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Sample records for cell study congestive heart

  1. Cell therapy in congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Congestive heart failure (CHF) has emerged as a major worldwide epidemic and its main causes seem to be the aging of the population and the survival of patients with post-myocardial infarction. Cardiomyocyte dropout (necrosis and apoptosis) plays a critical role in the progress of CHF; thus treatment of CHF by exogenous cell implantation will be a promising medical approach. In the acute phase of cardiac damage cardiac stem cells (CSCs) within the heart divide symmetrically and/or asymmetrically in response to the change of heart homeostasis, and at the same time homing of bone marrow stem cells (BMCs) to injured area is thought to occur, which not only reconstitutes CSC population to normal levels but also repairs the heart by differentiation into cardiac tissue. So far, basic studies by using potential sources such as BMCs and CSCs to treat animal CHF have shown improved ventricular remodelling and heart function. Recently, however, a few of randomized, double-blind, placebo-controlled clinical trials demonstrated mixed results in heart failure with BMC therapy during acute myocardial infarction.

  2. Stem Cell Therapy for Congestive Heart Failure

    Directory of Open Access Journals (Sweden)

    Gunduz E

    2011-01-01

    experience from this patient. ConclusionStudies in the era of cardiac stem cell therapy are heterogenous. It is not yet possible to comment on the most appropriate stem cell type and route of administration. When we assess the results from literature and the improvement in our own patient we think stem cell therapy can be an option for bridging to heart transplantation or an adjuvant therapy for CHF.References1.Ohnishi S, Ohgushi H, Kitamura S, Nagaya N. Mesenchymal stem cells for the treatment of heart failure. Int J Hematol 2007; 86: 17-21.2.Bukharovich IF, Kukin M. Optimal medical therapy for heart failure. Prog Cardiovasc Dis 2006; 48: 372-385.3.Tongers J, Losordo DW, Landmesser U. Stem and progenitor cell-based therapy in ischaemic heart disease: promise, uncertainties and challenges. Eur Heart J 2011. Epub ahead of print.4.Krause DS, Theise ND, Collector MI, Henegariu O, Hwang S, Gardner R, Neutzel S, Sharkis SJ. Multi-organ, multi-lineage engraftment by a single bone marrow-derived stem cell. Cell 2001; 105:369-377.5.Strauer BE, Yousef M, Schannwell CM. the acute and long term effects of intracoronary stem cell transplantation in 191 patients with chronic heart failure: the STAR-heart study. Eur J Heart Fail 2010; 12:721-729.6.Hamano K, Nishida M, Mirata K, Mikarno A, Li TS, Harada M, Miura T, Matsuzaki M, Esato K. Local implantation of autologous bone marrow cells for therapeutic angiogenesis in patients with ishemic heart disease: clinical trial and preliminary results Jpn Circ J. 2001; 65:845-847.7.Brehm M, Zeus T, Strauer BE. Stem cells-clinical application and perspectives. Herz 2002; 27:611-620.8.Ozbaran M, Omay SB, Nalbantgil S, Kultursay H, Kumanlioglu K, Nart D, Pektok E. Autologous peripheral stem cell transplantation in patients with congestive heart failure due to ischemic heart disease. Eur J Cardiothorac Surg. 2004; 25:342-350.9.Abdel-Latif A, Bolli R, Tleyjeh IM, Montori VM, Perin EC, Hornung CA, Zuba-Surma EK, Al-Mallah M, Dawn B. Adult bone marrow

  3. Effect of repeated intracoronary injection of bone marrow cells in patients with ischaemic heart failure the Danish stem cell study - congestive heart failure trial (DanCell-CHF)

    DEFF Research Database (Denmark)

    Diederichsen, A.C.; Møller, Jacob Eifer; Thayssen, P.;

    2008-01-01

    repeated infusions would have additional positive effects. AIMS: To assess whether two treatments of intracoronary infusion of bone marrow stem cells, administered 4 months apart, could improve left ventricular (LV) systolic function in patients with chronic ischaemic heart failure. METHODS: The study was......, NYHA class improved (p<0.0001). No deaths were observed. CONCLUSION: In this non-randomised study, no change in LV ejection fraction could be demonstrated after repeated intracoronary bone marrow stem cell treatment in patients with chronic ischaemic heart failure Udgivelsesdato: 2008/7...

