of cardiac arrest and one of sinus arrest with metoclopramide were found in the literature. The metoclopramide prescribing information does not list precautions or adverse drug reactions (ADRs related to cardiac arrest. The reaction is not dose related but may relate to the IV administration route. Coronary artery disease was the sole risk factor identified. According to Naranjo, the association was possible. Other reports of cardiac arrest, severe bradycardia, and SVT were reviewed. In one case, five separate IV doses of 10 mg metoclopramide were immediately followed by asystole repeatedly. The mechanism(s underlying metoclopramide’s cardiac arrest-inducing effects is unknown. Structural similarities to procainamide may play a role. In view of eight previous cases of cardiac arrest from metoclopramide having been reported, further elucidation of this ADR and patient monitoring is needed. Our report should alert clinicians to monitor patients and remain diligent in surveillance and

  12. Linear Feedback Analysis of Cardiovascular System using Seismocardiogram

    Directory of Open Access Journals (Sweden)

    Marcel Jiřina

    2005-01-01

    Full Text Available The paper deals with an analysis of relationship between heart rate described by a sequence of cardiac interbeat intervals and mechanical activity of heart represented by a sequence of systolic forces. Both the quantities were determined from seismocardiograms recorded from healthy subjects under two different experimental conditions. The method of the linear feedback baroreflex approach originally developed in [1], [2] and [3] was applied for the analysis. Different character of obtained results in comparison to those described in [1], [2] or [3], is explained by differences between frequency properties of the recorded sequences of the systolic forces and values of systolic blood pressure.

  13. Fractal mechanisms in the electrophysiology of the heart

    Science.gov (United States)

    Goldberger, A. L.

    1992-01-01

    The mathematical concept of fractals provides insights into complex anatomic branching structures that lack a characteristic (single) length scale, and certain complex physiologic processes, such as heart rate regulation, that lack a single time scale. Heart rate control is perturbed by alterations in neuro-autonomic function in a number of important clinical syndromes, including sudden cardiac death, congestive failure, cocaine intoxication, fetal distress, space sickness and physiologic aging. These conditions are associated with a loss of the normal fractal complexity of interbeat interval dynamics. Such changes, which may not be detectable using conventional statistics, can be quantified using new methods derived from "chaos theory.".

  14. Interval Size and Affect: An Ethnomusicological Perspective

    Directory of Open Access Journals (Sweden)

    Sarha Moore

    2013-08-01

    Full Text Available This commentary addresses Huron and Davis's question of whether "The Harmonic Minor Provides an Optimum Way of Reducing Average Melodic Interval Size, Consistent with Sad Affect Cues" within any non-Western musical cultures. The harmonic minor scale and other semitone-heavy scales, such as Bhairav raga and Hicaz makam, are featured widely in the musical cultures of North India and the Middle East. Do melodies from these genres also have a preponderance of semitone intervals and low incidence of the augmented second interval, as in Huron and Davis's sample? Does the presence of more semitone intervals in a melody affect its emotional connotations in different cultural settings? Are all semitone intervals equal in their effect? My own ethnographic research within these cultures reveals comparable connotations in melodies that linger on semitone intervals, centered on concepts of tension and metaphors of falling. However, across different musical cultures there may also be neutral or lively interpretations of these same pitch sets, dependent on context, manner of performance, and tradition. Small pitch movement may also be associated with social functions such as prayer or lullabies, and may not be described as "sad." "Sad," moreover may not connote the same affect cross-culturally.

  15. Interval Finite Element Analysis of Wing Flutter

    Institute of Scientific and Technical Information of China (English)

    Wang Xiaojun; Qiu Zhiping

    2008-01-01

    The influences of uncertainties in structural parameters on the flutter speed of wing are studied. On the basis of the deterministic flutter analysis model of wing, the uncertainties in structural parameters are considered and described by interval numbers. By virtue of first-order Taylor series expansion, the lower and upper bound curves of the transient decay rate coefficient versus wind velocity are given. So the interval estimation of the flutter critical wind speed of wing can be obtained, which is more reasonable than the point esti- mation obtained by the deterministic flutter analysis and provides the basis for the further non-probabilistic interval reliability analysis of wing flutter. The flow chart for interval finite element model of flutter analysis of wing is given. The proposed interval finite element model and the stochastic finite element model for wing flutter analysis are compared by the examples of a three degrees of freedorn airfoil and fuselage and a 15° swepthack wing, and the results have shown the effectiveness and feasibility of the presented model. The prominent advantage of the proposed interval finite element model is that only the bounds of uncertain parameters axe required, and the probabilistic distribution densities or other statistical characteristics are not needed.

  16. Recurrence interval analysis of trading volumes.

    Science.gov (United States)

    Ren, Fei; Zhou, Wei-Xing

    2010-06-01

    We study the statistical properties of the recurrence intervals τ between successive trading volumes exceeding a certain threshold q. The recurrence interval analysis is carried out for the 20 liquid Chinese stocks covering a period from January 2000 to May 2009, and two Chinese indices from January 2003 to April 2009. Similar to the recurrence interval distribution of the price returns, the tail of the recurrence interval distribution of the trading volumes follows a power-law scaling, and the results are verified by the goodness-of-fit tests using the Kolmogorov-Smirnov (KS) statistic, the weighted KS statistic and the Cramér-von Mises criterion. The measurements of the conditional probability distribution and the detrended fluctuation function show that both short-term and long-term memory effects exist in the recurrence intervals between trading volumes. We further study the relationship between trading volumes and price returns based on the recurrence interval analysis method. It is found that large trading volumes are more likely to occur following large price returns, and the comovement between trading volumes and price returns is more pronounced for large trading volumes.

  17. Acupuncture therapy related cardiac injury.

    Science.gov (United States)

    Li, Xue-feng; Wang, Xian

    2013-12-01

    Cardiac injury is the most serious adverse event in acupuncture therapy. The causes include needling chest points near the heart, the cardiac enlargement and pericardial effusion that will enlarge the projected area on the body surface and make the proper depth of needling shorter, and the incorrect needling method of the points. Therefore, acupuncture practitioners must be familiar with the points of the heart projected area on the chest and the correct needling methods in order to reduce the risk of acupuncture therapy related cardiac injury.

  18. Cardiac Involvement in Ankylosing Spondylitis

    Science.gov (United States)

    Ozkan, Yasemin

    2016-01-01

    Ankylosing spondylitis is one of the subgroup of diseases called “seronegative spondyloarthropathy”. Frequently, it affects the vertebral colon and sacroiliac joint primarily and affects the peripheral joints less often. This chronic, inflammatory and rheumatic disease can also affect the extraarticular regions of the body. The extraarticular affections can be ophthalmologic, cardiac, pulmonary or neurologic. The cardiac affection can be 2-10% in all patients. Cardiac complications such as left ventricular dysfunction, aortitis, aortic regurgitation, pericarditis and cardiomegaly are reviewed. PMID:27222669

  19. Epigenetic regulation in cardiac fibrosis

    Institute of Scientific and Technical Information of China (English)

    Li-Ming; Yu; Yong; Xu

    2015-01-01

    Cardiac fibrosis represents an adoptive response in the heart exposed to various stress cues. While resolution of the fibrogenic response heralds normalization of heart function, persistent fibrogenesis is usually associated with progressive loss of heart function and eventually heart failure. Cardiac fibrosis is regulated by a myriad of factors that converge on the transcription of genes encoding extracellular matrix proteins, a process the epigenetic machinery plays a pivotal role. In this minireview, we summarize recent advances regarding the epigenetic regulation of cardiac fibrosis focusing on the role of histone and DNA modifications and non-coding RNAs.

  20. Electrocardiography as an early cardiac screening test in children with mitochondrial disease

    Directory of Open Access Journals (Sweden)

    Ran Baik

    2010-05-01

    Full Text Available Purpose : To evaluate myocardial conductivity to understand cardiac involvement in patients with mitochondrial disease. Methods : We performed retrospective study on fifty-seven nonspecific mitochondrial encephalopathy patients with no clinical cardiac manifestations. The patients were diagnosed with mitochondrial respiratory chain complex defects through biochemical enzyme assays of muscle tissue. We performed standard 12-lead electrocardiography (ECG on all patients. Results : ECG abnormalities were observed in 30 patients (52.6%. Prolongation of the QTc interval (&gt;440 ms was seen in 19 patients (33.3%, widening of the corrected QRS interval in 15 (26.3%, and bundle branch block in four (7.0%. Atrioventricular block, premature atrial contraction and premature ventricular contraction were seen in two patients each (3.5% and Wolff-Parkinson-White syndrome in one patient (1.8%. Conclusion : Given this finding, we recommend active screening with ECG in patients with mitochondrial disease even in patients without obvious cardiac manifestation.

  1. Delayed cardiac tamponade in a patient with previous minor blunt chest trauma

    NARCIS (Netherlands)

    Hermens, Jeannine A.J.M.; Wajon, Elly M.C.J.; Grandjean, Jan G.; Haalebos, Max M.P.; Birgelen, von Clemens

    2009-01-01

    Hemopericardium with cardiac tamponade after non-penetrating chest trauma is a very rare but life-threatening condition. If this complication develops after an interval of several weeks following the non-penetrating chest trauma, the causal relation with the traumatic event is less evident, which ma

  2. Delayed cardiac tamponade in a patient with previous minor blunt chest trauma

    NARCIS (Netherlands)

    Hermens, Jeannine A.J.M.; Wajon, Elly M.C.J.; Grandjean, Jan G; Grandjean, Jan G.; Haalebos, Max M.P.; von Birgelen, Clemens

    2009-01-01

    Hemopericardium with cardiac tamponade after non-penetrating chest trauma is a very rare but life-threatening condition. If this complication develops after an interval of several weeks following the non-penetrating chest trauma, the causal relation with the traumatic event is less evident, which

  3. Cardiac Function in Long-Term Survivors of Childhood Lymphoma

    Directory of Open Access Journals (Sweden)

    Mark K. Friedberg

    2011-01-01

    Full Text Available Objectives. We studied long-term effects of therapy for childhood lymphoma on cardiac function. Design and patients. We prospectively evaluated 45 survivors of childhood lymphoma, using clinical parameters, electrocardiography and echocardiography. Further comparisons were made between lymphoma subgroups and between males and females. Results. Mean age at diagnosis was 9.1 years. Mean followup duration was 10.9 years. The NYHA functional class was I in 43 patients and II in 2 patients. A prolonged QTc interval (>0.44 msec was found in 8 patients. Left ventricular (LV systolic function and compliance were normal (LV shortening fraction 40±5.6%; cardiac index 2.84±1.13 L/min/m2; E/A wave ratio 2.5±1.3; mean ± S.D., LV mass was normal (97±40 grams/m2, mean ± S.D.. Mitral regurgitation was observed in 7/45 patients (16%. Asymptomatic pericardial effusions were found in 3/45 (7% patients. Conclusions. Long-term follow-up shows that most parameters of cardiac function are normal in survivors of childhood lymphoma. This is likely due to relatively low doses of anthracyclines in modern protocol modalities. Abnormalities in mitral valve flow, QTc prolongation and in a small proportion of survivors, and functional capacity necessitate long-term cardiac follow-up of these patients.

  4. Normal cardiac function in mice with supraphysiological cardiac creatine levels.

    Science.gov (United States)

    Santacruz, Lucia; Hernandez, Alejandro; Nienaber, Jeffrey; Mishra, Rajashree; Pinilla, Miguel; Burchette, James; Mao, Lan; Rockman, Howard A; Jacobs, Danny O

    2014-02-01

    Creatine and phosphocreatine levels are decreased in heart failure, and reductions in myocellular phosphocreatine levels predict the severity of the disease and portend adverse outcomes. Previous studies of transgenic mouse models with increased creatine content higher than two times baseline showed the development of heart failure and shortened lifespan. Given phosphocreatine's role in buffering ATP content, we tested the hypothesis whether elevated cardiac creatine content would alter cardiac function under normal physiological conditions. Here, we report the creation of transgenic mice that overexpress the human creatine transporter (CrT) in cardiac muscle under the control of the α-myosin heavy chain promoter. Cardiac transgene expression was quantified by qRT-PCR, and human CrT protein expression was documented on Western blots and immunohistochemistry using a specific anti-CrT antibody. High-energy phosphate metabolites and cardiac function were measured in transgenic animals and compared with age-matched, wild-type controls. Adult transgenic animals showed increases of 5.7- and 4.7-fold in the content of creatine and free ADP, respectively. Phosphocreatine and ATP levels were two times as high in young transgenic animals but declined to control levels by the time the animals reached 8 wk of age. Transgenic mice appeared to be healthy and had normal life spans. Cardiac morphometry, conscious echocardiography, and pressure-volume loop studies demonstrated mild hypertrophy but normal function. Based on our characterization of the human CrT protein expression, creatine and phosphocreatine content, and cardiac morphometry and function, these transgenic mice provide an in vivo model for examining the therapeutic value of elevated creatine content for cardiac pathologies.

  5. High-intensity interval training in patients with coronary heart disease: Prescription models and perspectives.

    Science.gov (United States)

    Ribeiro, Paula A B; Boidin, Maxime; Juneau, Martin; Nigam, Anil; Gayda, Mathieu

    2017-01-01

    Recently, high-intensity interval training (HIIT) has emerged as an alternative and/or complementary exercise modality to continuous aerobic exercise training (CAET) in CHD patients. However, the literature contains descriptions of many HIIT protocols with different stage durations, nature of recovery and intensities. In this review, we discuss the most recent forms of validated HIIT protocols in patients with coronary heart disease (CHD) and how to prescribe and use them during short- and long-term (phase II and III) cardiac rehabilitation programs. We also compare the superior and/or equivalent short- and long-term effects of HIIT versus CAET on aerobic fitness, cardiovascular function, and quality of life; their efficiency, safety, and tolerance; and exercise adherence. Short interval HIIT was found beneficial for CHD patients with lower aerobic fitness and would ideally be used in initiation and improvement stages. Medium and/or long interval HIIT protocols may be beneficial for CHD patients with higher aerobic fitness, and would be ideally used in the improvement and maintenance stages because of their high physiological stimulus. Finally, we propose progressive individualized models of HIIT programs (phase II to III) for patients with CHD and how to ideally use them according to the clinical status of patients and phase of the cardiac rehabilitation program.

  6. Uremic retention solute indoxyl sulfate level is associated with prolonged QTc interval in early CKD patients.

    Science.gov (United States)

    Tang, Wei-Hua; Wang, Chao-Ping; Chung, Fu-Mei; Huang, Lynn L H; Yu, Teng-Hung; Hung, Wei-Chin; Lu, Li-Fen; Chen, Po-Yuan; Luo, Ching-Hsing; Lee, Kun-Tai; Lee, Yau-Jiunn; Lai, Wen-Ter

    2015-01-01

    Total mortality and sudden cardiac death is highly prevalent in patients with chronic kidney disease (CKD). In CKD patients, the protein-bound uremic retention solute indoxyl sulfate (IS) is independently associated with cardiovascular disease. However, the underlying mechanisms of this association have yet to be elucidated. The relationship between IS and cardiac electrocardiographic parameters was investigated in a prospective observational study among early CKD patients. IS arrhythmogenic effect was evaluated by in vitro cardiomyocyte electrophysiological study and mathematical computer simulation. In a cohort of 100 early CKD patients, patients with corrected QT (QTc) prolongation had higher IS levels. Furthermore, serum IS level was independently associated with prolonged QTc interval. In vitro, the delay rectifier potassium current (IK) was found to be significantly decreased after the treatment of IS in a dose-dependent manner. The modulation of IS to the IK was through the regulation of the major potassium ion channel protein Kv 2.1 phosphorylation. In a computer simulation, the decrease of IK by IS could prolong the action potential duration (APD) and induce early afterdepolarization, which is known to be a trigger mechanism of lethal ventricular arrhythmias. In conclusion, serum IS level is independently associated with the prolonged QTc interval in early CKD patients. IS down-regulated IK channel protein phosphorylation and the IK current activity that in turn increased the cardiomyocyte APD and QTc interval in vitro and in the computer ORd model. These findings suggest that IS may play a role in the development of arrhythmogenesis in CKD patients.

  7. Cardiac catheterization is underutilized after in-hospital cardiac arrest.

    Science.gov (United States)

    Merchant, Raina M; Abella, Benjamin S; Khan, Monica; Huang, Kuang-Ning; Beiser, David G; Neumar, Robert W; Carr, Brendan G; Becker, Lance B; Vanden Hoek, Terry L

    2008-12-01

    Indications for immediate cardiac catheterization in cardiac arrest survivors without ST elevation myocardial infarction (STEMI) are uncertain as electrocardiographic and clinical criteria may be challenging to interpret in this population. We sought to evaluate rates of early catheterization after in-hospital ventricular fibrillation (VF) arrest and the association with survival. Using a billing database we retrospectively identified cases with an ICD-9 code of cardiac arrest (427.5) or VF (427.41). Discharge summaries were reviewed to identify in-hospital VF arrests. Rates of catheterization on the day of arrest were determined by identifying billing charges. Unadjusted analyses were performed using Chi-square, and adjusted analyses were performed using logistic regression. One hundred and ten in-hospital VF arrest survivors were included in the analysis. Cardiac catheterization was performed immediately or within 1 day of arrest in 27% (30/110) of patients and of these patients, 57% (17/30) successfully received percutaneous coronary intervention. Of those who received cardiac catheterization the indication for the procedure was STEMI or new left bundle branch block (LBBB) in 43% (13/30). Therefore, in the absence of standard ECG data suggesting acute myocardial infarction, 57% (17/30) received angiography. Patients receiving cardiac catheterization were more likely to survive than those who did not receive catheterization (80% vs. 54%, psurvival. Future recommendations need to be established to guide clinicians on which arrest survivors might benefit from immediate catheterization.

  8. Use of cardiac biomarkers in neonatology.

    Science.gov (United States)

    Vijlbrief, Daniel C; Benders, Manon J N L; Kemperman, Hans; van Bel, Frank; de Vries, Willem B

    2012-10-01

    Cardiac biomarkers are used to identify cardiac disease in term and preterm infants. This review discusses the roles of natriuretic peptides and cardiac troponins. Natriuretic peptide levels are elevated during atrial strain (atrial natriuretic peptide (ANP)) or ventricular strain (B-type natriuretic peptide (BNP)). These markers correspond well with cardiac function and can be used to identify cardiac disease. Cardiac troponins are used to assess cardiomyocyte compromise. Affected cardiomyocytes release troponin into the bloodstream, resulting in elevated levels of cardiac troponin. Cardiac biomarkers are being increasingly incorporated into clinical trials as indicators of myocardial strain. Furthermore, cardiac biomarkers can possibly be used to guide therapy and improve outcome. Natriuretic peptides and cardiac troponins are potential tools in the diagnosis and treatment of neonatal disease that is complicated by circulatory compromise. However, clear reference ranges need to be set and validation needs to be carried out in a population of interest.

  9. Light-intensity and high-intensity interval training improve cardiometabolic health in rats.

    Science.gov (United States)

    Batacan, Romeo B; Duncan, Mitch J; Dalbo, Vincent J; Connolly, Kylie J; Fenning, Andrew S

    2016-09-01

    Physical activity has the potential to reduce cardiometabolic risk factors but evaluation of different intensities of physical activity and the mechanisms behind their health effects still need to be fully established. This study examined the effects of sedentary behaviour, light-intensity training, and high-intensity interval training on biometric indices, glucose and lipid metabolism, inflammatory and oxidative stress markers, and vascular and cardiac function in adult rats. Rats (12 weeks old) were randomly assigned to 1 of 4 groups: control (CTL; no exercise), sedentary (SED; no exercise and housed in small cages to reduce activity), light-intensity trained (LIT; four 30-min exercise bouts/day at 8 m/min separated by 2-h rest period, 5 days/week), and high-intensity interval trained (HIIT, four 2.5-min work bouts/day at 50 m/min separated by 3-min rest periods, 5 days/week). After 12 weeks of intervention, SED had greater visceral fat accumulation (p < 0.01) and slower cardiac conduction (p = 0.04) compared with the CTL group. LIT and HIIT demonstrated beneficial changes in body weight, visceral and epididymal fat weight, glucose regulation, low-density lipoprotein cholesterol, total cholesterol, and mesenteric vessel contractile response compared with the CTL group (p < 0.05). LIT had significant improvements in insulin sensitivity and cardiac conduction compared with the CTL and SED groups whilst HIIT had significant improvements in systolic blood pressure and endothelium-independent vasodilation to aorta and mesenteric artery compared with the CTL group (p < 0.05). LIT and HIIT induce health benefits by improving traditional cardiometabolic risk factors. LIT improves cardiac health while HIIT promotes improvements in vascular health.

  10. Quetiapine, QTc interval prolongation, and torsade de pointes: a review of case reports.

    Science.gov (United States)

    Hasnain, Mehrul; Vieweg, W Victor R; Howland, Robert H; Kogut, Christopher; Breden Crouse, Ericka L; Koneru, Jayanthi N; Hancox, Jules C; Digby, Geneviève C; Baranchuk, Adrian; Deshmukh, Anand; Pandurangi, Ananda K

    2014-06-01

    Recently, both the manufacturer of quetiapine and the US Food and Drug Administration warned healthcare providers and patients about quetiapine-induced QTc interval prolongation and torsade de pointes (TdP) when using this drug within the approved labeling.  We reviewed the case-report literature and found 12 case reports of QTc interval prolongation in the setting of quetiapine administration. There were no cases of quetiapine-induced TdP or sudden cardiac death (SCD) among patients using quetiapine appropriately and free of additional risk factors for QTc interval prolongation and TdP. Among the 12 case reports risk factors included female sex (nine cases), coadministration of a drug associated with QTc interval prolongation (eight cases), hypokalemia or hypomagnesemia (six cases) quetiapine overdose (five cases), cardiac problems (four cases), and coadministration of cytochrome P450 3A4 inhibitors (two cases). There were four cases of TdP. As drug-induced TdP is a rare event, prospective studies to evaluate the risk factors associated with QTc prolongation and TdP are difficult to design, would be very costly, and would require very large samples to capture TdP rather than its surrogate markers. Furthermore, conventional statistical methods may not apply to studies of TdP, which is rare and an 'outlier' manifestation of QTc prolongation. We urge drug manufacturers and regulatory agencies to periodically publish full case reports of psychotropic drug-induced QTc interval prolongation, TdP, and SCD so that clinicians and investigators may better understand the clinical implications of prescribing such drugs as quetiapine.

  11. High Resolution ECG for Evaluation of QT Interval Variability during Exposure to Acute Hypoxia

    Science.gov (United States)

    Zupet, P.; Finderle, Z.; Schlegel, Todd T.; Starc, V.

    2010-01-01

    Ventricular repolarization instability as quantified by the index of QT interval variability (QTVI) is one of the best predictors for risk of malignant ventricular arrhythmias and sudden cardiac death. Because it is difficult to appropriately monitor early signs of organ dysfunction at high altitude, we investigated whether high resolution advanced ECG (HR-ECG) analysis might be helpful as a non-invasive and easy-to-use tool for evaluating the risk of cardiac arrhythmias during exposure to acute hypoxia. 19 non-acclimatized healthy trained alpinists (age 37, 8 plus or minus 4,7 years) participated in the study. Five-minute high-resolution 12-lead electrocardiograms (ECGs) were recorded (Cardiosoft) in each subject at rest in the supine position breathing room air and then after breathing 12.5% oxygen for 30 min. For beat-to-beat RR and QT variability, the program of Starc was utilized to derive standard time domain measures such as root mean square of the successive interval difference (rMSSD) of RRV and QTV, the corrected QT interval (QTc) and the QTVI in lead II. Changes were evaluated with paired-samples t-test with p-values less than 0.05 considered statistically significant. As expected, the RR interval and its variability both decreased with increasing altitude, with p = 0.000 and p = 0.005, respectively. Significant increases were found in both the rMSSDQT and the QTVI in lead II, with p = 0.002 and p = 0.003, respectively. There was no change in QTc interval length (p = non significant). QT variability parameters may be useful for evaluating changes in ventricular repolarization caused by hypoxia. These changes might be driven by increases in sympathetic nervous system activity at ventricular level.

  12. Robotic Applications in Cardiac Surgery

    Directory of Open Access Journals (Sweden)

    Alan P. Kypson

    2008-11-01

    Full Text Available Traditionally, cardiac surgery has been performed through a median sternotomy, which allows the surgeon generous access to the heart and surrounding great vessels. As a paradigm shift in the size and location of incisions occurs in cardiac surgery, new methods have been developed to allow the surgeon the same amount of dexterity and accessibility to the heart in confined spaces and in a less invasive manner. Initially, long instruments without pivot points were used, however, more recent robotic telemanipulation systems have been applied that allow for improved dexterity, enabling the surgeon to perform cardiac surgery from a distance not previously possible. In this rapidly evolving field, we review the recent history and clinical results of using robotics in cardiac surgery.

  13. Recent developments in cardiac pacing.

    Science.gov (United States)

    Rodak, D J

    1995-10-01

    Indications for cardiac pacing continue to expand. Pacing to improve functional capacity, which is now common, relies on careful patient selection and technical improvements, such as complex software algorithms and diagnostic capabilities.

  14. HOSPITAL EXPERIENCE WITH CARDIAC RESUSCITATION.

    Science.gov (United States)

    CASDORPH, H R

    1964-04-01

    In three cases of cardiac arrest in which resuscitation was successful, there were striking similarities. The patients were men with anterior myocardial infarction and the mode of cardiac arrest was ventricular fibrillation. Corrective action was begun promptly after arrest occurred. In each case vasopressor agents were required for three to five days after resuscitation before the cardiovascular system was able to maintain a normal blood pressure without this aid. Convalescence was satisfactory and each patient returned to his usual occupation. The procedure that was used for cardiac resuscitation was based on artifical respiration (by any of several methods) and artificial circulation by external cardiac compression to provide a flow of oxygenated blood to the brain. Once this is established, time is afforded to determine what other steps are needed.

  15. Robotic Applications in Cardiac Surgery

    Directory of Open Access Journals (Sweden)

    Alan P. Kypson MD

    2004-06-01

    Full Text Available Traditionally, cardiac surgery has been performed through a median sternotomy, which allows the surgeon generous access to the heart and surrounding great vessels. As a paradigm shift in the size and location of incisions occurs in cardiac surgery, new methods have been developed to allow the surgeon the same amount of dexterity and accessibility to the heart in confined spaces and in a less invasive manner. Initially, long instruments without pivot points were used, however, more recent robotic telemanipulation systems have been applied that allow for improved dexterity, enabling the surgeon to perform cardiac surgery from a distance not previously possible. In this rapidly evolving field, we review the recent history and clinical results of using robotics in cardiac surgery.

  16. An airline cardiac arrest program

    National Research Council Canada - National Science Library

    O'Rourke, M F; Donaldson, E; Geddes, J S

    1997-01-01

    ...) available for use on airline passengers with cardiac arrest. AEDs were installed on international Qantas aircraft and at major terminals, selected crew were trained in their use, and all crew members were trained in cardiopulmonary resuscitation...

  17. Exploring the Role of Calcium in Cardiac Cell Dynamics

    Science.gov (United States)

    Berger, Carolyn; Idriss, Salim; Rouze, Ned; Hall, David; Gauthier, Daniel

    2007-03-01

    Bifurcations in the electrical response of cardiac tissue can destabilize spatio-temporal waves of electrochemical activity in the heart, leading to tachycardia or even fibrillation. Therefore, it is important to understand the mechanisms that cause instabilities in cardiac tissue.Traditionally, researchers have focused on understanding how the transmembrane voltage is altered in response to an increase in pacing rate, i.e. a shorter time interval between propagating electrochemical waves. However, the dynamics of the transmembrane voltage are coupled to the activity of several ions that traverse the membrane. Therefore, to fully understand the mechanisms that drive these bifurcations, we must include an investigation of the ionic behavior. We will present our recent investigation of the role of intracellular calcium in an experimental testbed of frog ventricle. Calcium and voltage are measured simultaneously, allowing for the previous research regarding voltage to guide our understanding of the calcium dynamics.

  18. Cardiac manifestations in systemic sclerosis

    Institute of Scientific and Technical Information of China (English)

    Sevdalina; Lambova

    2014-01-01

    Primary cardiac involvement, which develops as a direct consequence of systemic sclerosis(SSc), may manifest as myocardial damage, fibrosis of the conduction system, pericardial and, less frequently, as valvular disease. In addition, cardiac complications in SSc may develop as a secondary phenomenon due to pulmonary arterial hypertension and kidney pathology. The prevalence of primary cardiac involvement in SSc is variable and difficult to determine because of the diversity of cardiac manifestations, the presence of subclinical periods, the type of diagnostic tools applied, and the diversity of patient populations. When clinically manifested, cardiac involvement is thought to be an important prognostic factor. Profound microvascular disease is a pathognomonic feature of SSc, as both vasospasm and structural alterations are present. Such alterations are thought to predict macrovascular atherosclerosis over time. There are contradictory reports regarding the prevalence of atherosclerosis in SSc. According to some authors, the prevalence of atherosclerosis of the large epicardial coronary arteries is similar to that of the general population, in contrast with other rheumatic diseases such as rheumatoid arthritis and systemic lupus erythematosus. However, the level of inflammation in SSc is inferior. Thus, the atherosclerotic process may not be as aggressive and not easily detectable in smaller studies. Echocardiography(especially tissue Doppler imaging), single-photon emission computed tomography, magnetic resonance imaging and cardiac computed tomography are sensitive techniques for earlier detection of both structural and functional scleroderma-related cardiac pathologies. Screening for subclinical cardiac involvement via modern, sensitive tools provides an opportunity for early diagnosis and treatment, which is of crucial importance for a positive outcome.

  19. Cardiac transplantation in Friedreich ataxia.

    Science.gov (United States)

    Yoon, Grace; Soman, Teesta; Wilson, Judith; George, Kristen; Mital, Seema; Dipchand, Anne I; McCabe, Jane; Logan, William; Kantor, Paul

    2012-09-01

    In this article, we describe a 14-year-old boy with a confirmed diagnosis of Friedreich ataxia who underwent cardiac transplantation for left ventricular failure secondary to dilated cardiomyopathy with restrictive physiology. His neurological status prior to transplantation reflected early signs of neurological disease, with evidence of dysarthria, weakness, mild gait impairment, and limb ataxia. We review the ethical issues considered during the process leading to the decision to offer cardiac transplantation.

  20. Cardiac Transplantation in Friedreich Ataxia

    OpenAIRE

    Yoon, Grace; Soman, Teesta; Wilson, Judith; George, Kristen; Mital, Seema; Dipchand, Anne I; McCabe, Jane; Logan, William; Kantor, Paul

    2012-01-01

    In this paper, we describe a 14-year-old boy with a confirmed diagnosis of Friedreich ataxia who underwent cardiac transplantation for left ventricular failure secondary to dilated cardiomyopathy with restrictive physiology. His neurological status prior to transplantation reflected early signs of neurologic disease, with evidence of dysarthria, weakness, mild gait impairment, and limb ataxia. We review the ethical issues considered during the process leading to the decision to offer cardiac ...

  1. Infrequent cardiac manifestations of sarcoidosis.

    Science.gov (United States)

    Ashraf, Said; Briasoulis, Alexandros; Afonso, Luis

    Cardiac sarcoidosis (CS) is found in 2-7% of patients with systemic sarcoidosis (SS). Its diagnosis and treatment is challenging, notwithstanding the poor prognosis and treatment. Hereby, we present a case of systemic sarcoidosis with rare cardiac manifestations of severe mitral incompetence and large coronary aneurysm in a previously healthy woman. She underwent successful mitral valve replacement and coronary artery bypass surgery and was maintained on low dose glucocorticoid therapy. Copyright © 2016. Published by Elsevier Inc.

  2. Genetic analyses of a seasonal interval timer.

    Science.gov (United States)

    Prendergast, Brian J; Renstrom, Randall A; Nelson, Randy J

    2004-08-01

    Seasonal clocks (e.g., circannual clocks, seasonal interval timers) permit anticipation of regularly occurring environmental events by timing the onset of seasonal transitions in reproduction, metabolism, and behavior. Implicit in the concept that seasonal clocks reflect adaptations to the local environment is the unexamined assumption that heritable genetic variance exists in the critical features of such clocks, namely, their temporal properties. These experiments quantified the intraspecific variance in, and heritability of, the photorefractoriness interval timer in Siberian hamsters (Phodopus sungorus), a seasonal clock that provides temporal information to mechanisms that regulate seasonal transitions in body weight. Twenty-seven families consisting of 54 parents and 109 offspring were raised in a long-day photoperiod and transferred as adults to an inhibitory photoperiod (continuous darkness; DD). Weekly body weight measurements permitted specification of the interval of responsiveness to DD, a reflection of the duration of the interval timer, in each individual. Body weights of males and females decreased after exposure to DD, but 3 to 5 months later, somatic recrudescence occurred, indicative of photorefractoriness to DD. The interval timer was approximately 5 weeks longer and twice as variable in females relative to males. Analyses of variance of full siblings revealed an overall intraclass correlation of 0.71 +/- 0.04 (0.51 +/- 0.10 for male offspring and 0.80 +/- 0.06 for female offspring), suggesting a significant family resemblance in the duration of interval timers. Parent-offspring regression analyses yielded an overall heritability estimate of 0.61 +/- 0.2; h(2) estimates from parent-offspring regression analyses were significant for female offspring (0.91 +/- 0.4) but not for male offspring (0.35 +/- 0.2), indicating strong additive genetic components for this trait, primarily in females. In nature, individual differences, both within and between

  3. Heart rate dependency of JT interval sections.

    Science.gov (United States)

    Hnatkova, Katerina; Johannesen, Lars; Vicente, Jose; Malik, Marek

    2017-08-09

    Little experience exists with the heart rate correction of J-Tpeak and Tpeak-Tend intervals. In a population of 176 female and 176 male healthy subjects aged 32.3±9.8 and 33.1±8.4years, respectively, curve-linear and linear relationship to heart rate was investigated for different sections of the JT interval defined by the proportions of the area under the vector magnitude of the reconstructed 3D vectorcardiographic loop. The duration of the JT sub-section between approximately just before the T peak and almost the T end was found heart rate independent. Most of the JT heart rate dependency relates to the beginning of the interval. The duration of the terminal T wave tail is only weakly heart rate dependent. The Tpeak-Tend is only minimally heart rate dependent and in studies not showing substantial heart rate changes does not need to be heart rate corrected. For any correction formula that has linear additive properties, heart rate correction of JT and JTpeak intervals is practically the same as of the QT interval. However, this does not apply to the formulas in the form of Int/RR(a) since they do not have linear additive properties. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Transmission line sag calculations using interval mathematics

    Energy Technology Data Exchange (ETDEWEB)

    Shaalan, H. [Institute of Electrical and Electronics Engineers, Washington, DC (United States)]|[US Merchant Marine Academy, Kings Point, NY (United States)

    2007-07-01

    Electric utilities are facing the need for additional generating capacity, new transmission systems and more efficient use of existing resources. As such, there are several uncertainties associated with utility decisions. These uncertainties include future load growth, construction times and costs, and performance of new resources. Regulatory and economic environments also present uncertainties. Uncertainty can be modeled based on a probabilistic approach where probability distributions for all of the uncertainties are assumed. Another approach to modeling uncertainty is referred to as unknown but bounded. In this approach, the upper and lower bounds on the uncertainties are assumed without probability distributions. Interval mathematics is a tool for the practical use and extension of the unknown but bounded concept. In this study, the calculation of transmission line sag was used as an example to demonstrate the use of interval mathematics. The objective was to determine the change in cable length, based on a fixed span and an interval of cable sag values for a range of temperatures. The resulting change in cable length was an interval corresponding to the interval of cable sag values. It was shown that there is a small change in conductor length due to variation in sag based on the temperature ranges used in this study. 8 refs.

  5. Immediate and long term effects of endurance and high intensity interval exercise on linear and nonlinear heart rate variability.

    Science.gov (United States)

    Perkins, Steven E; Jelinek, Herbert F; Al-Aubaidy, Hayder A; de Jong, Berverlie

    2017-03-01

    Recovery of cardiac autonomic modulation following exercise can be measured using heart rate variability. The objective of this study was to investigate and compare recovery of autonomic cardiac regulation over three days following a single session of high intensity interval training compared to endurance training. Nine untrained students completed two exercise protocols in a one-way crossover design. The endurance protocol consisted of 45min of moderate intensity cycling, and the high intensity interval protocol of six 30s sets of high intensity cycling. Cardiac autonomic activity recovery was measured over three days post-exercise for two hours immediately following each exercise session and each morning thereafter using linear and nonlinear heart rate variability analysis. Both linear and nonlinear measures were significantly decreased immediately following exercise indicating loss of vagal activity. Root mean sum of squared differences (p=0.031) and high frequency (p=0.031) were suppressed following the interval exercise only. The long term correlation of the heart rate applying detrended fluctuation analysis was decreased immediately following endurance training (p=0.039) and trended to increase immediately following the interval protocol (p=0.156). Sample entropy was decreased immediately following both the endurance (p=0.023) and interval (p=0.031) protocols. No exercise effects were noted from 24h post exercise onwards. High intensity interval training had a greater impact on neurocardiac activity than moderate intensity endurance training as indicated by both linear and nonlinear heart rate variability measures. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  6. A RELATIONSHIP BETWEEN QT INTERVAL AND CARDIOVASCULAR RISK FACTORS IN WOMEN WITH RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    D. S. Novikova

    2014-07-01

    Full Text Available Objective: to study a relationship of QT interval to cardiovascular risk factors in women with rheumatoid arthritis (RA.Subjects and methods. 291 female patients aged less than 60 years with a valid diagnosis of RA were examined. A control group consisted of125 women without rheumatic diseases. In addition to the clinical manifestations, acidity, and severity of RA, the authors assessed traditional risk factors (TRF of cardiovascular diseases (CVD, performed Holter ECG monitoring, common carotid artery duplex scanning, transthoracic echocardiographic study, and determined the levels of serum inflammatory markers.Results. The patients with RA differ from the control group in a longer adjusted QT interval, corrected for TRF of CVD. The major factorsassociated with a daily prolonged QTc interval in the women with RA are arterial hypertension, systolic, diastolic, pulse blood pressure level s, body mass index, subclinical target organ damage (carotid artery atherosclerosis, left ventricular (LV diastolic dysfunction, LV hypertrophyand remodeling, and the duration of RA. Leflunomide therapy is an additional factor associated with a prolonged nocturnal QT interval.Conclusion. The RA patients with a prolonged QTc interval and no clinical signs of cardiac lesion need meticulous examination aimed to identify CVD.