  4. Incidence and predictors of congestive heart failure after autologous hematopoietic cell transplantation

    OpenAIRE

    Armenian, Saro H; Sun, Can-Lan; Shannon, Tabitha; Mills, George; Francisco, Liton; Venkataraman, Kalyanasundaram; Wong, F. Lennie; Forman, Stephen J.; Bhatia, Smita

    2011-01-01

    Advances in autologous hematopoietic cell transplantation (HCT) strategies have resulted in a growing number of long-term survivors. However, these survivors are at increased risk of developing cardiovascular complications due to pre-HCT therapeutic exposures and conditioning and post-HCT comorbidities. We examined the incidence and predictors of congestive heart failure (CHF) in 1244 patients undergoing autologous HCT for a hematologic malignancy between 1988 and 2002. The cumulative inciden...

  5. Bisoprolol for congestive heart failure

    DEFF Research Database (Denmark)

    Rosenberg, J.; Gustafsson, F.

    2008-01-01

    Background: beta-Blockers are a cornerstone in the treatment of systolic heart failure treatment, but not all beta-blockers are effective or in this setting. Objective: To define the role of bisoprolol, a highly selective beta(1)-antagonist in congestive heart failure due to systolic dysfunction....... Methods: Using the keywords 'bisoprolol' and 'heart failure' PubMed and BIOSIS databases were searched for information regarding pharmacology and relevant randomised clinical trials. Supplementary publications were acquired by scrutinising reference lists of relevant papers. Additional information was...... obtained from the FDA website. Conclusion: Bisoprolol is an effective and well-tolerated first-line beta-blocker for patients with systolic heart failure. The knowledge is primarily based on study patients with moderate-to-severe heart failure from the three CIBIS trials Udgivelsesdato: 2008/2...

  6. Effect of repeated intracoronary injection of bone marrow cells in patients with ischaemic heart failure the Danish stem cell study--congestive heart failure trial (DanCell-CHF)

    DEFF Research Database (Denmark)

    Diederichsen, Axel Cosmus Pyndt; Møller, Jacob E; Thayssen, Per;

    2008-01-01

    BACKGROUND: It has been suggested that myocardial regeneration may be achieved by a single intracoronary bone marrow derived stem cell infusion in selected patients with ischaemic heart disease. The effect is uncertain in patients with chronic ischaemic heart failure and it is not known whether...... repeated infusions would have additional positive effects. AIMS: To assess whether two treatments of intracoronary infusion of bone marrow stem cells, administered 4 months apart, could improve left ventricular (LV) systolic function in patients with chronic ischaemic heart failure. METHODS: The study was......, NYHA class improved (p<0.0001). No deaths were observed. CONCLUSION: In this non-randomised study, no change in LV ejection fraction could be demonstrated after repeated intracoronary bone marrow stem cell treatment in patients with chronic ischaemic heart failure....

  7. Congestive heart failure in the elderly.

    Science.gov (United States)

    Rengo, F; Acanfora, D; Trojano, L; Furgi, G; Picone, C; Iannuzzi, G L; Vitale, D F; Rengo, C; Ferrara, N

    1996-01-01

    Several aspects of congestive heart failure are discussed in the light of international literature and of recent findings of our group. The annual incidence of heart failure in elderly subjects, aged >or=75y, is 13 to 50/1000, while it is 1.6/1000 in people aged 45-54 y. The prevalence of heart failure is about 3% in subjects aged 45-64% in subjects aged more than 65 y and 10% in subjects aged more than 75 y. These data are confirmed by our population based study in elderly subjects. The etiology of congestive heart failure is similar in elderly and middle-aged patients. However, several anatomo-functional, hormonal and autonomic nervous system changes, typical of congestive heart failure, occur during physiologic ageing processes also. These findings may explain the dramatic evolution of congestive heart failure in elderly patients. Moreover, some features of the elderly - e.g. comorbidity, atypical clinical presentations, loss of autonomy, increased iatrogen risk should be considered. No specific drugs exist for the pharmacologic treatment of heart failure in the elderly, so that the geriatric specificity in the treatment of heart failure can be recognized in the art of drug choice and dosage, to obtain the best results with the least side effects. The multiple etiology of congestive heart failure, the comorbidity, the loss of autonomy and the deterioration of cognitive functions suggest the need for multidimensional approach and continuative intervention in elderly patients with heart disease, and in particular with congestive heart failure. Further studies on disease- and age-related changes are necessary to develop new and more potent strategies to secure 'successful ageing'. PMID:15374141