  7. A RELATIONSHIP BETWEEN QT INTERVAL AND CARDIOVASCULAR RISK FACTORS IN WOMEN WITH RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    D. S. Novikova

    2013-01-01

    Full Text Available Objective: to study a relationship of QT interval to cardiovascular risk factors in women with rheumatoid arthritis (RA.Subjects and methods. 291 female patients aged less than 60 years with a valid diagnosis of RA were examined. A control group consisted of125 women without rheumatic diseases. In addition to the clinical manifestations, acidity, and severity of RA, the authors assessed traditional risk factors (TRF of cardiovascular diseases (CVD, performed Holter ECG monitoring, common carotid artery duplex scanning, transthoracic echocardiographic study, and determined the levels of serum inflammatory markers.Results. The patients with RA differ from the control group in a longer adjusted QT interval, corrected for TRF of CVD. The major factorsassociated with a daily prolonged QTc interval in the women with RA are arterial hypertension, systolic, diastolic, pulse blood pressure level s, body mass index, subclinical target organ damage (carotid artery atherosclerosis, left ventricular (LV diastolic dysfunction, LV hypertrophyand remodeling, and the duration of RA. Leflunomide therapy is an additional factor associated with a prolonged nocturnal QT interval.Conclusion. The RA patients with a prolonged QTc interval and no clinical signs of cardiac lesion need meticulous examination aimed to identify CVD.

  8. Cardiac imaging. A multimodality approach

    Energy Technology Data Exchange (ETDEWEB)

    Thelen, Manfred [Johannes Gutenberg University Hospital, Mainz (Germany); Erbel, Raimund [University Hospital Essen (Germany). Dept. of Cardiology; Kreitner, Karl-Friedrich [Johannes Gutenberg University Hospital, Mainz (Germany). Clinic and Polyclinic for Diagnostic and Interventional Radiology; Barkhausen, Joerg (eds.) [University Hospital Schleswig-Holstein, Luebeck (Germany). Dept. of Radiology and Nuclear Medicine

    2009-07-01

    An excellent atlas on modern diagnostic imaging of the heart Written by an interdisciplinary team of experts, Cardiac Imaging: A Multimodality Approach features an in-depth introduction to all current imaging modalities for the diagnostic assessment of the heart as well as a clinical overview of cardiac diseases and main indications for cardiac imaging. With a particular emphasis on CT and MRI, the first part of the atlas also covers conventional radiography, echocardiography, angiography and nuclear medicine imaging. Leading specialists demonstrate the latest advances in the field, and compare the strengths and weaknesses of each modality. The book's second part features clinical chapters on heart defects, endocarditis, coronary heart disease, cardiomyopathies, myocarditis, cardiac tumors, pericardial diseases, pulmonary vascular diseases, and diseases of the thoracic aorta. The authors address anatomy, pathophysiology, and clinical features, and evaluate the various diagnostic options. Key features: - Highly regarded experts in cardiology and radiology off er image-based teaching of the latest techniques - Readers learn how to decide which modality to use for which indication - Visually highlighted tables and essential points allow for easy navigation through the text - More than 600 outstanding images show up-to-date technology and current imaging protocols Cardiac Imaging: A Multimodality Approach is a must-have desk reference for cardiologists and radiologists in practice, as well as a study guide for residents in both fields. It will also appeal to cardiac surgeons, general practitioners, and medical physicists with a special interest in imaging of the heart. (orig.)

  9. Genetic manipulation of cardiac ageing.

    Science.gov (United States)

    Cannon, Leah; Bodmer, Rolf

    2016-04-15

    Ageing in humans is associated with a significant increase in the prevalence of cardiovascular disease. We still do not fully understand the molecular mechanisms underpinning this correlation. However, a number of insights into which genes control cardiac ageing have come from studying hearts of the fruit fly, Drosophila melanogaster. The fly's simple heart tube has similar molecular structure and basic physiology to the human heart. Also, both fly and human hearts experience significant age-related morphological and functional decline. Studies on the fly heart have highlighted the involvement of key nutrient sensing, ion channel and sarcomeric genes in cardiac ageing. Many of these genes have also been implicated in ageing of the mammalian heart. Genes that increase oxidative stress, or are linked to cardiac hypertrophy or neurodegenerative diseases in mammals also affect cardiac ageing in the fruit fly. Moreover, fly studies have demonstrated the potential of exercise and statins to treat age-related cardiac disease. These results show the value of Drosophila as a model to discover the genetic causes of human cardiac ageing. © 2015 The Authors. The Journal of Physiology © 2015 The Physiological Society.

  10. [Stem cells and cardiac regeneration].

    Science.gov (United States)

    Perez Millan, Maria Ines; Lorenti, Alicia

    2006-01-01

    Stem cells are defined by virtue of their functional attributes: absence of tissue specific differentitated markers, capable of proliferation, able to self-maintain the population, able to produce a large number of differentiated, functional progeny, able to regenerate the tissue after injury. Cell therapy is an alternative for the treatment of several diseases, like cardiac diseases (cell cardiomyoplasty). A variety of stem cells could be used for cardiac repair: from cardiac and extracardiac sources. Each cell type has its own profile of advantages, limitations, and practicability issues in specific clinical settings. Differentiation of bone marrow stem cells to cardiomyocyte-like cells have been observed under different culture conditions. The presence of resident cardiac stem cell population capable of differentiation into cardiomyocyte or vascular lineage suggests that these cells could be used for cardiac tissue repair, and represent a great promise for clinical application. Stem cells mobilization by cytokines may also offer a strategy for cardiac regeneration. The use of stem cells (embryonic and adult) may hold the key to replacing cells lost in many devastating diseases. This potential benefit is a major focus for stem cell research.

  11. Cardiac Regeneration and Stem Cells.

    Science.gov (United States)

    Zhang, Yiqiang; Mignone, John; MacLellan, W Robb

    2015-10-01

    After decades of believing the heart loses the ability to regenerate soon after birth, numerous studies are now reporting that the adult heart may indeed be capable of regeneration, although the magnitude of new cardiac myocyte formation varies greatly. While this debate has energized the field of cardiac regeneration and led to a dramatic increase in our understanding of cardiac growth and repair, it has left much confusion in the field as to the prospects of regenerating the heart. Studies applying modern techniques of genetic lineage tracing and carbon-14 dating have begun to establish limits on the amount of endogenous regeneration after cardiac injury, but the underlying cellular mechanisms of this regeneration remained unclear. These same studies have also revealed an astonishing capacity for cardiac repair early in life that is largely lost with adult differentiation and maturation. Regardless, this renewed focus on cardiac regeneration as a therapeutic goal holds great promise as a novel strategy to address the leading cause of death in the developed world.

  12. Physiological and pathological cardiac hypertrophy.

    Science.gov (United States)

    Shimizu, Ippei; Minamino, Tohru

    2016-08-01

    The heart must continuously pump blood to supply the body with oxygen and nutrients. To maintain the high energy consumption required by this role, the heart is equipped with multiple complex biological systems that allow adaptation to changes of systemic demand. The processes of growth (hypertrophy), angiogenesis, and metabolic plasticity are critically involved in maintenance of cardiac homeostasis. Cardiac hypertrophy is classified as physiological when it is associated with normal cardiac function or as pathological when associated with cardiac dysfunction. Physiological hypertrophy of the heart occurs in response to normal growth of children or during pregnancy, as well as in athletes. In contrast, pathological hypertrophy is induced by factors such as prolonged and abnormal hemodynamic stress, due to hypertension, myocardial infarction etc. Pathological hypertrophy is associated with fibrosis, capillary rarefaction, increased production of pro-inflammatory cytokines, and cellular dysfunction (impairment of signaling, suppression of autophagy, and abnormal cardiomyocyte/non-cardiomyocyte interactions), as well as undesirable epigenetic changes, with these complex responses leading to maladaptive cardiac remodeling and heart failure. This review describes the key molecules and cellular responses involved in physiological/pathological cardiac hypertrophy. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. The diagnostic and therapeutic aspects of loss-of-function cardiac sodium channelopathies in children.

    Science.gov (United States)

    Chockalingam, Priya; Clur, Sally-Ann B; Breur, Johannes M P J; Kriebel, Thomas; Paul, Thomas; Rammeloo, Lukas A; Wilde, Arthur A M; Blom, Nico A

    2012-12-01

    Loss-of-function sodium channelopathies manifest as a spectrum of diseases including Brugada syndrome (BrS) and cardiac conduction disease. To analyze the diagnostic and therapeutic aspects of these disorders in children. Patients aged ≤ 16 years with genetically confirmed loss-of-function sodium channelopathies (SCN5A mutation), presenting with cardiac symptoms, positive family history, and/or abnormal electrocardiogram (ECG), were included. Abnormal ECG consisted of type 1 BrS ECG and/or prolonged conduction intervals (PR interval/QRS duration > 98th percentile for age). Among the cohort (n = 33, age 6 ± 5 years, 58% male subjects, 30% probands), 14 (42%) patients were symptomatic, presenting with syncope (n = 5), palpitations (n = 1), supraventricular arrhythmias (n = 3), aborted cardiac arrest (n = 3), and sudden cardiac death (n = 2). Heart rate was 91 ± 26 beats/min, PR interval 168 ± 35 ms, QRS duration 112 ± 20 ms, and heart-rate corrected QT interval 409 ± 26 ms. Conduction intervals were prolonged in 28 (85%) patients; 6 of these patients also had spontaneous type 1 BrS ECG. Eight fever-associated events occurred in 6 patients; 2 of these were vaccination-related fever episodes. Treatment included aggressive antipyretics during fever in all patients; antiarrhythmic treatment included implantable cardioverter-defibrillator (n = 4), pacemaker (n = 2), and beta-blockers, either alone (n = 3) or in combination with device (n = 2). During follow-up (4 ± 4 years), 2 previously symptomatic patients had monomorphic ventricular tachycardia; there were no deaths. Diagnosis of loss-of-function sodium channelopathies in children relies on cardiac symptoms, family history, and ECG. Fever and vaccination are potential arrhythmia triggers; conduction delay is the commonest finding on ECG. Beta-blockers have a role in preventing tachycardia-induced arrhythmias; implantable cardioverter-defibrillator should probably be reserved for severe cases. Copyright © 2012

  14. Recurrent late cardiac tamponade following cardiac surgery : a deceiving and potentially lethal complication

    NARCIS (Netherlands)

    Harskamp, Ralf E.; Meuzelaar, Jacobus J.

    2010-01-01

    Background - Cardiac tamponade, characterized by inflow obstruction of the heart chambers by extracardiac compression, is a potentially lethal complication following cardiac surgery. Case report - We present a case of recurrent cardiac tamponade following valve surgery. At first presentation, diagno

  15. Recurrent late cardiac tamponade following cardiac surgery : a deceiving and potentially lethal complication

    NARCIS (Netherlands)

    Harskamp, Ralf E.; Meuzelaar, Jacobus J.

    2010-01-01

    Background - Cardiac tamponade, characterized by inflow obstruction of the heart chambers by extracardiac compression, is a potentially lethal complication following cardiac surgery. Case report - We present a case of recurrent cardiac tamponade following valve surgery. At first presentation,

  16. Recurrent late cardiac tamponade following cardiac surgery : a deceiving and potentially lethal complication

    NARCIS (Netherlands)

    Harskamp, Ralf E.; Meuzelaar, Jacobus J.

    2010-01-01

    Background - Cardiac tamponade, characterized by inflow obstruction of the heart chambers by extracardiac compression, is a potentially lethal complication following cardiac surgery. Case report - We present a case of recurrent cardiac tamponade following valve surgery. At first presentation, diagno

  17. Measurement of cardiac output from dynamic pulmonary circulation time CT

    Energy Technology Data Exchange (ETDEWEB)

    Yee, Seonghwan, E-mail: Seonghwan.Yee@Beaumont.edu [Department of Radiation Oncology, Beaumont Health System, Royal Oak, Michigan 48073 (United States); Scalzetti, Ernest M. [Department of Radiology, SUNY Upstate Medical University, Syracuse, New York 13210 (United States)

    2014-06-15

    Purpose: To introduce a method of estimating cardiac output from the dynamic pulmonary circulation time CT that is primarily used to determine the optimal time window of CT pulmonary angiography (CTPA). Methods: Dynamic pulmonary circulation time CT series, acquired for eight patients, were retrospectively analyzed. The dynamic CT series was acquired, prior to the main CTPA, in cine mode (1 frame/s) for a single slice at the level of the main pulmonary artery covering the cross sections of ascending aorta (AA) and descending aorta (DA) during the infusion of iodinated contrast. The time series of contrast changes obtained for DA, which is the downstream of AA, was assumed to be related to the time series for AA by the convolution with a delay function. The delay time constant in the delay function, representing the average time interval between the cross sections of AA and DA, was determined by least square error fitting between the convoluted AA time series and the DA time series. The cardiac output was then calculated by dividing the volume of the aortic arch between the cross sections of AA and DA (estimated from the single slice CT image) by the average time interval, and multiplying the result by a correction factor. Results: The mean cardiac output value for the six patients was 5.11 (l/min) (with a standard deviation of 1.57 l/min), which is in good agreement with the literature value; the data for the other two patients were too noisy for processing. Conclusions: The dynamic single-slice pulmonary circulation time CT series also can be used to estimate cardiac output.

  18. Risk factors and the effect of cardiac resynchronization therapy on cardiac and non-cardiac mortality in MADIT-CRT

    DEFF Research Database (Denmark)

    Perkiomaki, Juha S; Ruwald, Anne-Christine; Kutyifa, Valentina;

    2015-01-01

    causes, 108 (63.9%) deemed cardiac, and 61 (36.1%) non-cardiac. In multivariate analysis, increased baseline creatinine was significantly associated with both cardiac and non-cardiac deaths [hazard ratio (HR) 2.97, P ...AIMS: To understand modes of death and factors associated with the risk for cardiac and non-cardiac deaths in patients with cardiac resynchronization therapy with implantable cardioverter-defibrillator (CRT-D) vs. implantable cardioverter-defibrillator (ICD) therapy, which may help clarify...... the action and limitations of cardiac resynchronization therapy (CRT) in relieving myocardial dysfunction. METHODS AND RESULTS: In Multicenter Automatic Defibrillator Implantation Trial-Cardiac Resynchronization Therapy (MADIT-CRT), during 4 years of follow-up, 169 (9.3%) of 1820 patients died of known...

  19. Cardiac output during exercise

    DEFF Research Database (Denmark)

    Siebenmann, C; Rasmussen, P.; Sørensen, H.

    2015-01-01

    Several techniques assessing cardiac output (Q) during exercise are available. The extent to which the measurements obtained from each respective technique compares to one another, however, is unclear. We quantified Q simultaneously using four methods: the Fick method with blood obtained from...... the right atrium (Q(Fick-M)), Innocor (inert gas rebreathing; Q(Inn)), Physioflow (impedance cardiography; Q(Phys)), and Nexfin (pulse contour analysis; Q(Pulse)) in 12 male subjects during incremental cycling exercise to exhaustion in normoxia and hypoxia (FiO2  = 12%). While all four methods reported...... a progressive increase in Q with exercise intensity, the slopes of the Q/oxygen uptake (VO2) relationship differed by up to 50% between methods in both normoxia [4.9 ± 0.3, 3.9 ± 0.2, 6.0 ± 0.4, 4.8 ± 0.2 L/min per L/min (mean ± SE) for Q(Fick-M), Q(Inn), QP hys and Q(Pulse), respectively; P = 0...

  20. Cardiac Imaging System

    Science.gov (United States)

    1990-01-01

    Although not available to all patients with narrowed arteries, balloon angioplasty has expanded dramatically since its introduction with an estimated further growth to 562,000 procedures in the U.S. alone by 1992. Growth has fueled demand for higher quality imaging systems that allow the cardiologist to be more accurate and increase the chances of a successful procedure. A major advance is the Digital Cardiac Imaging (DCI) System designed by Philips Medical Systems International, Best, The Netherlands and marketed in the U.S. by Philips Medical Systems North America Company. The key benefit is significantly improved real-time imaging and the ability to employ image enhancement techniques to bring out added details. Using a cordless control unit, the cardiologist can manipulate images to make immediate assessment, compare live x-ray and roadmap images by placing them side-by-side on monitor screens, or compare pre-procedure and post procedure conditions. The Philips DCI improves the cardiologist's precision by expanding the information available to him.

  1. [Cardiac syncope in children].

    Science.gov (United States)

    Villain, E

    2004-02-01

    Syncope is a frequent problem in childhood; generally, it is an isolated event and the common causes are benign. However, in some circumstances, syncope can herald a potentially lethal problem, especially when occurring during exercise. Routine evaluation includes history, physical examination and a 12-lead standard ECG should be performed in all cases. Worrying features which should be an indication for further investigation include syncope during exercise, collapse in a swimming pool, history of familial sudden death, and abnormalities on clinical exam or ECG. Structural cardiac abnormalities that may cause syncope and sudden death include aortic stenosis, hypertrophic cardiomyopathy and coronary malformations. All children with unrepaired or repaired congenital heart disease who experienced a syncope should be referred to a specialist. Primary arrhythmias that are easily diagnosed on ECG are the long QT syndrome, complete atrio-ventricular block and Wolff-Parkinson-White syndrome; ST elevation in V1-V3 may reveal a Brugada syndrome. Another arrhythmia which is known to be potentially fatal if undiagnosed is the catecholaminergic ventricular tachycardia; the baseline ECG is normal but the arrhythmia is easily reproduced during exercise testing. Finally, vasovagal syncope is the most likely cause of syncope in the young and it usually easily recognized.

  2. [Calpains and cardiac diseases].

    Science.gov (United States)

    Perrin, C; Vergely, C; Rochette, L

    2004-09-01

    Calpains are a large family of cytosolic cysteine proteases composed of at least fourteen distinct isoforms. The family can be divided into two groups on the basis of distribution: ubiquitous and tissue-specific. Our current knowledge about calpains properties apply mainly to the ubiquitous isozymes, micro- and milli-calpain (classic calpains). These forms are activated after autolysis. Translocation and subsequent interactions with phospholipids of these enzymes increase their activity. Calpains are able to cleave a subset of substrates, as enzymes, structural and signalling proteins. Cardiac pathologies, such as heart failure, atrial fibrillation or clinical states particularly ischemia reperfusion, are associated with an increase of cytosolic calcium and in this regards, calpain activation has been evoked as one of the mediators leading to myocardial damage. Calpain activities have been shown to be increased in hearts experimentally subjected to ischemia reperfusion or during hypertrophy, but also in atrial tissue harvested from patients suffering from atrial fibrillations. These activities have been related to an increase of the proteolysis of different myocardial components, particularly, troponins, which are major regulators of the contraction of cardiomyocytes. Moreover, recent works have demonstrated that calpains are involved in the development of myocardial cell death by necrosis or apoptosis.

  3. Optimal prediction intervals of wind power generation

    DEFF Research Database (Denmark)

    Wan, Can; Wu, Zhao; Pinson, Pierre

    2014-01-01

    Accurate and reliable wind power forecasting is essential to power system operation. Given significant uncertainties involved in wind generation, probabilistic interval forecasting provides a unique solution to estimate and quantify the potential impacts and risks facing system operation with wind...... penetration beforehand. This paper proposes a novel hybrid intelligent algorithm approach to directly formulate optimal prediction intervals of wind power generation based on extreme learning machine and particle swarm optimization. Prediction intervals with Associated confidence levels are generated through...... conducted. Comparing with benchmarks applied, experimental results demonstrate the high efficiency and reliability of the developed approach. It is therefore convinced that the proposed method provides a new generalized framework for probabilistic wind power forecasting with high reliability and flexibility...

  4. Confidence intervals with a priori parameter bounds

    CERN Document Server

    Lokhov, A V

    2014-01-01

    We review the methods of constructing confidence intervals that account for a priori information about one-sided constraints on the parameter being estimated. We show that the so-called method of sensitivity limit yields a correct solution of the problem. Derived are the solutions for the cases of a continuous distribution with non-negative estimated parameter and a discrete distribution, specifically a Poisson process with background. For both cases, the best upper limit is constructed that accounts for the a priori information. A table is provided with the confidence intervals for the parameter of Poisson distribution that correctly accounts for the information on the known value of the background along with the software for calculating the confidence intervals for any confidence levels and magnitudes of the background (the software is freely available for download via Internet).

  5. Existence test for asynchronous interval iterations

    DEFF Research Database (Denmark)

    Madsen, Kaj; Caprani, O.; Stauning, Ole

    1997-01-01

    In the search for regions that contain fixed points ofa real function of several variables, tests based on interval calculationscan be used to establish existence ornon-existence of fixed points in regions that are examined in the course ofthe search. The search can e.g. be performed...... as a synchronous (sequential) interval iteration:In each iteration step all components of the iterate are calculatedbased on the previous iterate. In this case it is straight forward to base simple interval existence and non-existencetests on the calculations done in each step of the iteration. The search can also...... be performed as an asynchronous (parallel) iteration: Only a few components are changed in each stepand this calculation is in general based on components from differentprevious iterates. For the asynchronous iteration it turns out thatsimple tests of existence and non-existence can be based...

  6. A prospective evaluation of non-interval- and interval-based exercise training progressions in rodents.

    Science.gov (United States)

    Jendzjowsky, Nicholas G; DeLorey, Darren S

    2011-10-01

    Non-interval and interval training progressions were used to determine (i) the mean rate at which treadmill speed could be incremented daily using a non-interval training progression to train rats to run continuously at different intensities and (ii) the number of training days required for rats to run continuously at different exercise intensities with non-interval- and interval-based training progressions to establish methods of progressive overload for rodent exercise training studies. Rats were randomly assigned to mild-intensity (n = 5, 20 m·min(-1), 5% grade), moderate-intensity (n = 5, 30 m·min(-1), 5% grade), and heavy-intensity non-interval groups (n = 5, 40 m·min(-1), 5% grade) or a heavy-intensity interval (n = 5, 40 m·min(-1), 5% grade) group and ran 5 days·week(-1) for 6 weeks. Non-interval training involved a daily increase of treadmill speed, whereas interval training involved a daily increase of interval time, until the animal could run continuously at a prescribed intensity. In mild-, moderate-, and heavy-intensity non-interval-trained rats, treadmill speed was increased by 0.6 ± 0.7 m·min(-1)·day(-1), 0.6 ± 0.2 m·min(-1)·day(-1), and 0.8 ± 0.1 m·min(-1)·day(-1), respectively. Target training intensity and duration were obtained following 0.4 ± 0.5 days, 17 ± 3 days, and 23 ± 3 training days (p progression enables rats to run continuously at moderate and heavy intensities with 3-4 weeks of progressive overload. Interval training significantly reduces the number of training days required to attain a target intensity.

  7. Interval Estimation of Seismic Hazard Parameters

    Science.gov (United States)

    Orlecka-Sikora, Beata; Lasocki, Stanislaw

    2016-11-01

    The paper considers Poisson temporal occurrence of earthquakes and presents a way to integrate uncertainties of the estimates of mean activity rate and magnitude cumulative distribution function in the interval estimation of the most widely used seismic hazard functions, such as the exceedance probability and the mean return period. The proposed algorithm can be used either when the Gutenberg-Richter model of magnitude distribution is accepted or when the nonparametric estimation is in use. When the Gutenberg-Richter model of magnitude distribution is used the interval estimation of its parameters is based on the asymptotic normality of the maximum likelihood estimator. When the nonparametric kernel estimation of magnitude distribution is used, we propose the iterated bias corrected and accelerated method for interval estimation based on the smoothed bootstrap and second-order bootstrap samples. The changes resulted from the integrated approach in the interval estimation of the seismic hazard functions with respect to the approach, which neglects the uncertainty of the mean activity rate estimates have been studied using Monte Carlo simulations and two real dataset examples. The results indicate that the uncertainty of mean activity rate affects significantly the interval estimates of hazard functions only when the product of activity rate and the time period, for which the hazard is estimated, is no more than 5.0. When this product becomes greater than 5.0, the impact of the uncertainty of cumulative distribution function of magnitude dominates the impact of the uncertainty of mean activity rate in the aggregated uncertainty of the hazard functions. Following, the interval estimates with and without inclusion of the uncertainty of mean activity rate converge. The presented algorithm is generic and can be applied also to capture the propagation of uncertainty of estimates, which are parameters of a multiparameter function, onto this function.

  8. Intervality and coherence in complex networks

    Science.gov (United States)

    Domínguez-García, Virginia; Johnson, Samuel; Muñoz, Miguel A.

    2016-06-01

    Food webs—networks of predators and prey—have long been known to exhibit "intervality": species can generally be ordered along a single axis in such a way that the prey of any given predator tend to lie on unbroken compact intervals. Although the meaning of this axis—usually identified with a "niche" dimension—has remained a mystery, it is assumed to lie at the basis of the highly non-trivial structure of food webs. With this in mind, most trophic network modelling has for decades been based on assigning species a niche value by hand. However, we argue here that intervality should not be considered the cause but rather a consequence of food-web structure. First, analysing a set of 46 empirical food webs, we find that they also exhibit predator intervality: the predators of any given species are as likely to be contiguous as the prey are, but in a different ordering. Furthermore, this property is not exclusive of trophic networks: several networks of genes, neurons, metabolites, cellular machines, airports, and words are found to be approximately as interval as food webs. We go on to show that a simple model of food-web assembly which does not make use of a niche axis can nevertheless generate significant intervality. Therefore, the niche dimension (in the sense used for food-web modelling) could in fact be the consequence of other, more fundamental structural traits. We conclude that a new approach to food-web modelling is required for a deeper understanding of ecosystem assembly, structure, and function, and propose that certain topological features thought to be specific of food webs are in fact common to many complex networks.

  9. A Preliminary Exercise Study of Japanese Version of High-intensity Interval Aerobic Training (J-HIAT)

    Science.gov (United States)

    Matsuo, Tomoaki; Seino, Satoshi; Ohkawara, Kazunori; Tanaka, Kiyoji; Yamada, Shin; Ohshima, Hiroshi; Mukai, Chiaki

    In a microgravity environment, the volume load on the left ventricle is reduced and the cardiac function deteriorates.Consequently, maximal oxygen consumption (VO2max) decreases during spaceflight. Reduced cardiac function can lead to serious health problems such as cardiac atrophy, diastolic dysfunction, and orthostatic hypotension. An exercise using a bicycle ergometer during spaceflight may help to increase the volume load on the left ventricle. On the other hand, many astronauts also experience weight loss during spaceflight because energy imbalances can occur. Some researchers indicate that excessive exercise may promote the energy deficit and have a negative impact on long-term spaceflight. Therefore, we have been devising an original bicyle erogometer protocol better suited to astronauts experiencing long-term spaceflight.One of our candidate protocols is the 3 × 3 protocol named J-HIAT, i.e., three times 3-min intervals with a 2-min active recovery period between intervals. In response to our preliminary experiments, we concluded that J-HIAT would be a potential protocol to control the increase of energy consumption and to have a significant impact on VO2max and the cardiac function. To further verify this method, we are working on full-scale experiments. In future, we will show the results of these experiments.

  10. Radial basis function networks with linear interval regression weights for symbolic interval data.

    Science.gov (United States)

    Su, Shun-Feng; Chuang, Chen-Chia; Tao, C W; Jeng, Jin-Tsong; Hsiao, Chih-Ching

    2012-02-01

    This paper introduces a new structure of radial basis function networks (RBFNs) that can successfully model symbolic interval-valued data. In the proposed structure, to handle symbolic interval data, the Gaussian functions required in the RBFNs are modified to consider interval distance measure, and the synaptic weights of the RBFNs are replaced by linear interval regression weights. In the linear interval regression weights, the lower and upper bounds of the interval-valued data as well as the center and range of the interval-valued data are considered. In addition, in the proposed approach, two stages of learning mechanisms are proposed. In stage 1, an initial structure (i.e., the number of hidden nodes and the adjustable parameters of radial basis functions) of the proposed structure is obtained by the interval competitive agglomeration clustering algorithm. In stage 2, a gradient-descent kind of learning algorithm is applied to fine-tune the parameters of the radial basis function and the coefficients of the linear interval regression weights. Various experiments are conducted, and the average behavior of the root mean square error and the square of the correlation coefficient in the framework of a Monte Carlo experiment are considered as the performance index. The results clearly show the effectiveness of the proposed structure.

  11. Interval Continuous Plant Identification from Value Sets

    Directory of Open Access Journals (Sweden)

    R. Hernández

    2012-01-01

    Full Text Available This paper shows how to obtain the values of the numerator and denominator Kharitonov polynomials of an interval plant from its value set at a given frequency. Moreover, it is proven that given a value set, all the assigned polynomials of the vertices can be determined if and only if there is a complete edge or a complete arc lying on a quadrant. This algorithm is nonconservative in the sense that if the value-set boundary of an interval plant is exactly known, and particularly its vertices, then the Kharitonov rectangles are exactly those used to obtain these value sets.

  12. A sequent calculus for signed interval logic

    DEFF Research Database (Denmark)

    Rasmussen, Thomas Marthedal

    2001-01-01

    We propose and discuss a complete sequent calculus formulation for Signed Interval Logic (SIL) with the chief purpose of improving proof support for SIL in practice. The main theoretical result is a simple characterization of the limit between decidability and undecidability of quantifier-free SIL....... We present a mechanization of SIL in the generic proof assistant Isabelle and consider techniques for automated reasoning. Many of the results and ideas of this report are also applicable to traditional (non-signed) interval logic and, hence, to Duration Calculus....

  13. ECPR for Refractory Out-Of-Hospital Cardiac Arrest

    Science.gov (United States)

    2017-05-17

    Cardiac Arrest; Heart Arrest; Sudden Cardiac Arrest; Cardiopulmonary Arrest; Death, Sudden, Cardiac; Cardiopulmonary Resuscitation; CPR; Extracorporeal Cardiopulmonary Resuscitation; Extracorporeal Membrane Oxygenation

  14. Optimisation of atrioventricular delay during exercise improves cardiac output in patients stabilised with cardiac resynchronisation therapy.

    Science.gov (United States)

    Sun, Jing Ping; Lee, Alex Pui-Wai; Grimm, Richard A; Hung, Ming-Jui; Yang, Xing Sheng; Delurgio, David; Leon, Angel R; Merlino, John D; Yu, Cheuk-Man

    2012-01-01

    Atrioventricular (AV) delay in cardiac resynchronisation therapy (CRT) recipients are typically optimised at rest. However, there are limited data on the impact of exercise-induced changes in heart rate on the optimal AV delay and left ventricular function. The authors serially programmed AV delays in 41 CRT patients with intrinsic sinus rhythm at rest and during two stages of supine bicycle exercise with heart rates at 20 bpm (stage I) and 40 bpm (stage II) above baseline. The optimal AV delay during exercise was determined by the iterative method to maximise cardiac output using Doppler echocardiography. Results were compared to physiological change in PR intervals in 56 normal controls during treadmill exercise. The optimal AV delay was progressively shortened (pexercise level (baseline: 123±26 ms vs. stage I: 102±24 ms vs stage II: 70±22 ms, pexercise. A linear inverse relationship existed between optimal AV delays and heart rates in CRT patients (AV delay=241-1.61×heart rate, R2=0.639, pheart rate during exercise, which suggests the need for programming of rate-adaptive AV delay in CRT recipients.

  15. Non-linear properties of R-R distributions as a measure of heart rate variability

    Energy Technology Data Exchange (ETDEWEB)

    Irurzun, I.M.; Bergero, P.; Cordero, M.C.; Defeo, M.M.; Vicente, J.L.; Mola, E.E

    2003-06-01

    We analyze the dynamic quality of the R-R interbeat intervals of electrocardiographic signals from healthy people and from patients with premature ventricular contractions (PVCs) by applying different measure algorithms to standardised public domain data sets of heart rate variability. Our aim is to assess the utility of these algorithms for the above mentioned purposes. Long and short time series, 24 and 0.50 h respectively, of interbeat intervals of healthy and PVC subjects were compared with the aim of developing a fast method to investigate their temporal organization. Two different methods were used: power spectral analysis and the integral correlation method. Power spectral analysis has proven to be a powerful tool for detecting long-range correlations. If it is applied in a short time series, power spectra of healthy and PVC subjects show a similar behavior, which disqualifies power spectral analysis as a fast method to distinguish healthy from PVC subjects. The integral correlation method allows us to study the fractal properties of interbeat intervals of electrocardiographic signals. The cardiac activity of healthy and PVC people stems from dynamics of chaotic nature characterized by correlation dimensions d{sub f} equal to 3.40{+-}0.50 and 5.00{+-}0.80 for healthy and PVC subjects respectively. The methodology presented in this article bridges the gap between theoretical and experimental studies of non-linear phenomena. From our results we conclude that the minimum number of coupled differential equations to describe cardiac activity must be six and seven for healthy and PVC individuals respectively. From the present analysis we conclude that the correlation integral method is particularly suitable, in comparison with the power spectral analysis, for the early detection of arrhythmias on short time (0.5 h) series.

  16. Usefulness of short-term variability of QT intervals as a predictor for electrical remodeling and proarrhythmia in patients with nonischemic heart failure

    DEFF Research Database (Denmark)

    Hinterseer, Martin; Beckmann, Britt-Maria; Thomsen, Morten Bækgaard;

    2010-01-01

    The high incidence of sudden cardiac death in heart failure (HF) reflects electrophysiologic changes in response to myocardial failure. We previously showed that short-term variability of QT intervals (STV(QT)) identifies latent repolarization disorders in patients with drug-induced or congenital...

  17. Reference intervals and allometric scaling of echocardiographic measurements in Bengal cats.

    Science.gov (United States)

    Scansen, Brian A; Morgan, Kyla L

    2015-12-01

    The Bengal is a relatively new hybrid breed, reported to develop hypertrophic cardiomyopathy. The aim of this study was to determine reference intervals for echocardiographic measurements in Bengal cats. Sixty-six apparently healthy Bengal cats. The study included a retrospective review of echocardiograms from 39 Bengal cats evaluated from March 2004 to June 2012 and reported to be normal by a board-certified cardiologist. An additional 27 cats were enrolled prospectively from June 2012 to June 2013. The effects of sex and body weight on linear cardiac dimensions were evaluated by regression analysis. Reference intervals were determined by the robust method with bootstrapping. Allometric equations scaled to body weight were derived for each echocardiographic variable. Intra- and interobserver variability were evaluated by coefficient of variation from 6 of the prospective studies. Reference intervals were determined from all 66 Bengal cats as no significant differences were observed between the retrospective and prospective data. An effect of sex, separate from body weight, was suggested and unique reference intervals for male and female cats were determined. Body weight was a significant co-variate and 95% prediction intervals for linear dimensions were determined by allometric scaling. Coefficients of variation were less than 10% for 2-dimensional variables and less than 18% for M-mode variables. These data provide reference intervals and weight-based 95% prediction intervals for echocardiographic measurements in the Bengal cat, potentially aiding cardiologists who screen this breed in detecting pathologic variants from normal dimensions. Copyright © 2015 Elsevier B.V. All rights reserved.

  18. Coefficient Omega Bootstrap Confidence Intervals: Nonnormal Distributions

    Science.gov (United States)

    Padilla, Miguel A.; Divers, Jasmin

    2013-01-01

    The performance of the normal theory bootstrap (NTB), the percentile bootstrap (PB), and the bias-corrected and accelerated (BCa) bootstrap confidence intervals (CIs) for coefficient omega was assessed through a Monte Carlo simulation under conditions not previously investigated. Of particular interests were nonnormal Likert-type and binary items.…

  19. [Short pregnancy interval and reproductive disorders

    NARCIS (Netherlands)

    Jongbloet, P.H.; Zielhuis, G.A.; Pasker-de Jong, P.C.M.

    2002-01-01

    The cause of the 'borderline personality disorder' of Vincent van Gogh has been discussed in social-psychiatric terms related to so-called 'substitute children', born after the loss of a previous child. A biological-organic genesis, i.e. the very short birth interval of precisely one year between Va

  20. Happiness Scale Interval Study. Methodological Considerations

    Science.gov (United States)

    Kalmijn, W. M.; Arends, L. R.; Veenhoven, R.