  8. A usability study of a mobile monitoring system for congestive heart failure patients.

    Science.gov (United States)

    Svagård, I; Austad, H O; Seeberg, T; Vedum, J; Liverud, A; Mathiesen, B M; Keller, B; Bendixen, O C; Osborne, P; Strisland, F

    2014-01-01

    Sensor-based monitoring of congestive heart-failure (CHF) patients living at home can improve quality of care, detect exacerbations of disease at an earlier stage and motivate the patient for better self care. This paper reports on a usability study of the ESUMS system that provides continuous measurements of heart rate, activity, upper body posture and skin temperature via a sensor belt and a smartphone as patient terminal. Five CHF patients were included in the trial, all recently discharged from hospital. The nurses experienced continuous heart rate, activity and posture monitoring as useful and objective tools that helped them in their daily assessment of patient health. They also saw the system as an important educational tool to help patients gain insight into their own condition. Three patients liked that they could have a view of their own physiological and activity data, however the smartphones used in the study turned out to be too complicated for the patients to operate. A smartphone is built to be a multi-purpose device, and this may (conceptually and practically) be incompatible with the patients' demands for ease of use. PMID:25160241

  9. Xamoterol in severe congestive heart failure

    DEFF Research Database (Denmark)

    Tangø, M; Lyngborg, K; Mehlsen, J;

    1992-01-01

    Twelve patients in severe congestive heart failure were given placebo, 100 mg xamoterol (Corwin) twice daily and 200 mg xamoterol twice daily, respectively, in 3 two-week periods in a double-blind randomised study. At the end of each treatment period the patients were evaluated. No differences were...... found between placebo and xamoterol in the following parameters: New York Heart Association function group index, heart volume, body weight, exercise duration on bicycle and treadmill, heart rate and systolic and diastolic blood pressure at rest. However, during exercise we found significantly lower...... heart rate and rate-pressure product during xamoterol treatment. This reduction is probably indicating occupation of beta-adrenoreceptors with concomitant reduced oxygen consumption during exercise....

  10. Pneumoconiosis increases the risk of congestive heart failure: A nationwide population-based cohort study.

    Science.gov (United States)

    Yen, Chia-Ming; Lin, Cheng-Li; Lin, Ming-Chia; Chen, Huei-Yong; Lu, Nan-Han; Kao, Chia-Hung

    2016-06-01

    The purpose of the study was to determine the relationship between pneumoconiosis and congestive heart failure (CHF).We collected data from the National Health Insurance Research Database in Taiwan. The study sample comprised 8923 patients with pneumoconiosis and 35,692 nonpneumoconiosis controls enrolled from 2000 to 2011. Patients were followed up until the end of 2011 to evaluate the incidence of CHF. The risk of CHF was analyzed using Cox proportional hazard regression models, and the analysis accounted for factors such as sex, age, comorbidities, and air pollutants (μg/m).The overall incidence of CHF was higher in the pneumoconiosis cohort (15.7 per 1000 person-y) than in the nonpneumoconiosis cohort (11.2 per 1000 person-y), with a crude hazard ratio (HR) of 1.40 (P pneumoconiosis cohort than in the nonpneumoconiosis cohort (P pneumoconiosis cohort compared with the nonpneumoconiosis cohort was significant for men (adjusted HR = 1.40, 95% confidence interval = 1.21-1.62, P pneumoconiosis patients had a higher relative risk of CHF for all age group.Patients with pneumoconiosis were at higher risk for developing CHF than patients in the nonpneumoconiosis cohort, particularly in cases with coexisting coronary artery disease, hypertension, and chronic obstructive pulmonary disease. PMID:27336897

  11. Effects of Ambient Air Pollution on Functional Status in Patients with Chronic Congestive Heart Failure: a Repeated-Measures Study

    OpenAIRE

    Phillips Russell S; Suh Helen H; Coull Brent A; Yeh Gloria Y; Wellenius Gregory A; Mittleman Murray A

    2007-01-01

    Abstract Background Studies using administrative data report a positive association between ambient air pollution and the risk of hospitalization for congestive heart failure (HF). Circulating levels of B-type natriuretic peptide (BNP) are directly associated with cardiac hemodynamics and symptom severity in patients with HF and, therefore, serves as a marker of functional status. We tested the hypothesis that BNP levels would be positively associated with short-term changes in ambient pollut...