    2011-01-01

    The Happiness Scale Interval Study deals with survey questions on happiness, using verbal response options, such as "very happy" and "pretty happy". The aim is to estimate what degrees of happiness are denoted by such terms in different questions and languages. These degrees are expressed in numerical values on a continuous [0,10] scale, which are…

  1. Interval-based Specification of Concurrent Objects

    DEFF Research Database (Denmark)

    Løvengreen, Hans Henrik; Sørensen, Morten U.

    1998-01-01

    We propose a logic for specifying the behaviour of concurrent objects, ie. concurrent entities that invoke operation of each other. The logic is an interval logic whith operation invocatins as primitive formulas. The strengths and deficiencies of the logic are illustrated by specifying a variety...

  2. Interval logic. Proof theory and theorem proving

    DEFF Research Database (Denmark)

    Rasmussen, Thomas Marthedal

    2002-01-01

    Real-time systems are computer systems which have to meet real-time constraints. To increase the confidence in such systems, formal methods and formal verification are utilized. The class of logics known as interval logics can be used for expressing properties and requirements of real-time system...

  3. Mitotic activity index in interval breast cancers.

    NARCIS (Netherlands)

    Groenendijk, R.P.R.; Bult, P.; Noppen, C.M.; Boetes, C.; Ruers, T.J.M.; Wobbes, Th.

    2003-01-01

    AIMS: The Mitotic Activity Index (MAI) is a strong prognostic factor for disease free survival in breast cancer. The MAI is lower in screen detected tumours, correlating with less aggressive biological behaviour in this group. In this study the MAI is compared between screen detected, interval and s

  4. High Intensity Interval Training: New Insights

    Institute of Scientific and Technical Information of China (English)

    Martin J.Gibala

    2008-01-01

    @@ KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief,intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.,≥90%of VO2 peak).

  5. Robust stability of interval parameter matrices

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    This note is devoted to the problem of robust stability of interval parameter matrices. Based on some basic facts relating the H∞ norm of a transfer function to the Riccati matrix inequality and Hamilton matrix, several test conditions with parameter perturbation bounds are obtained.

  6. Precise Interval Timer for Software Defined Radio

    Science.gov (United States)

    Pozhidaev, Aleksey (Inventor)

    2014-01-01

    A precise digital fractional interval timer for software defined radios which vary their waveform on a packet-by-packet basis. The timer allows for variable length in the preamble of the RF packet and allows to adjust boundaries of the TDMA (Time Division Multiple Access) Slots of the receiver of an SDR based on the reception of the RF packet of interest.

  7. Happiness Scale Interval Study. Methodological Considerations

    Science.gov (United States)

    Kalmijn, W. M.; Arends, L. R.; Veenhoven, R.

    2011-01-01

    The Happiness Scale Interval Study deals with survey questions on happiness, using verbal response options, such as "very happy" and "pretty happy". The aim is to estimate what degrees of happiness are denoted by such terms in different questions and languages. These degrees are expressed in numerical values on a continuous…

  8. Computation of confidence intervals for Poisson processes

    Science.gov (United States)

    Aguilar-Saavedra, J. A.

    2000-07-01

    We present an algorithm which allows a fast numerical computation of Feldman-Cousins confidence intervals for Poisson processes, even when the number of background events is relatively large. This algorithm incorporates an appropriate treatment of the singularities that arise as a consequence of the discreteness of the variable.

  9. Computation of confidence intervals for Poisson processes

    CERN Document Server

    Aguilar-Saavedra, J A

    2000-01-01

    We present an algorithm which allows a fast numerical computation of Feldman-Cousins confidence intervals for Poisson processes, even when the number of background events is relatively large. This algorithm incorporates an appropriate treatment of the singularities that arise as a consequence of the discreteness of the variable.

  10. [Determination and verification of reference intervals].

    Science.gov (United States)

    Henny, J; Arnaud, J; Giroud, C; Vassault, A

    2010-12-01

    Based on the original recommendation of the Expert Panel on the Theory of Reference values of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC-LM), updated guidelines were recently published under the auspices of IFCC and the Clinical and Laboratory Standards Institute. These updated guidelines add valuable improvements (transference, validation and verifying reference intervals).

  11. Interval Mapping of Multiple Quantitative Trait Loci

    NARCIS (Netherlands)

    Jansen, Ritsert C.

    1993-01-01

    The interval mapping method is widely used for the mapping of quantitative trait loci (QTLs) in segregating generations derived from crosses between inbred lines. The efficiency of detecting and the accuracy of mapping multiple QTLs by using genetic markers are much increased by employing multiple Q

  12. Linear chord diagrams on two intervals

    DEFF Research Database (Denmark)

    Andersen, Jørgen Ellegaard; Penner, Robert; Reidys, Christian

    generating function ${\\bf C}_g(z)=z^{2g}R_g(z)/(1-4z)^{3g-{1\\over 2}}$ for chords attached to a single interval is algebraic, for $g\\geq 1$, where the polynomial $R_g(z)$ with degree at most $g-1$ has integer coefficients and satisfies $R_g(1/4)\

  13. John Buridan's Sophismata and interval temporal semantics

    NARCIS (Netherlands)

    Uckelman, S.L.; Johnston, S.

    2010-01-01

    In this paper we look at the suitability of modern interval-based temporal logic for modeling John Buridan’s treatment of tensed sentences in his Sophismata. Building on the paper [Øhrstrøm 1984], we develop Buridan’s analysis of temporal logic, paying particular attention to his notions of negation

  14. Modal Transition Systems with Weight Intervals

    DEFF Research Database (Denmark)

    Juhl, Line; Larsen, Kim Guldstrand; Srba, Jiri

    2012-01-01

    We propose weighted modal transition systems, an extension to the well-studied specification formalism of modal transition systems that allows to express both required and optional behaviours of their intended implementations. In our extension we decorate each transition with a weight interval th...

  15. Learned Interval Time Facilitates Associate Memory Retrieval

    Science.gov (United States)

    van de Ven, Vincent; Kochs, Sarah; Smulders, Fren; De Weerd, Peter

    2017-01-01

    The extent to which time is represented in memory remains underinvestigated. We designed a time paired associate task (TPAT) in which participants implicitly learned cue-time-target associations between cue-target pairs and specific cue-target intervals. During subsequent memory testing, participants showed increased accuracy of identifying…

  16. Patch in Cardiac Surgery

    Directory of Open Access Journals (Sweden)

    Alireza Alizadeh Ghavidel

    2014-06-01

    Full Text Available Introduction: Excessive bleeding presents a risk for the patient in cardiovascular surgery. Local haemostatic agents are of great value to reduce bleeding and related complications. TachoSil (Nycomed, Linz, Austria is a sterile, haemostatic agent that consists of an equine collagen patchcoated with human fibrinogen and thrombin. This study evaluated the safety and efficacy of TachoSil compared to conventional technique.Methods: Forty-two patients scheduled for open heart surgeries, were entered to this study from August 2010 to May 2011. After primary haemostatic measures, patients divided in two groups based on surgeon’s judgment. Group A: 20 patients for whom TachoSil was applied and group B: 22 patients that conventional method using Surgicel (13 patients or wait and see method (9 cases, were performed in order to control the bleeding. In group A, 10 patients were male with mean age of 56.95±15.67 years and in group B, 9 cases were male with mean age of 49.95±14.41 years. In case group 70% (14/20 of the surgeries were redo surgeries versus 100% (22/22 in control group.Results: Baseline characteristics were similar in both groups. In TachoSil group 75% of patients required transfusion versus 90.90% in group B (P=0.03.Most transfusions consisted of packed red blood cell; 2±1.13 units in group A versus 3.11±1.44 in group B (P=0.01, however there were no significant differences between two groups regarding the mean total volume of intra and post-operative bleeding. Re-exploration was required in 10% in group A versus 13.63% in group B (P=0.67.Conclusion: TachoSil may act as a superior alternative in different types of cardiac surgery in order to control the bleeding and therefore reducing transfusion requirement.

  17. Dying from cardiac tamponade

    Directory of Open Access Journals (Sweden)

    Powari Manish

    2007-09-01

    Full Text Available Abstract Background To determine the causes of cardiac tamponade (CT, focussing especially on haemopericardium (HP, as a terminal mode of death, within a 430,000 rural English population. Methods Our hospital mortuary register and, all postmortem reports between 1995 and 2004 inclusive, were interrogated for patients dying of CT or HP. The causes of CT/HP and selected morphological characteristics were then determined. Results 14,368 postmortems were performed in this period: of these, 461 patients died of CT. Three cases were due to non-haemorrhagic pericardial effusion. HP accounted for the remaining 458 cases of which, five were post-traumatic, 311 followed rupture of an acute myocardial infarction (RAMI, 138 after intra-pericardial rupture of dissecting ascending aortic aneurysms (RD3A and four were due to miscellaneous causes. HP was more commonly due to RAMI. Men tended to die from RAMI or RD3A earlier than women. RAMI or RD3A were commoner in men Two thirds of RAMI were associated with coronary artery thrombosis. Anterior free wall rupture was commonest overall, and in women, but posterior free wall rupture was commoner in men. The volume of intrapericardial blood in RAMI (mean = 440 ml and RD3A (mean = 498 ml varied between 150 and 1000 ml: intrapericardial blood volume was greater in men than in women dying from either RAMI or RD3A. Conclusion At postmortem, CT is most often related to HP, attributable to either RAMI or intrapericardial RD3A. Post-traumatic and other causes of CT are infrequent.

  18. Cardiac output monitoring

    Directory of Open Access Journals (Sweden)

    Mathews Lailu

    2008-01-01

    Full Text Available Minimally invasive and non-invasive methods of estimation of cardiac output (CO were developed to overcome the limitations of invasive nature of pulmonary artery catheterization (PAC and direct Fick method used for the measurement of stroke volume (SV. The important minimally invasive techniques available are: oesophageal Doppler monitoring (ODM, the derivative Fick method (using partial carbon dioxide (CO 2 breathing, transpulmonary thermodilution, lithium indicator dilution, pulse contour and pulse power analysis. Impedance cardiography is probably the only non-invasive technique in true sense. It provides information about haemodynamic status without the risk, cost and skill associated with the other invasive or minimally invasive techniques. It is important to understand what is really being measured and what assumptions and calculations have been incorporated with respect to a monitoring device. Understanding the basic principles of the above techniques as well as their advantages and limitations may be useful. In addition, the clinical validation of new techniques is necessary to convince that these new tools provide reliable measurements. In this review the physics behind the working of ODM, partial CO 2 breathing, transpulmonary thermodilution and lithium dilution techniques are dealt with. The physical and the physiological aspects underlying the pulse contour and pulse power analyses, various pulse contour techniques, their development, advantages and limitations are also covered. The principle of thoracic bioimpedance along with computation of CO from changes in thoracic impedance is explained. The purpose of the review is to help us minimize the dogmatic nature of practice favouring one technique or the other.

  19. Cardiac pacing and aviation.

    Science.gov (United States)

    Toff, W D; Edhag, O K; Camm, A J

    1992-12-01

    Certain applicants with stable disturbances of rhythm or conduction requiring cardiac pacing, in whom no other disqualifying condition is present, may be considered fit for medical certification restricted to multi-crew operations. The reliability of modern pacing systems appears adequate to permit restricted certification even in pacemaker dependent subjects except for certain models of pacemakers and leads known to be at increased risk of failure. These are to be avoided. There is little evidence to suggest that newer devices are any more reliable than their predecessors. Single and dual chamber systems appear to have similar reliability up to 4 years, after which time significant attrition of dual chamber devices occurs, principally due to battery depletion. All devices require increased scrutiny as they approach their end of life as predicted from longevity data and pacing characteristics. Unipolar and bipolar leads are of similar reliability, apart from a number of specific bipolar polyurethane leads which have been identified. Atrial leads, particularly those without active fixation, are less secure than ventricular leads and applicants who are dependent on atrial sensing or pacing should be denied certification. Bipolar leads are to be preferred due to the lower risk of myopotential and exogenous EMI. Sensor-driven adaptive-rate pacing systems using active sensors may have reduced longevity and require close scrutiny. Activity-sensing devices using piezoelectric crystal sensors may be subject to significant rate rises in rotary wing aircraft. The impracticality of restricted certification in helicopters will, in any event, preclude certification. Such devices would best be avoided in hovercraft (air cushioned vehicle) pilots. Only minor rate rises are likely in fixed-wing aircraft which are unlikely to be of significance. Anti-tachycardia devices and implanted defibrillators are inconsistent with any form of certification to fly.

  20. Heritability of Tpeak-Tend Interval and T-wave Amplitude: A Twin Study

    DEFF Research Database (Denmark)

    Haarmark, Christian; Kyvik, Kirsten O; Vedel-Larsen, Esben;

    2011-01-01

    BACKGROUND: -Tpeak-Tend interval (TpTe) and T-wave amplitude (Tamp) carry diagnostic and prognostic information regarding cardiac morbidity and mortality. Heart rate and QT interval are known to be heritable traits. The heritability of T-wave morphology parameters such as TpTe and Tamp is unknown....... TpTe and Tamp were evaluated in a large sample of twins. METHODS AND RESULTS: -Twins from the GEMINAKAR study (611 pairs, 246 monozygotic, 365 dizygotic, aged 38±11 years, 49 % men) who had an ECG performed during 1997-2000 were included. Tamp was measured in leads V1 and V5. Duration variables (RR...... are heritable ECG parameters....

  1. Haematological reference intervals in a multiethnic population.

    Directory of Open Access Journals (Sweden)

    Angeli Ambayya

    Full Text Available INTRODUCTION: Similar to other populations, full blood count reference (FBC intervals in Malaysia are generally derived from non-Malaysian subjects. However, numerous studies have shown significant differences between and within populations supporting the need for population specific intervals. METHODS: Two thousand seven hundred twenty five apparently healthy adults comprising all ages, both genders and three principal races were recruited through voluntary participation. FBC was performed on two analysers, Sysmex XE-5000 and Unicel DxH 800, in addition to blood smears and haemoglobin analysis. Serum ferritin, soluble transferrin receptor and C-reactive protein assays were performed in selected subjects. All parameters of qualified subjects were tested for normality followed by determination of reference intervals, measures of central tendency and dispersion along with point estimates for each subgroup. RESULTS: Complete data was available in 2440 subjects of whom 56% (907 women and 469 men were included in reference interval calculation. Compared to other populations there were significant differences for haemoglobin, red blood cell count, platelet count and haematocrit in Malaysians. There were differences between men and women, and between younger and older men; unlike in other populations, haemoglobin was similar in younger and older women. However ethnicity and smoking had little impact. 70% of anemia in premenopausal women, 24% in postmenopausal women and 20% of males is attributable to iron deficiency. There was excellent correlation between Sysmex XE-5000 and Unicel DxH 800. CONCLUSION: Our data confirms the importance of population specific haematological parameters and supports the need for local guidelines rather than adoption of generalised reference intervals and cut-offs.

  2. Evaluation of Resting Cardiac Power Output as a Prognostic Factor in Patients with Advanced Heart Failure.

    Science.gov (United States)

    Yildiz, Omer; Aslan, Gamze; Demirozu, Zumrut T; Yenigun, Cemal Deniz; Yazicioglu, Nuran

    2017-09-15

    If the heart is represented by a hydraulic pump, cardiac power represents the hydraulic function of the heart. Cardiac pump function is frequently determined through left ventricular ejection fraction using imaging. This study aims to validate resting cardiac power output (CPO) as a predictive biomarker in patients with advanced heart failure (HF). One hundred and seventy-two patients with HF severe enough to warrant cardiac transplantation were retrospectively reviewed at a single tertiary care institution between September 2010 and July 2013. Patients were initially evaluated with simultaneous right-sided and left-sided cardiac catheter-based hemodynamic measurements, followed by longitudinal follow-up (median of 52 months) for adverse events (cardiac mortality, cardiac transplantation, or ventricular assist device placement). Median resting CPO was 0.54 W (long rank chi-square = 33.6; p < 0.0001). Decreased resting CPO (<0.54 W) predicted increased risk for adverse outcomes. Fifty cardiac deaths, 10 cardiac transplants, and 12 ventricular assist device placements were documented. The prognostic relevance of resting CPO remained significant after adjustment for age, gender, left ventricular ejection fraction, mean arterial pressure, pulmonary vascular resistance, right atrial pressure, and estimated glomerular filtration rate (HR, 3.53; 95% confidence interval, 1.66 to 6.77; p = 0.0007). In conclusion, lower resting CPO supplies independent prediction of adverse outcomes. Thus, it could be effectively used for risk stratification in patients with advanced HF. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. "J waves" induced after short coupling intervals: a manifestations of latent depolarization abnormality?

    Science.gov (United States)

    Aizawa, Yoshifusa; Nakayama, Masafumi; Sato, Masahito; Okabe, Masaaki; Aizawa, Yoshiyasu; Takatsuki, Seiji; Fukuda, Keiichi

    2017-04-24

    To confirm the presence of tachycardia-induced slur or notch in the terminal portion of the QRS complexes in a general patient population. A tachycardia-induced J wave was defined as a slur or notch in the terminal portion of the QRS complexes newly induced at short RR intervals during atrial premature contractions (APCs) or atrial electrical stimulation in the electrophysiological study (EPS). Twenty-three out of 2000 patients with general diseases were involved. All patients with aborted sudden cardiac death, ventricular fibrillation or a family history of sudden cardiac death were excluded. The mean age was 72 ± 9 years, and 11 patients were male (47.8%). When the RR interval was shortened from 821 ± 142 ms to 464 ± 52 ms in the conducted APCs (P waves became diagnostic (0.02 ± 0.03 mV to 0.20 ± 0.07 mV, P waves were confined to the inferior leads in 22 (95.7%) patients and were notched in 11 (47.8%) and slurred in 12 (52.2%) patients. The induction of J waves was accompanied by visible changes of the QRS morphology. When the post-APC RR interval was prolonged to 992 ± 305 ms (P = 0.0154 vs. baseline), the J waves were similar to baseline levels. During the EPS, J wave induction was confirmed during atrial stimulation. There were no characteristic clinical or ECG features in the patients with tachycardia-induced J waves. J waves can be newly induced by short RR intervals in a general patient population, and a conduction delay is the likely mechanism causing such J waves.