  12. Atrial Fibrillation in Congestive Heart Failure

    OpenAIRE

    Lubitz, Steven A.; Benjamin, Emelia J.; Ellinor, Patrick T.

    2010-01-01

    Atrial fibrillation and congestive heart failure are morbid conditions that share common risk factors and frequently coexist. Each condition predisposes to the other, and the concomitant presence of the two identifies individuals at increased risk for mortality. Recent data have emerged which help elucidate the complex genetic and non-genetic pathophysiological mechanisms that contribute to the development of atrial fibrillation in individuals with congestive heart failure. Clinical trial res...

  13. Prevalence, prognostic significance, and treatment of atrial fibrillation in congestive heart failure with particular reference to the DIAMOND-CHF study

    DEFF Research Database (Denmark)

    Pedersen, Ole Dyg; Brendorp, Bente; Køber, Lars;

    2003-01-01

    failure and the prevalence increases with the severity of the disease. These two conditions seem to be linked together, and congestive heart failure may either be the cause or the consequence of atrial fibrillation. The prognosis of atrial fibrillation is controversial, but studies indicate that atrial...... fibrillation is a risk factor in congestive heart failure patients. In the last 10-15 years, significant advances in the treatment of heart failure have improved survival, whereas effective management of atrial fibrillation in heart failure patients still awaits similar progress. Empirically, two strategies...

  14. Congestive Heart Failure and Central Sleep Apnea.

    Science.gov (United States)

    Sands, Scott A; Owens, Robert L

    2016-03-01

    Congestive heart failure (CHF) is among the most common causes of admission to hospitals in the United States, especially in those over age 65. Few data exist regarding the prevalence CHF of Cheyne-Stokes respiration (CSR) owing to congestive heart failure in the intensive care unit (ICU). Nevertheless, CSR is expected to be highly prevalent among those with CHF. Treatment should focus on the underlying mechanisms by which CHF increases loop gain and promotes unstable breathing. Few data are available to determine prevalence of CSR in the ICU, or how CSR might affect clinical management and weaning from mechanical ventilation. PMID:26972039

  15. Update in cardiomyopathies and congestive heart failure

    Directory of Open Access Journals (Sweden)

    The Heart Hospital, London, UK and Monaldi Hospital, Naples, Italy

    2012-05-01

    Full Text Available This abstract book contains four reports and all abstracts presented to the Joint Meeting: Update in cardiomyopathies and congestive heart failure, 22-23 September 2011 - Naples, Italy, endorsed by the Working Group on Myocardial and Pericardial Diseases (WG 21 of the European Society of Cardiology (ESC.

  16. Functional decline after congestive heart failure and acute myocardial infarction and the impact of psychological attributes. A prospective study

    NARCIS (Netherlands)

    Kempen, GIJM; Sanderman, R; Miedema, [No Value; Meyboom-de Jong, B; Ormel, J; Miedema, I.

    2000-01-01

    This article examines the influence of three pre-morbidly assessed psychological attributes (i.e. neuroticism, mastery and self-efficacy expectancies) on functional decline after congestive heart failure (CHF; n = 134) and acute myocardial infarction (AMI; n = 79) in late middle-aged and older perso

  17. CONGESTIVE HEART FAILURE: EXPERIMENTAL MODEL

    Directory of Open Access Journals (Sweden)

    Antonio Francesco Corno

    2013-10-01

    Full Text Available INTRODUCTION.Surgically induced, combined volume and pressure overload has been used in rabbits to create a simplified and reproducible model of acute left ventricular (LV failure.MATERIALS AND METHODS.New Zealand white male rabbits (n=24, mean weight 3.1±0.2kg were randomly assigned to either the Control group (n=10 or to the Heart Failure group (HF, n=14. Animals in the Control group underwent sham procedures. Animals in the HF group underwent procedures to induce LV volume overload by inducing severe aortic valve regurgitation with aortic cusp disruption and pressure overload using an occlusive silver clip positioned around the pre-renal abdominal aorta.RESULTS.Following Procedure-1 (volume overload echocardiography confirmed severe aortic regurgitation in all animals in the HF group, with increased mean pulse pressure difference from 18±3mmHg to 38±3mmHg (P

  18. Dronedarone in patients with congestive heart failure: insights from ATHENA

    DEFF Research Database (Denmark)

    Hohnloser, Stefan H; Crijns, Harry J G M; van Eickels, Martin;

    2010-01-01

    Dronedarone is a new multichannel blocking antiarrhythmic drug for treatment of atrial fibrillation (AF). In patients with recently decompensated congestive heart failure (CHF) and depressed LV function, the drug was associated with excess mortality compared with a placebo group. The present study...

  19. Secular trends in the etiology and comorbidity of hospitalized patients with congestive heart failure: A single-center retrospective study

    Institute of Scientific and Technical Information of China (English)

    Zhi-Yong Pei; Yu-Sheng Zhao; Jia-Yue Li; Qiao Xue; Lei Gao; Shi-Wen Wang

    2012-01-01

    Objective To assess the secular trends in the etiology and comorbidity of patients hospitalized with congestive heart failure (CHF). Methods Data of 7,319 patients (mean age 59.6 years, 62.1% male) with a primary discharge diagnosis of CHF, hospitalized from January 1, 1993 to December 31, 2007 at the Chinese People's Liberation Army (PLA) General Hospital were extracted and analyzed. These patients were divided into three groups according to hospitalization period: 1993-1997 (n = 1623), 1998-2002 (n = 2444), and 2003-2007 (n = 3252). The etiological characteristics and comorbidities were assessed. Results Over the study period, the proportion of patients with ischemic heart disease (IHD) increased from 37.2% during the period 1993-1997 to 46.8% during the period 2003-2007, while that with valvular heart disease (VHD) decreased from 35.2% during the period 1993-1997 to 16.6% during the period 2003-2007 (both P < 0.05). Atrial fibrillation (AF) was the most common comorbidity of heart failure (23.2%, 23.0% and 20.6%, respectively, in the three periods). Compared to that of the period of 1993-1997 with that of, the proportion of patients with myocardial infarction, pneumonia, renal function impairment and hepatic cirrhosis of the period of 2003-2007 increased significantly (P < 0.05) and the proportion of patients with chronic obstructive pulmonary disease and atrial fibrillation decreased significantly (P < 0.05). Conclusions This study implies that IHD has became a more common etiology of CHF, while VHD has deceased as an etiology of CHF in Chinese patients during the last two decades.

  20. THE METHODS OF TOTAL BODY BIOIMPEDANCE SPECTROSCOPY IN ANALYSIS THE FUNCTIONAL CLASS OF CONGESTIVE HEART FAILURE

    OpenAIRE

    Ivanov, G.; Dvornicov, V.; Niculina, L.; Kotlarova, L.; Bernshtein, Ju; Pavlovich, A.

    2004-01-01

    The article presented result of studies, which determined signs an studies of total body bioimpedance spectros-copy analysis in evaluate of functional class of chronic heart failure. Key words: biompedance, congestive heart failure.

  1. Respiratory sound energy and its distribution patterns following clinical improvement of congestive heart failure: a pilot study

    Directory of Open Access Journals (Sweden)

    Gruber Karen N

    2010-01-01

    Full Text Available Abstract Background Although congestive heart failure (CHF patients typically present with abnormal auscultatory findings on lung examination, respiratory sounds are not normally subjected to additional analysis. The aim of this pilot study was to examine respiratory sound patterns of CHF patients using acoustic-based imaging technology. Lung vibration energy was examined during acute exacerbation and after clinical improvement. Methods Respiratory sounds throughout the respiratory cycle were captured using an acoustic-based imaging technique. Twenty-three consecutive CHF patients were imaged at the time of presentation to the emergency department and after clinical improvement. Digital images were created (a larger image represents more homogeneously distributed vibration energy of respiratory sound. Geographical area of the images and respiratory sound patterns were quantitatively analyzed. Data from the CHF patients were also compared to healthy volunteers. Results The median (interquartile range geographical areas of the vibration energy image of acute CHF patients without and with radiographically evident pulmonary edema were 66.9 (9.0 and 64.1(9.0 kilo-pixels, respectively (p p p Conclusions With clinical improvement of acute CHF exacerbations, there was more homogenous distribution of lung vibration energy, as demonstrated by the increased geographical area of the vibration energy image.

  2. Key role of congestion in natural history of heart failure

    OpenAIRE

    Guglin M

    2011-01-01

    Maya GuglinUniversity of South Florida, Tampa, FL, USAAbstract: The natural course of heart failure with decreased and preserved systolic function is almost identical. The current concept of heart failure where decreased cardiac output plays the major role does not explain this similarity. We suggest a revised concept of heart failure where congestion plays the leading role. While congestion is almost invariably present in heart failure with normal and with reduced systolic function, the low ...