  4. The effect of arsenic trioxide on QT interval prolongation during APL therapy

    Institute of Scientific and Technical Information of China (English)

    周晋; 孟然; 李晓霞; 吕成芳; 范圣瑾; 杨宝峰

    2003-01-01

    Objective To investigate the cardiac effect of QT interval prolongation in the treatment of acute promyelocytic leukemia (APL) with arsenic trioxide (As2O3), and the relationship between QT and serum arsenic concentration.Methods Blood serum arsenic concentrations of thirty APL patients were determined at 2 hours, 4 hours, 8 hours, and 24 hours after As2O3 injection using atomic fluorophotometry. Cardiac functions were measured simultaneously using a 12-lead body-surface electrocardiogram (ECG). Q-T intervals were manually measured, and then corrected using Bazett ' s formula (QTc). QT dispersion (QTd) was also calculated. In order to assess the effects of arsenic on the symptoms of anemia, twenty-four anemia patients were divided into two groups on the basis hemoglobin concentration: Group1 (Hb≥90 g/L), and Group 2 (60 g/L≤Hb<90 g/L). QTc and QTd of these patients were also manually measured.Results All QT intervals of APL patients treated with As2O3 injection were prolonged [32.2 ms (27, 41 ms); P 0.05]. There was a delay of 2 hours in maximum QTc following peaks in serum arsenic concentration. Changes in QTc and QTd of the two anemic groups were not prominent.Conclusions As2O3 can prolong QTc intervals in APL patients, but the effects are delayed compared to peak serum arsenic concentrations. As2O3 has no prolongation effect on QTd. Mild and moderate anemia do not effect QTc and QTd.

  5. Interval and continuous exercise enhances aerobic capacity and hemodynamic function in CHF rats

    Directory of Open Access Journals (Sweden)

    Ramiro B. Nunes

    2015-08-01

    Full Text Available OBJECTIVE: The aim of the present study was to compare the effects of continuous versus interval aerobic exercise training on hemodynamic parameters, cardiac remodeling, and maximal exercise capacity (MEC in chronic heart failure (CHF rats.METHOD: Twenty-four male Wistar rats were subjected to myocardial infarction (MI surgery. Five weeks post MI, the animals were assigned to one of three groups: sedentary group (CHF-Sed, n=8, aerobic continuous training group (CHF-ACT, n=8, and aerobic interval training group (CHF-AIT, n=8. Treadmill training was performed five times a week for 8 weeks (ACT: 50 min/day at 15 m/min and AIT: 40 min/day with 8 min of warm-up at 10 m/min and exercise at 15 m/min 4×4 min interspersed with 4×4 min at 23 m/min. MEC was evaluated pre and post exercise program.RESULTS: Left ventricular end-diastolic pressure (LVEDP, left ventricular mass/body mass ratio (LVM:BM, and total collagen volume fraction were lower in the trained groups compared with the sedentary group, but no difference was found between the trained groups. Systolic ventricular pressure (SVP and maximum positive derivative of LV pressure (+dP/dtmax were higher in the trained groups, but CHF-ACT showed higher +dP/dtmax compared to CHF-AIT. Both training regimens were able to increase MEC. However, the aerobic interval training was superior for improving MEC.CONCLUSION: Aerobic training is an important intervention to improve cardiac function and remodeling and physical capacity in CHF rats. Interval training is a potential strategy to maximize the results, but exercise type and intensity are still topics to be explored.

  6. Cardiac Penetrating Injuries and Pseudoaneurysm

    Institute of Scientific and Technical Information of China (English)

    CHEN Shifeng

    2002-01-01

    Objective To discuss the early diagnosis and treatment of cardiac penetrating injuries and pseudoaneurysm. Methods 18 cases of cardiac penetrating injuries, in which 2 cases were complicated with pseudoaneurysm, were diagnosed by emergency operation and color Doppler echocardiography between May 1973 and Dec. 2001 in our hospital. The basis for emergency operation is the injured path locating in cardiac dangerous zone, severe shock or pericardial tamponade. ResultsAmong 18 cases of this study, 17 cases underwent emergency operation. During the operation, 11 cases were found injured in right ventricle, 2 cases were found injured in right atrium, 1 case was found injured in pulmonary artery,4 cases were found injured in left ventricle, 2 cases were found complicated with pseudoaneurysm. 17cases underwent cardiac repair including 1 case of rupture of aneurysm. 1 case underwent elective aneurysm resection. In whole group, 15 cases survived(83.33% ), 3 cases died( 16.67%). The cause of death is mainly hemorrhagic shock. Conclusion Highly suspicious cardiac penetrating injuries or hemopericaridium should undergo direct operative exploration. Pseudoaneurysm should be resected early,which can prevent severe complications.

  7. Cardiac Manifestation in Dengue Fever.

    Science.gov (United States)

    Arora, Mohit; Patil, Rekha S

    2016-07-01

    To study the cardiac manifestations of the dengue fever. This one year descriptive study was undertaken at KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum under the Department of Medicine. A total of 120 patients with either dengue IgM or IgM and IgG were studied. The assessment of cardiac manifestations was done based on electrocardiogram, 2D echocardiography and cardiac enzymes. Of the 120 patients, 85 (70.83%) were males and the male to female ratio was 2.4:1. The mean age of the patients was 33.02 ± 12.71 years. The commonest clinical presentation was myalgia (97.5%) followed by fever (92.5%). On clinical examination 33.33% of the patients had petecheia and only 9 patients having active bleeding manifestation at the time of presentation. A raised CK-MB and Troponin I was observed in 33.3% and 26.7% patients ECG findings revealed normal rhythm among 95% with 15.8% of them having an abnormal heart rate. Rhythm disturbance was noted in 5% of the patients with AV block being the most common (66.67%). Cardiac manifestation in the form of myocarditis was observed in 37.50% of the patients with a positive correlation with the severity of the dengue fever defined as by W.H.O. criteria. Patients with dengue fever are at high risk of developing myocarditis and rhythm disturbance and therefore require a close cardiac monitoring.

  8. Nuclear imaging in cardiac amyloidosis

    Energy Technology Data Exchange (ETDEWEB)

    Glaudemans, A.W.J.M.; Slart, R.H.J.A.; Veltman, N.C.; Dierckx, R.A.J.O. [University Medical Center Groningen, Department of Nuclear Medicine and Molecular Imaging, Hanzeplein 1, P.O. Box 30001, Groningen (Netherlands); Zeebregts, C.J. [University Medical Center Groningen, Department of Surgery (Division of Vascular Surgery), Groningen (Netherlands); Tio, R.A. [University Medical Center Groningen, Department of Cardiology, Groningen (Netherlands); Hazenberg, B.P.C. [University Medical Center Groningen, Department of Rheumatology and Clinical Immunology, Groningen (Netherlands)

    2009-04-15

    Amyloidosis is a disease characterized by depositions of amyloid in organs and tissues. It can be localized (in just one organ) or systemic. Cardiac amyloidosis is a debilitating disease and can lead to arrhythmias, deterioration of heart function and even sudden death. We reviewed PubMed/Medline, without time constraints, on the different nuclear imaging modalities that are used to visualize myocardial amyloid involvement. Several SPECT tracers have been used for this purpose. The results with these tracers in the evaluation of myocardial amyloidosis and their mechanisms of action are described. Most clinical evidence was found for the use of {sup 123}I-MIBG. Myocardial defects in MIBG activity seem to correlate well with impaired cardiac sympathetic nerve endings due to amyloid deposits. {sup 123}I-MIBG is an attractive option for objective evaluation of cardiac sympathetic level and may play an important role in the indirect measurement of the effect of amyloid myocardial infiltration. Other, less sensitive, options are {sup 99m}Tc-aprotinin for imaging amyloid deposits and perhaps {sup 99m}Tc-labelled phosphate derivatives, especially in the differential diagnosis of the aetiology of cardiac amyloidosis. PET tracers, despite the advantage of absolute quantification and higher resolution, are not yet well evaluated for the study of cardiac amyloidosis. Because of these advantages, there is still the need for further research in this field. (orig.)

  9. Therapeutic Hypothermia after In-Hospital Cardiac Arrest in Children.

    Science.gov (United States)

    Moler, Frank W; Silverstein, Faye S; Holubkov, Richard; Slomine, Beth S; Christensen, James R; Nadkarni, Vinay M; Meert, Kathleen L; Browning, Brittan; Pemberton, Victoria L; Page, Kent; Gildea, Marianne R; Scholefield, Barnaby R; Shankaran, Seetha; Hutchison, Jamie S; Berger, John T; Ofori-Amanfo, George; Newth, Christopher J L; Topjian, Alexis; Bennett, Kimberly S; Koch, Joshua D; Pham, Nga; Chanani, Nikhil K; Pineda, Jose A; Harrison, Rick; Dalton, Heidi J; Alten, Jeffrey; Schleien, Charles L; Goodman, Denise M; Zimmerman, Jerry J; Bhalala, Utpal S; Schwarz, Adam J; Porter, Melissa B; Shah, Samir; Fink, Ericka L; McQuillen, Patrick; Wu, Theodore; Skellett, Sophie; Thomas, Neal J; Nowak, Jeffrey E; Baines, Paul B; Pappachan, John; Mathur, Mudit; Lloyd, Eric; van der Jagt, Elise W; Dobyns, Emily L; Meyer, Michael T; Sanders, Ronald C; Clark, Amy E; Dean, J Michael

    2017-01-26

    Targeted temperature management is recommended for comatose adults and children after out-of-hospital cardiac arrest; however, data on temperature management after in-hospital cardiac arrest are limited. In a trial conducted at 37 children's hospitals, we compared two temperature interventions in children who had had in-hospital cardiac arrest. Within 6 hours after the return of circulation, comatose children older than 48 hours and younger than 18 years of age were randomly assigned to therapeutic hypothermia (target temperature, 33.0°C) or therapeutic normothermia (target temperature, 36.8°C). The primary efficacy outcome, survival at 12 months after cardiac arrest with a score of 70 or higher on the Vineland Adaptive Behavior Scales, second edition (VABS-II, on which scores range from 20 to 160, with higher scores indicating better function), was evaluated among patients who had had a VABS-II score of at least 70 before the cardiac arrest. The trial was terminated because of futility after 329 patients had undergone randomization. Among the 257 patients who had a VABS-II score of at least 70 before cardiac arrest and who could be evaluated, the rate of the primary efficacy outcome did not differ significantly between the hypothermia group and the normothermia group (36% [48 of 133 patients] and 39% [48 of 124 patients], respectively; relative risk, 0.92; 95% confidence interval [CI], 0.67 to 1.27; P=0.63). Among 317 patients who could be evaluated for change in neurobehavioral function, the change in VABS-II score from baseline to 12 months did not differ significantly between the groups (P=0.70). Among 327 patients who could be evaluated for 1-year survival, the rate of 1-year survival did not differ significantly between the hypothermia group and the normothermia group (49% [81 of 166 patients] and 46% [74 of 161 patients], respectively; relative risk, 1.07; 95% CI, 0.85 to 1.34; P=0.56). The incidences of blood-product use, infection, and serious adverse

  10. Orders on Intervals Over Partially Ordered Sets: Extending Allen's Algebra and Interval Graph Results

    Energy Technology Data Exchange (ETDEWEB)

    Zapata, Francisco; Kreinovich, Vladik; Joslyn, Cliff A.; Hogan, Emilie A.

    2013-08-01

    To make a decision, we need to compare the values of quantities. In many practical situations, we know the values with interval uncertainty. In such situations, we need to compare intervals. Allen’s algebra describes all possible relations between intervals on the real line, and ordering relations between such intervals are well studied. In this paper, we extend this description to intervals in an arbitrary partially ordered set (poset). In particular, we explicitly describe ordering relations between intervals that generalize relation between points. As auxiliary results, we provide a logical interpretation of the relation between intervals, and extend the results about interval graphs to intervals over posets.

  11. Exercise-induced cardiac remodeling.

    Science.gov (United States)

    Weiner, Rory B; Baggish, Aaron L

    2012-01-01

    Early investigations in the late 1890s and early 1900s documented cardiac enlargement in athletes with above-normal exercise capacity and no evidence of cardiovascular disease. Such findings have been reported for more than a century and continue to intrigue scientists and clinicians. It is well recognized that repetitive participation in vigorous physical exercise results in significant changes in myocardial structure and function. This process, termed exercise-induced cardiac remodeling (EICR), is characterized by structural cardiac changes including left ventricular hypertrophy with sport-specific geometry (eccentric vs concentric). Associated alterations in both systolic and diastolic functions are emerging as recognized components of EICR. The increasing popularity of recreational exercise and competitive athletics has led to a growing number of individuals exhibiting these findings in routine clinical practice. This review will provide an overview of EICR in athletes.

  12. [Ectopia cordis and cardiac anomalies].

    Science.gov (United States)

    Cabrera, Alberto; Rodrigo, David; Luis, María Teresa; Pastor, Esteban; Galdeano, José Miguel; Esteban, Susana

    2002-11-01

    Ectopia cordis is a rare disease that occurs in 5.5 to 7.9 per million live births. Only 267 cases had been reported as of 2001, most (95%) associated with other cardiac anomalies. We studied the cardiac malformations associated in 6 patients with ectopia cordis. Depending on where the defect was located, the cases of ectopia were classified into four groups: cervical, thoracic, thoraco-abdominal, and abdominal. All 6 patients died before the third day of life, 4 during delivery. Three of the patients were included in the thoracic group, whereas the other 3 belonged to the thoraco-abdominal group. All the patients had associated ventricular septal defects, 3 double-outlet right ventricle (50%) and the rest (50%) tetralogy of Fallot-pulmonary atresia. Two patients with double-outlet right ventricle presented mitral-valve pathology, a parachute valve and an atresic mitral valve. None of these cardiac anomalies have been reported to date.

  13. Electrophysiological Cardiac Modeling: A Review.

    Science.gov (United States)

    Beheshti, Mohammadali; Umapathy, Karthikeyan; Krishnan, Sridhar

    2016-01-01

    Cardiac electrophysiological modeling in conjunction with experimental and clinical findings has contributed to better understanding of electrophysiological phenomena in various species. As our knowledge on underlying electrical, mechanical, and chemical processes has improved over time, mathematical models of the cardiac electrophysiology have become more realistic and detailed. These models have provided a testbed for various hypotheses and conditions that may not be easy to implement experimentally. In addition to the limitations in experimentally validating various scenarios implemented by the models, one of the major obstacles for these models is computational complexity. However, the ever-increasing computational power of supercomputers facilitates the clinical application of cardiac electrophysiological models. The potential clinical applications include testing and predicting effects of pharmaceutical agents and performing patient-specific ablation and defibrillation. A review of studies involving these models and their major findings are provided.

  14. Physical Stress Echocardiography: Prediction of Mortality and Cardiac Events in Patients with Exercise Test showing Ischemia

    Directory of Open Access Journals (Sweden)

    Ana Carla Pereira de Araujo

    2014-11-01

    Full Text Available Background: Studies have demonstrated the diagnostic accuracy and prognostic value of physical stress echocardiography in coronary artery disease. However, the prediction of mortality and major cardiac events in patients with exercise test positive for myocardial ischemia is limited. Objective: To evaluate the effectiveness of physical stress echocardiography in the prediction of mortality and major cardiac events in patients with exercise test positive for myocardial ischemia. Methods: This is a retrospective cohort in which 866 consecutive patients with exercise test positive for myocardial ischemia, and who underwent physical stress echocardiography were studied. Patients were divided into two groups: with physical stress echocardiography negative (G1 or positive (G2 for myocardial ischemia. The endpoints analyzed were all-cause mortality and major cardiac events, defined as cardiac death and non-fatal acute myocardial infarction. Results: G2 comprised 205 patients (23.7%. During the mean 85.6 ± 15.0-month follow-up, there were 26 deaths, of which six were cardiac deaths, and 25 non-fatal myocardial infarction cases. The independent predictors of mortality were: age, diabetes mellitus, and positive physical stress echocardiography (hazard ratio: 2.69; 95% confidence interval: 1.20 - 6.01; p = 0.016. The independent predictors of major cardiac events were: age, previous coronary artery disease, positive physical stress echocardiography (hazard ratio: 2.75; 95% confidence interval: 1.15 - 6.53; p = 0.022 and absence of a 10% increase in ejection fraction. All-cause mortality and the incidence of major cardiac events were significantly higher in G2 (p < 0. 001 and p = 0.001, respectively. Conclusion: Physical stress echocardiography provides additional prognostic information in patients with exercise test positive for myocardial ischemia.

  15. Relation of cardiac abnormalities and CTG-repeat size in myotonic dystrophy.

    Science.gov (United States)

    Finsterer, J; Gharehbaghi-Schnell, E; Stöllberger, C; Fheodoroff, K; Seiser, A

    2001-05-01

    It is unclear if the severity of cardiac involvement in patients with myotonic dystrophy (MD) is related to the size of the CTG-repeat expansion. This open, uncontrolled, observational, prospective study aimed to find out if there is a relation between the severity of cardiac involvement in MD and the CTG-repeat size. In 21 patients with MD, (8 women, 13 men, aged 11-88 years) a detailed cardiologic examination, including history, clinical examination, electrocardiography (ECG), transthoracic echocardiography and ambulatory 24-h ECG, was carried out and cardiac involvement was assessed according to a previously described scoring system. Additionally, the CTG-repeat size was determined from nuclear DNA of blood leukocytes. The correlation between the CTG-repeat size and the mean heart rate, PQ-interval, QTc-interval, fractional shortening, left ventricular enddiastolic diameter, septal thickness, posterior wall thickness, mean heart rate on 24-h ECG and cardiac involvement score was r=0.47, r=0.086, r=0.11, r=-0.27, r=-0.34, r=-0.06, r=-0.12, r=0.16 and r=0.09 (all p>0.05), respectively. In patients 21-30, 31-40 and 41-50 years of age, cardiac involvement increased with increasing CTG-repeat size. In younger patients, the number of CTG-repeats needed to develop a reasonable cardiac involvement was higher than in older patients. Depending on age, cardiac involvement increases with increasing CTG-repeat size obtained from blood leukocytes in patients with MD.

  16. Effects of Disulfiram on QTc Interval in non-Opioid Dependent and Methadone-Treated Cocaine Dependent Patients

    Science.gov (United States)

    Atkinson, Thomas S.; Sanders, Nichole; Mancino, Michael; Oliveto, Alison

    2013-01-01

    Objectives Methadone and cocaine are each known to prolong the QTc interval, a risk factor for developing potentially fatal cardiac arrhythmias. Disulfiram, often administered in the context of methadone maintenance to facilitate alcohol abstinence, has been shown to have some efficacy for cocaine dependence. Disulfiram has differential effects on cocaine and methadone metabolism, but its impact on methadone- or cocaine-induced changes in QTc interval is unclear. Thus, the effects of disulfiram on QTc interval in a subset of cocaine dependent patients participating in a 14 week, randomized, double blind, placebo-controlled clinical trial of disulfiram was prospectively determined. Methods Opioid dependent participants were inducted onto methadone (wks 1-2; MT) and both MT and nonopioid dependent (UT) participants were randomized to receive disulfiram (wks 3-14) at one of the following doses: 0, 250, 375, or 500 mg/day. Electrocardiograms (ECGs) were obtained prior to study entry and during weeks 2 and 4. Results Complete QTc interval data in 23 MT and 18 UT participants were analyzed. QTc interval tended to be higher in MT relative to UT dependent participants, regardless of disulfiram dose and time point, but disulfiram did not differentially alter QTc interval. QTc interval was, however, significantly greater in participants with recent cocaine use than those with no recent use. Conclusions These results suggest that cocaine use and possibly MT status, but not disulfiram, are risk factors for QTc prolongation. PMID:23648640

  17. Effects of phenobarbital and levetiracetam on PR and QTc intervals in patients with post-stroke seizure.

    Science.gov (United States)

    Siniscalchi, Antonio; Scaglione, Francesco; Sanzaro, Enzo; Iemolo, Francesco; Albertini, Giorgio; Quirino, Gianluca; Manes, Maria Teresa; Gratteri, Santo; Mercuri, Nicola Biagio; De Sarro, Giovambattista; Gallelli, Luca

    2014-12-01

    Sudden unexplained/unexpected death (SUDEP) is related to high mortality in patients with epilepsy. The prolongation of QT interval, involved in cardiac arrhythmia-related SUDEP, may be precipitated by antiepileptic drugs (AEDs). In this study, we evaluated the effects of phenobarbital and levetiracetam on PR-QTc intervals in patients with post-stroke seizures. We performed an open-label, parallel group, prospective, multicenter study between June 2009 and December 2013 in patients older than 18 years of age with a clinical diagnosis of post-stroke seizure and treated with phenobarbital or levetiracetam. In order to exclude a role of cerebral post-stroke injury on modulation of PR and QTc intervals, patients with cerebral post-stroke injury and without seizures were also enrolled as controls. Interictal electrocardiography analysis revealed no significant difference in PR interval between patients treated with an AED (n = 49) and control patients (n = 50) (181.25 ± 12.05 vs. 182.4 ± 10.3 ms; p > 0.05). In contrast, a significantly longer QTc interval was recorded in patients treated with an AED compared with control patients (441.2 ± 56.6 vs. 396.8 ± 49.3 ms; p phenobarbital showed a significantly longer QTc interval than patients treated with levetiracetam (460.0 ± 57.2 vs. 421.5 ± 50.1 ms; p phenobarbital prolonged QTc interval more so than levetiracetam.

  18. Delayed Interval Delivery in a Triplet Pregnancy

    Directory of Open Access Journals (Sweden)

    Sheng-Po Kao

    2006-02-01

    Full Text Available Due to a surge in the availability of assisted reproductive techniques (ART, the incidence of multiple pregnancies is increasing. Preterm labor is a major complication in such pregnancies. Preterm delivery of the first fetus is often followed by delivery of the remaining fetuses. However, conservative management and delayed interval delivery in the remaining fetuses might allow for fetal lung maturity and would reduce perinatal morbidities. A 32-year-old female had a quadruplet pregnancy after receiving ART. Fetal reduction to triplet pregnancy was performed at 11 weeks of gestation. The remaining triplet pregnancy was stable until 29 weeks of gestation, when the first triplet was delivered after spontaneous rupture of membranes. Under intensive monitoring, the remaining 2 fetuses were delivered by cesarean section at 31 weeks of gestation. Only the first fetus had retinopathy after discharge. In conclusion, delayed interval delivery of the remaining fetuses should be attempted after preterm delivery of the first fetus.

  19. On singular interval-valued iteration groups

    Directory of Open Access Journals (Sweden)

    Marek Cezary Zdun

    2016-09-01

    Full Text Available Let I=(a,b and L be a nowhere dense perfect set containing the ends of the interval I and let varphi:Ito mathbb R be a non-increasing continuoussurjection constant on the components of Isetminus L and the closures of these components be the maximal intervals of constancy of varphi . The family F^t,tin mathbb R of theinterval-valued functions F^t(x:=varphi^ -1 t+varphi(x , xin I forms a set-valued iteration group. We determine a maximal densesubgroup Tsubsetneq mathbb R such that the set-valued subgroup F^t,tin T has some regular properties. In particular, the mappings Tbackepsilon tto F^t(x for tin T possess selections f^t(x in F^t(x, which are disjoint group of continuous functions.

  20. Cardiac tumours in intrauterine life.

    OpenAIRE

    Groves, A.M.; Fagg, N. L.; Cook, A C; Allan, L. D.

    1992-01-01

    Since 1980, 11 examples of cardiac tumour have been detected in the fetus out of a total of 794 congenital cardiac malformations. Patients were referred because of fetal hydrops in two, a family history of tuberous sclerosis in two, and because of the detection of a tumour mass during a scan at the local hospital in seven. The gestational age range at presentation was from 20-34 weeks. Of eight fetuses where death occurred, the histological type was rhabdomyoma in seven and teratoma in one. I...

  1. Clinical advances on Cardiac Insuffiency

    Directory of Open Access Journals (Sweden)

    Angel Julio Romero Cabrera

    2007-06-01

    Full Text Available Cardiac insuffiency is a complex clinical syndrome which constitutes a common final path to get in by the majority of the cardiac diseases. Studies based on the communitarian surveys shows that from 30 to 40 % of the patients decease within the first year of the diagnosis. The rest of the patients (from 60 to 70 % die within the 5 years after being diagnosed. For this reason it has been called as the ¨cancer of cardiology¨. The objective of this article is to update the advances reached in the clinical and therapeutic aspects of this important syndrome.

  2. Complications after cardiac implantable electronic device implantations

    DEFF Research Database (Denmark)

    Kirkfeldt, Rikke Esberg; Johansen, Jens Brock; Nohr, Ellen Aagaard;

    2014-01-01

    Complications after cardiac implantable electronic device (CIED) treatment, including permanent pacemakers (PMs), cardiac resynchronization therapy devices with defibrillators (CRT-Ds) or without (CRT-Ps), and implantable cardioverter defibrillators (ICDs), are associated with increased patient...

  3. An update on insertable cardiac monitors

    DEFF Research Database (Denmark)

    Olsen, Flemming J; Biering-Sørensen, Tor; Krieger, Derk W

    2015-01-01

    Continuous cardiac rhythm monitoring has undergone compelling progress over the past decades. Cardiac monitoring has emerged from 12-lead electrocardiograms being performed at the discretion of the treating physician to in-hospital telemetry, Holter monitoring, prolonged external event monitoring...

  4. QTC INTERVAL DURATION CLASS AND DRUG THERAPY OF PATIENCE IN A FIRST YEAR AFTER PACEMAKER IMPLANTATION

    Directory of Open Access Journals (Sweden)

    M. S. Brynza

    2016-12-01

    Full Text Available 49 patients (28 female, 21 male with implanted DDD/DDDR, VVI/VVIR and CRT pacemakers are investigated. Purpose frequency and dose rate of anticoagulants, antiplatelet agents, direct thrombin inhibitors, cardiac glycosides, amiodarone; ivabradine, diuretics, aldosterone antagonists, beta-adrenergic blockers, calcium channel blockers, angiotensin-converting enzyme (ACE inhibitors, angiotensin II receptor blockers (ARBs, statins were evaluated before, in acute postoperative period (3–5 days, 6 months and 1 year after pacemaker implantation. Patients were divided into classes 1 (normal QTc (320–440 ms – 24 (49 % patients and 2 (long QTc (> 440 msec – 25 (51 % patients of QTc interval duration. To process the data using standard statistical procedures using Microsoft Excel. It was more often prescriptions of new anticoagulants, beta-adrenergic blockers, ARBs, statins to patients in the first year after pacemaker implantation. QTc interval duration lengthening was associated with a greater purpose frequency and doses of amiodarone, diuretics, beta-adrenergic blockers, ACE inhibitors, ARBs and statins. Patients with implanted pacemaker need individualized drug therapy according to QTc interval duration, in particular, enhancing antiischemic, antihypertensive, antiarrhythmic therapy and therapy of chronic heart failure in patients with QTc interval duration lengthening.

  5. Using simulated noise to define optimal QT intervals for computer analysis of ambulatory ECG.

    Science.gov (United States)

    Tikkanen, P E; Sellin, L C; Kinnunen, H O; Huikuri, H V

    1999-01-01

    The ambulatory electrocardiogram (ECG) is an important medical tool, not only for diagnosis of adverse cardiac events, but also to predict the risk of such events occurring. The 24-hour ambulatory ECG has certain problems and drawbacks because the signal is corrupted by noise from various sources and also several other conditions which may alter the ECG morphology. We have developed a Windows based program for the computer analysis of ambulatory ECG which attempts to address these problems. The software includes options for importing ECG data, different methods of waveform analysis, data-viewing, and exporting the extracted time series. In addition, the modular structure allows for flexible maintenance and expansion of the software. The ECG was recorded using a Holter device and oversampled to enhance the fidelity of the low sampling rate of the ambulatory ECG. The influence of different sampling rates on the interval variability were studied. The noise sensitivity of the implemented algorithm was tested with several types of simulated noise and the precision of the interval measurement was reported with SD values. Our simulations showed that, in most of the cases, defining the end of QT interval at the maximum of the T wave gave the most precise measurement. The definition of the onset of the ventricular repolarization duration is most precisely made on the maximum or descending maximal slope of the R wave. We also analyzed some examples of time series from patients using power spectrum estimates in order to validate the low level QT interval variability.

  6. Two-sorted Point-Interval Temporal Logics

    DEFF Research Database (Denmark)

    Balbiani, Philippe; Goranko, Valentin; Sciavicco, Guido

    2011-01-01

    There are two natural and well-studied approaches to temporal ontology and reasoning: point-based and interval-based. Usually, interval-based temporal reasoning deals with points as particular, duration-less intervals. Here we develop explicitly two-sorted point-interval temporal logical framework...... their expressiveness, comparative to interval-based logics, and the complexity of their satisfiability problems. In particular, we identify some previously not studied and potentially interesting interval logics. © 2011 Elsevier B.V....

  7. Option Pricing Method in a Market Involving Interval Number Factors

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    The method for pricing the option in a market with interval number factors is proposed. The no-arbitrage principle in the interval number valued market and the rule to judge the reasonability of a price interval are given. Using the method, the price interval where the riskless interest and the volatility under B-S setting is given. The price interval from binomial tree model when the key factors u, d, R are all interval numbers is also discussed.

  8. Learning about confidence intervals with software R

    OpenAIRE

    Gariela Gonçalves; Luís Afonso; Marta Ferreira; Teresa Ferro; Nascimento, Maria M.

    2013-01-01

    This work was to study the feasibility of implementing a teaching method that employs software, in a Computational Mathematics course, involving students and teachers through the use of the statistical software R in carrying out practical work, such as strengthening the traditional teaching. The statistical inference, namely the determination of confidence intervals, was the content selected for this experience. It was intended show, first of all, that it is possible to promote, through t...

  9. Understanding Confidence Intervals With Visual Representations

    OpenAIRE

    Navruz, Bilgin; DELEN, Erhan

    2014-01-01

    In the present paper, we showed how confidence intervals (CIs) are valuable and useful in research studies when they are used in the correct form with correct interpretations. The sixth edition of the APA (2010) Publication Manual strongly recommended reporting CIs in research studies, and it was described as “the best reporting strategy” (p. 34). Misconceptions and correct interpretations of CIs were presented from several textbooks. In addition, limitations of the null hypothesis statistica...

  10. Periodicity In The Intervals Between Primes

    Science.gov (United States)

    2015-07-02

    simple proportionality in Eq.(32), such that the basic form of Dc over the range (0,Γ] is repeated in progressively smaller scale over subsequent...striations are an aggregate visual effect that could be produced only from finely-grained periodicity in the δ- dependence of Dp. Figure (6) is a...a randomized analogue of the first 104 primes. indicates a certain ‘Russian dolls’-style self-similarity in the periodicity of the prime intervals

  11. Interval Mathematics Applied to Critical Point Transitions

    OpenAIRE

    Stradi, Benito A.

    2012-01-01

    The determination of critical points of mixtures is important for both practical and theoretical reasons in the modeling of phase behavior, especially at high pressure. The equations that describe the behavior of complex mixtures near critical points are highly nonlinear and with multiplicity of solutions to the critical point equations. Interval arithmetic can be used to reliably locate all the critical points of a given mixture. The method also verifies the nonexistence of a critical point ...

  12. Heart Rate Variability for Early Detection of Cardiac Iron Deposition in Patients with Transfusion-Dependent Thalassemia

    Science.gov (United States)

    Silvilairat, Suchaya; Charoenkwan, Pimlak; Saekho, Suwit; Tantiworawit, Adisak; Phrommintikul, Arintaya; Srichairatanakool, Somdet; Chattipakorn, Nipon

    2016-01-01

    Background Iron overload cardiomyopathy remains the major cause of death in patients with transfusion-dependent thalassemia. Cardiac T2* magnetic resonance imaging is costly yet effective in detecting cardiac iron accumulation in the heart. Heart rate variability (HRV) has been used to evaluate cardiac autonomic function and is depressed in cases of thalassemia. We evaluated whether HRV could be used as an indicator for early identification of cardiac iron deposition. Methods One hundred and one patients with transfusion-dependent thalassemia were enrolled in this study. The correlation between recorded HRV and hemoglobin, non-transferrin bound iron (NTBI), serum ferritin and cardiac T2* were evaluated. Results The median age was 18 years (range 8–59 years). The patient group with a 5-year mean serum ferritin >5,000 ng/mL included significantly more homozygous β-thalassemia and splenectomized patients, had lower hemoglobin levels, and had more cardiac iron deposit than all other groups. Anemia strongly influenced all domains of HRV. After adjusting for anemia, neither serum ferritin nor NTBI impacted the HRV. However cardiac T2* was an independent predictor of HRV, even after adjusting for anemia. For receiver operative characteristic (ROC) curve analysis of cardiac T2* ≤20 ms, only mean ferritin in the last 12 months and the average of the standard deviation of all R-R intervals for all five-minute segments in the 24-hour recording were predictors for cardiac T2* ≤20 ms, with area under the ROC curve of 0.961 (p<0.0001) and 0.701 (p = 0.05), respectively. Conclusions Hemoglobin and cardiac T2* as significant predictors for HRV indicate that anemia and cardiac iron deposition result in cardiac autonomic imbalance. The mean ferritin in the last 12 months could be useful as the best indicator for further evaluation of cardiac risk. The ability of serum ferritin to predict cardiac risk is stronger than observed in other thalassemia cohorts. HRV might be a

  13. Exercise-related cardiac cardiac rehabilitation arrest In

    African Journals Online (AJOL)

    ... its possible risks. This study attempted to establish the safety of cardiac ... Patients at risk of CA during exercise were essentially not identifiable, since they .... Patient 2 had had a belO\\~-knee amputation as a consequence of a motor vehicle.

  14. Elevated sensitivity to cardiac ischemia in proteinuric rats is independent of adverse cardiac remodeling

    NARCIS (Netherlands)

    Szymanski, Mariusz K.; Hillege, Hans L.; Danser, A. H. Jan; Garrelds, Ingrid M.; Schoemaker, Regien G.

    2013-01-01

    Objectives: Chronic renal dysfunction severely increases cardiovascular risk. Adverse cardiac remodeling is suggested to play a major role as predisposition for increased cardiac ischemic vulnerability. The aim of the present study was to examine the role of adverse cardiac remodeling in cardiac sen

  15. Effect of female sex on cardiac arrhythmias.

    Science.gov (United States)

    Gowd, B M Pampana; Thompson, Paul D

    2012-01-01

    We performed a systematic literature review to examine the effect of female sex on cardiac electrophysiology and arrhythmias. Women have faster resting heart rates yet longer QTc intervals. Women also have shorter PR and QRS intervals; these are presumed to be due to the small heart size of women and hormonal effects on ion channels. Women are two times more likely to experience atrioventricular nodal re-entry tachycardia than men. In contrast to atrioventricular nodal re-entry tachycardia, accessory-pathway-mediated atrial arrhythmias are less common in women, and women have more concealed and fewer manifest accessory pathways. Supraventricular tachycardia in women varies with the menstrual cycle and is more frequent in the luteal phase and inversely correlated with estrogen levels. Atrial fibrillation (AF) is less prevalent in women, but the absolute number of women with AF is higher because AF prevalence increases with age and women live longer. Also, complications of AF are greater in women. Women are generally less prone to ventricular arrhythmias, but they comprise a higher percentage of symptomatic subjects with congenital long QT syndrome and are more often affected by drugs that prolong the QT. Women are less prone to arrhythmias during pregnancy although they commonly complain of palpitations, which are sometimes related to the increase in heart rate during pregnancy. Clinicians should explore the relationship of arrhythmias to the menstrual cycle in female patients and should know that the menstrual cycle may affect the induction of arrhythmias during electrophysiological testing. Clinicians should also be aware that the arrhythmia and the result of clinical trials examining arrhythmia treatment may have different implications in women than in men.

  16. Pregnancy as a cardiac stress model

    OpenAIRE

    2014-01-01

    Cardiac hypertrophy occurs during pregnancy as a consequence of both volume overload and hormonal changes. Both pregnancy- and exercise-induced cardiac hypertrophy are generally thought to be similar and physiological. Despite the fact that there are shared transcriptional responses in both forms of cardiac adaptation, pregnancy results in a distinct signature of gene expression in the heart. In some cases, however, pregnancy can induce adverse cardiac events in previously healthy women witho...

  17. Fetal cardiac activity analysis during twin pregnancy using a multi-channel SQUID system

    Science.gov (United States)

    Costa Monteiro, E.; Schleussner, E.; Kausch, S.; Grimm, B.; Schneider, A.; Hall Barbosa, C.; Haueisen, J.

    2001-05-01

    The use of SQUID magnetometers for non-invasive in utero assessment of cardiac electrical disturbances has already been shown to be a valuable clinical tool. In this way, its applicability also for the complicated case of twin pregnancy, in which the proximity of the cardiac magnetic source of each fetus can hamper the individual analysis of cardiac electrical activity, is of clinical interest. In this paper, we present fetal magnetocardiography performed on a mother pregnant of twins with 26 weeks gestational age, measured inside a magnetically shielded room, by using two identical 31-channel low- Tc SQUID magnetometer systems. Each sensor array has been positioned over one of the fetuses, according to its heart position previously assessed with the aid of ultrasound measurements. The raw data is initially averaged in time and, afterwards, analyzed by means of time plots and isofield maps. The time recordings allow the study of the morphology of each fetus’ cardiac signal and the cardiac time intervals. The resultant equivalent dipole obtained from the isofield maps indicates the position and orientation of each fetus heart. The results agree with the ultrasound analysis performed immediately before the measurements and used to obtain the approximate location of the fetuses’ hearts. Since a distinct analysis of the cardiac electrical activity of each fetus could be achieved, the results indicate the potential of the fetal magnetocardiography in the individual antenatal diagnosis of each one of the fetuses of a twin pregnancy.

  18. Bifid cardiac apex in a 25-year-old male with sudden cardiac death.

    Science.gov (United States)

    Wu, Annie; Kay, Deborah; Fishbein, Michael C

    2014-01-01

    Although a bifid cardiac apex is common in certain marine animals, it is an uncommon finding in humans. When present, bifid cardiac apex is usually associated with other congenital heart anomalies. We present a case of bifid cardiac apex that was an incidental finding in a 25-year-old male with sudden cardiac death from combined drug toxicity. On gross examination, there was a bifid cardiac apex with a 2-cm long cleft. There were no other significant gross or microscopic abnormalities. This case represents the very rare occurrence of a bifid cardiac apex as an isolated cardiac anomaly.

  19. A comparison between brachial and echocardiographic systolic time intervals.

    Directory of Open Access Journals (Sweden)

    Ho-Ming Su

    Full Text Available Systolic time interval (STI is an established noninvasive technique for the assessment of cardiac function. Brachial STIs can be automatically determined by an ankle-brachial index (ABI-form device. The aims of this study are to evaluate whether the STIs measured from ABI-form device can represent those measured from echocardiography and to compare the diagnostic values of brachial and echocardiographic STIs in the prediction of left ventricular ejection fraction (LVEF <50%. A total of 849 patients were included in the study. Brachial pre-ejection period (bPEP and brachial ejection time (bET were measured using an ABI-form device and pre-ejection period (PEP and ejection time (ET were measured from echocardiography. Agreement was assessed by correlation coefficient and Bland-Altman plot. Brachial STIs had a significant correlation with echocardiographic STIs (r = 0.644, P<0.001 for bPEP and PEP; r  = 0.850, P<0.001 for bET and ET; r = 0.708, P<0.001 for bPEP/bET and PEP/ET. The disagreement between brachial and echocardiographic STIs (brachial STIs minus echocardiographic STIs was 28.55 ms for bPEP and PEP, -4.15 ms for bET and ET and -0.11 for bPEP/bET and PEP/ET. The areas under the curve for bPEP/bET and PEP/ET in the prediction of LVEF <50% were 0.771 and 0.765, respectively. Brachial STIs were good alternatives to STIs obtained from echocardiography and also helpful in prediction of LVEF <50%. Brachial STIs automatically obtained from an ABI-form device may be helpful for evaluation of left ventricular systolic dysfunction.

  20. Decrease of cardiac chaos in congestive heart failure

    Science.gov (United States)

    Poon, Chi-Sang; Merrill, Christopher K.

    1997-10-01

    The electrical properties of the mammalian heart undergo many complex transitions in normal and diseased states. It has been proposed that the normal heartbeat may display complex nonlinear dynamics, including deterministic chaos,, and that such cardiac chaos may be a useful physiological marker for the diagnosis and management, of certain heart trouble. However, it is not clear whether the heartbeat series of healthy and diseased hearts are chaotic or stochastic, or whether cardiac chaos represents normal or abnormal behaviour. Here we have used a highly sensitive technique, which is robust to random noise, to detect chaos. We analysed the electrocardiograms from a group of healthy subjects and those with severe congestive heart failure (CHF), a clinical condition associated with a high risk of sudden death. The short-term variations of beat-to-beat interval exhibited strongly and consistently chaotic behaviour in all healthy subjects, but were frequently interrupted by periods of seemingly non-chaotic fluctuations in patients with CHF. Chaotic dynamics in the CHF data, even when discernible, exhibited a high degree of random variability over time, suggesting a weaker form of chaos. These findings suggest that cardiac chaos is prevalent in healthy heart, and a decrease in such chaos may be indicative of CHF.

  1. Interactions between cardiac, respiratory, and brain activity in humans

    Science.gov (United States)

    Musizza, Bojan; Stefanovska, Aneta

    2005-05-01

    The electrical activity of the heart (ECG), respiratory function and electric activity of the brain (EEG) were simultaneously recorded in conscious, healthy humans. Instantaneous frequencies of the heart beat, respiration and α-waves were then determined from 30-minutes recordings. The instantaneous cardiac frequency was defined as the inverse value of the time interval between two consecutive R-peaks. The instantaneous respiratory frequency was obtained from recordings of the excursions of thorax by application of the Hilbert transform. To obtain the instantaneous frequency of α-waves, the EEG signal recorded from the forehead was first analysed using the wavelet transform. Then the frequency band corresponding to α-waves was extracted and the Hilbert transform applied. Synchronization analysis was performed and the direction of coupling was ascertained, using pairs of instantaneous frequencies in each case. It is shown that the systems are weakly bidirectionally coupled. It was confirmed that, in conscious healthy humans, respiration drives cardiac activity. We also demonstrate from these analyses that α-activity drives both respiration and cardiac activity.

  2. Influence of computer work under time pressure on cardiac activity.

    Science.gov (United States)

    Shi, Ping; Hu, Sijung; Yu, Hongliu

    2015-03-01

    Computer users are often under stress when required to complete computer work within a required time. Work stress has repeatedly been associated with an increased risk for cardiovascular disease. The present study examined the effects of time pressure workload during computer tasks on cardiac activity in 20 healthy subjects. Heart rate, time domain and frequency domain indices of heart rate variability (HRV) and Poincaré plot parameters were compared among five computer tasks and two rest periods. Faster heart rate and decreased standard deviation of R-R interval were noted in response to computer tasks under time pressure. The Poincaré plot parameters showed significant differences between different levels of time pressure workload during computer tasks, and between computer tasks and the rest periods. In contrast, no significant differences were identified for the frequency domain indices of HRV. The results suggest that the quantitative Poincaré plot analysis used in this study was able to reveal the intrinsic nonlinear nature of the autonomically regulated cardiac rhythm. Specifically, heightened vagal tone occurred during the relaxation computer tasks without time pressure. In contrast, the stressful computer tasks with added time pressure stimulated cardiac sympathetic activity. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Cardiac manifestations of myotonic dystrophy type 1

    DEFF Research Database (Denmark)

    Petri, Helle; Vissing, John; Witting, Nanna

    2012-01-01

    To estimate the degree of cardiac involvement regarding left ventricular ejection fraction, conduction abnormalities, arrhythmia, risk of sudden cardiac death (SCD) and the associations between cardiac involvement and cytosine-thymine-guanine (CTG)-repeat, neuromuscular involvement, age and gende...... in patients with myotonic dystrophy type 1 (MD1)....

  4. Optimal Technique in Cardiac Anesthesia Recovery

    NARCIS (Netherlands)

    Svircevic, V.

    2014-01-01

    The aim of this thesis is to evaluate fast-track cardiac anesthesia techniques and investigate their impact on postoperative mortality, morbidity and quality of life. The following topics will be discussed in the thesis. (1.) Is fast track cardiac anesthesia a safe technique for cardiac surgery?

  5. Cardiac anatomy and physiology: a review.

    Science.gov (United States)

    Gavaghan, M

    1998-04-01

    This article reviews the normal anatomy and physiology of the heart. Understanding the normal anatomic and physiologic relationships described in this article will help perioperative nurses care for patients who are undergoing cardiac procedures. Such knowledge also assists nurses in educating patients about cardiac procedures and about activities that can prevent, reverse, or improve cardiac illness.

  6. Multimodality imaging to guide cardiac interventional procedures

    NARCIS (Netherlands)

    Tops, Laurens Franciscus

    2010-01-01

    In recent years, a number of new cardiac interventional procedures have been introduced. Catheter ablation procedures for atrial fibrillation (AF) have been refined and are now considered a good treatment option in patients with drug-refractory AF. In cardiac pacing, cardiac resynchronization therap

  7. Regulation of Cardiac Hypertrophy: the nuclear option

    NARCIS (Netherlands)

    D.W.D. Kuster (Diederik)

    2011-01-01

    textabstractCardiac hypertrophy is the response of the heart to an increased workload. After myocardial infarction (MI) the surviving muscle tissue has to work harder to maintain cardiac output. This sustained increase in workload leads to cardiac hypertrophy. Despite its apparent appropriateness, c

  8. Discovery and progress of direct cardiac reprogramming.

    Science.gov (United States)

    Kojima, Hidenori; Ieda, Masaki

    2017-02-14

    Cardiac disease remains a major cause of death worldwide. Direct cardiac reprogramming has emerged as a promising approach for cardiac regenerative therapy. After the discovery of MyoD, a master regulator for skeletal muscle, other single cardiac reprogramming factors (master regulators) have been sought. Discovery of cardiac reprogramming factors was inspired by the finding that multiple, but not single, transcription factors were needed to generate induced pluripotent stem cells (iPSCs) from fibroblasts. We first reported a combination of cardiac-specific transcription factors, Gata4, Mef2c, and Tbx5 (GMT), that could convert mouse fibroblasts into cardiomyocyte-like cells, which were designated as induced cardiomyocyte-like cells (iCMs). Following our first report of cardiac reprogramming, many researchers, including ourselves, demonstrated an improvement in cardiac reprogramming efficiency, in vivo direct cardiac reprogramming for heart regeneration, and cardiac reprogramming in human cells. However, cardiac reprogramming in human cells and adult fibroblasts remains inefficient, and further efforts are needed. We believe that future research elucidating epigenetic barriers and molecular mechanisms of direct cardiac reprogramming will improve the reprogramming efficiency, and that this new technology has great potential for clinical applications.

  9. Multimodality imaging to guide cardiac interventional procedures

    NARCIS (Netherlands)

    Tops, Laurens Franciscus

    2010-01-01

    In recent years, a number of new cardiac interventional procedures have been introduced. Catheter ablation procedures for atrial fibrillation (AF) have been refined and are now considered a good treatment option in patients with drug-refractory AF. In cardiac pacing, cardiac resynchronization

  10. Regulation of Cardiac Hypertrophy: the nuclear option

    NARCIS (Netherlands)

    D.W.D. Kuster (Diederik)

    2011-01-01

    textabstractCardiac hypertrophy is the response of the heart to an increased workload. After myocardial infarction (MI) the surviving muscle tissue has to work harder to maintain cardiac output. This sustained increase in workload leads to cardiac hypertrophy. Despite its apparent appropriateness, c

  11. Regulation of Cardiac Hypertrophy: the nuclear option

    NARCIS (Netherlands)

    D.W.D. Kuster (Diederik)

    2011-01-01

    textabstractCardiac hypertrophy is the response of the heart to an increased workload. After myocardial infarction (MI) the surviving muscle tissue has to work harder to maintain cardiac output. This sustained increase in workload leads to cardiac hypertrophy. Despite its apparent appropriateness,

  12. Genetic testing for inheritable cardiac channelopathies.

    Science.gov (United States)

    Szepesváry, Eszter; Kaski, Juan Pablo

    2016-05-01

    Cardiac channelopathies are linked to an increased risk of ventricular arrhythmia and sudden death. This article reviews the clinical characteristics and genetic basis of common cardiac ion-channel diseases, highlights some genotype-phenotype correlations, and summarizes genetic testing for inheritable cardiac channelopathies.

  13. Influence of Dietary Sodium and Potassium Intake on the Heart Rate Corrected-QT Interval in Elderly Subjects.

    Science.gov (United States)

    Michishita, Ryoma; Ishikawa-Takata, Kazuko; Yoshimura, Eiichi; Mihara, Rikako; Ikenaga, Masahiro; Morimura, Kazuhiro; Takeda, Noriko; Yamada, Yosuke; Higaki, Yasuki; Tanaka, Hiroaki; Kiyonaga, Akira

    2015-01-01

    It is well known that imbalances in the dietary electrolytes are associated with a significantly higher incidence of cardiovascular disease (CVD). On the other hand, a prolonged heart rate corrected-QT (QTc) interval is associated with an increased risk of cardiac autonomic nervous system dysfunction, the incidence of CVD and sudden cardiac death. This study was designed to clarify the association between the nutritional status and the QTc interval in elderly subjects. The subjects included 119 elderly subjects (46 males and 73 females, age; 72.9±4.8 y) without a history of CVD, who were taking cardioactive drugs. Resting 12-lead electrocardiography was performed, while the QTc interval was calculated according to Bazett's formula. The nutritional status was assessed using a brief self-administered diet history questionnaire. The subjects were divided into three categories, which were defined as equally trisected distributions of the body mass index (BMI). The QTc interval was significantly longer in both the low and high BMI groups than in the moderate BMI group in both genders (pintake in the low BMI group and the sodium intake in the high BMI group in both genders (psodium and potassium intake, depending on the body mass.

  14. One-way ANOVA based on interval information

    Science.gov (United States)

    Hesamian, Gholamreza

    2016-08-01

    This paper deals with extending the one-way analysis of variance (ANOVA) to the case where the observed data are represented by closed intervals rather than real numbers. In this approach, first a notion of interval random variable is introduced. Especially, a normal distribution with interval parameters is introduced to investigate hypotheses about the equality of interval means or test the homogeneity of interval variances assumption. Moreover, the least significant difference (LSD method) for investigating multiple comparison of interval means is developed when the null hypothesis about the equality of means is rejected. Then, at a given interval significance level, an index is applied to compare the interval test statistic and the related interval critical value as a criterion to accept or reject the null interval hypothesis of interest. Finally, the method of decision-making leads to some degrees to accept or reject the interval hypotheses. An applied example will be used to show the performance of this method.

  15. Cardiac tumors: optimal cardiac MR sequences and spectrum of imaging appearances.

    LENUS (Irish Health Repository)

    O'Donnell, David H

    2012-02-01

    OBJECTIVE: This article reviews the optimal cardiac MRI sequences for and the spectrum of imaging appearances of cardiac tumors. CONCLUSION: Recent technologic advances in cardiac MRI have resulted in the rapid acquisition of images of the heart with high spatial and temporal resolution and excellent myocardial tissue characterization. Cardiac MRI provides optimal assessment of the location, functional characteristics, and soft-tissue features of cardiac tumors, allowing accurate differentiation of benign and malignant lesions.

  16. Deep sternal wound infection after cardiac surgery.

    Science.gov (United States)

    Kubota, Hiroshi; Miyata, Hiroaki; Motomura, Noboru; Ono, Minoru; Takamoto, Shinichi; Harii, Kiyonori; Oura, Norihiko; Hirabayashi, Shinichi; Kyo, Shunei

    2013-05-20

    Deep sternal wound infection (DSWI) is a serious postoperative complication of cardiac surgery. In this study we investigated the incidence of DSWI and effect of re-exploration for bleeding on DSWI mortality. We reviewed 73,700 cases registered in the Japan Adult Cardiovascular Surgery Database (JACVSD) during the period from 2004 to 2009 and divided them into five groups: 26,597 of isolated coronary artery bypass graft (CABG) cases, 23,136 valvular surgery cases, 17,441 thoracic aortic surgery cases, 4,726 valvular surgery plus CABG cases, and 1,800 thoracic aortic surgery plus CABG cases. We calculated the overall incidence of postoperative DSWI, incidence of postoperative DSWI according to operative procedure, 30-day mortality and operative mortality of postoperative DSWI cases according to operative procedure, 30-day mortality and operative mortality of postoperative DSWI according to whether re-exploration for bleeding, and the intervals between the operation and deaths according to whether re-exploration for bleeding were investigated. Operative mortality is defined as in-hospital or 30-day mortality. Risk factors for DSWI were also examined. The overall incidence of postoperative DSWI was 1.8%. The incidence of postoperative DSWI was 1.8% after isolated CABG, 1.3% after valve surgery, 2.8% after valve surgery plus CABG, 1.9% after thoracic aortic surgery, and 3.4% after thoracic aortic surgery plus CABG. The 30-day and operative mortality in patients with DSWI was higher after more complicated operative procedures. The incidence of re-exploration for bleeding in DSWI cases was 11.1%. The overall 30-day/operative mortality after DSWI with re-exploration for bleeding was 23.0%/48.0%, and it was significantly higher than in the absence of re-exploration for bleeding (8.1%/22.0%). The difference between the intervals between the operation and death according to whether re-exploration for bleeding had been performed was not significant. Age and cardiogenic shock

  17. Cardiac connexins and impulse propagation

    NARCIS (Netherlands)

    J.A. Jansen; T.A.B. van Veen; J.M.T. de Bakker; H.V.M. van Rijen

    2010-01-01

    Gap junctions form the intercellular pathway for cell-to-cell transmission of the cardiac impulse from its site of origin, the sinoatrial node, along the atria, the atrioventricular conduction system to the ventricular myocardium. The component parts of gap junctions are proteins called connexins (C

  18. Cardiac abnormalities after subarachnoid hemorrhage

    NARCIS (Netherlands)

    Bilt, I.A.C. van der

    2016-01-01

    Aneurysmal subarachnoid hemorrhage(aSAH) is a devastating neurological disease. During the course of the aSAH several neurological and medical complications may occur. Cardiac abnormalities after aSAH are observed often and resemble stress cardiomyopathy or Tako-tsubo cardiomyopathy(Broken Heart Syn

  19. Reninoma presenting as cardiac syncope

    Directory of Open Access Journals (Sweden)

    Tak Shahid

    2011-01-01

    Full Text Available Reninoma, a renin-secreting tumor of the juxta-glomerular cells of the kidney, is a rare but surgically treatable cause of secondary hypertension in children. We report a case of reninoma presenting as cardiac syncope with long QTc on electrocardiogram due to hypokalemia.

  20. Takotsubo Cardiomyopathy Following Cardiac Surgery.

    Science.gov (United States)

    Chiariello, Giovanni Alfonso; Bruno, Piergiorgio; Colizzi, Christian; Crea, Filippo; Massetti, Massimo

    2016-02-01

    Takotsubo cardiomyopathy syndrome, commonly occurring in postmenopausal women, is characterized by transient apical systolic dysfunction in absence of coronary lesions. The cardiomyopathy is often observed after intense stressful events such as a major surgical procedure. A 72-year-old woman symptomatic for dyspnea at rest, chest pain, and peripheral edema successfully underwent surgery for noncoronary sinus aneurysm-right atrium fistula repair. Two days after surgery the patient developed takotsubo syndrome, diagnosed according to the Mayo Clinic criteria. We reviewed the literature on takotsubo cardiomyopathy as a complication of major cardiac surgery procedures. Takotsubo cardiomyopathy is confirmed as a possible early complication of cardiac surgery. Exaggerated sympathetic stimulation may cause massive endogenous catecholamine release. Hypoperfusion during cardiopulmonary bypass, inotropic drugs administration, and postoperative anxiety and pain are all factors generating stress, possible coronary artery spasm and transient cardiomyopathy, clinically simulating acute myocardial infarction. Several clinical features have been described such as acute mitral insufficiency, systolic anterior motion of the anterior mitral valve leaflet, left ventricular outflow tract obstruction, acute cardiac failure, and cardiogenic shock. Intraventricular thrombi and adverse cerebrovascular events may also be possible complications. Rare catastrophic events such as left ventricular free wall rupture and ventricular septal perforation have been also encountered. After cardiac surgery takotsubo cardiomyopathy should be suspected if clinical and instrumental criteria are met, and promptly differentiated from the more frequent acute myocardial infarction. Prognosis may be favorable if appropriate conservative medical treatment is promptly started. © 2015 Wiley Periodicals, Inc.