  3. Congestive Heart Failure With Apparently Preserved Left Ventricular Systolic Function: A 10-Year Observational Study.

    Science.gov (United States)

    El-Menyar, Ayman; Shabana, Adel; Arabi, Abdulrahman; Al-Thani, Hassan; Asaad, Nidal; AlBinALi, Hajar; Singh, Rajvir; Gomaa, Mohammed; Gehani, A

    2015-09-01

    We analyzed the clinical presentation and outcomes (from 2003 to 2013) of heart failure (HF) with apparently normal systolic function (HFPEF). Based on the echocardiographic left ventricular ejection fraction (LVEF), patients were divided into 2 groups, group 1 (<50%) and group 2 (≥50%). Of 2212 patients with HF, 20% were in group 2. Patients in group 2 were more likely to be older, females, Arabs, hypertensive, and obese (P = .001). Patients in group 1 were mostly Asians and had more troponin-T positivity (P = .001). Inhospital cardiac arrest, shock, and deaths were significantly greater in group 1. On multivariate analysis, age, ST-segment elevation myocardial infarction, lack of on-admission β-blockers, and angiotensin-converting enzyme inhibitors use were independent predictors of mortality. HFPEF is associated with less mortality compared to those who presented with reduced LVEF. On admission, use of evidence-based medications could in part predict this difference in the hospital outcome. PMID:25248442

  4. Nitrendipine binding in congestive heart failure due to myocardial infarction

    International Nuclear Information System (INIS)

    Depressed cardiac pump function is the hallmark of congestive heart failure, and it is suspected that decreased influx of Ca2+ into the cardiac cell is responsible for depressed contractile function. Since Ca2+ channels in the sarcolemmal membrane are considered to be an important route for the entry of Ca2+, we examined the status of Ca2+ receptors/channels in failing rat hearts after myocardial infarction of the left ventricular free wall. For this purpose, the left coronary artery was ligated and hearts were examined 4, 8, and 16 weeks later; sham-operated animals served as controls. Hemodynamic assessment revealed decreased total mechanical energy (left ventricular systolic pressure x heart rate), increased left ventricular diastolic pressure, and decreased positive and negative dP/dt in experimental animals at 4, 8, and 16 weeks. Although accumulation of ascites in the abdominal cavity was evident at 4 weeks, other clinical signs of congestive heart failure in experimental rats were evident from the presence of lung congestion and cardiac dilatation at 8 and 16 weeks after induction of myocardial infarction. The density of Ca2+ receptors/channels in crude membranes, as assessed by [3H]nitrendipine binding assay, was found to be decreased in the uninfarcted experimental left ventricle at 8 and 16 weeks; however, no change in the affinity of nitrendipine was evident. A similar depression in the specific binding of another dihydropyridine compound, [3H]PN200-110, was also evident in failing hearts. Brain and skeletal muscle crude membrane preparations, unlike those of the right ventricle and liver, revealed a decrease in Ca2+ receptors/channels density in experimental animals at 16 weeks

  5. Assessment of congestive heart failure in chest radiographs

    International Nuclear Information System (INIS)

    The effect of observer variations and film-screen quality on the diagnosis of congestive heart failure based on chest radiographs was studied in 27 patients. For each patient, two films were exposed, one with the Kodak Lanex Medium system and one with the Agfa MR 400 system. The films were presented to three observers who assessed the presence of congestive heart failure on a three-graded scale. The results showed no significant difference between the two systems but large systematic differences between the observers. There were also differences between the two ratings by the same observer that could not be explained by the film-screen factor. It is concluded that the choice between these two systems is of little importance in view of the interobserver and intraobserver variability that can exist within the same department. (orig.)

  6. Effects of ambient air pollution on functional status in patients with chronic congestive heart failure: a repeated-measures study

    Directory of Open Access Journals (Sweden)

    Phillips Russell S

    2007-09-01

    Full Text Available Abstract Background Studies using administrative data report a positive association between ambient air pollution and the risk of hospitalization for congestive heart failure (HF. Circulating levels of B-type natriuretic peptide (BNP are directly associated with cardiac hemodynamics and symptom severity in patients with HF and, therefore, serves as a marker of functional status. We tested the hypothesis that BNP levels would be positively associated with short-term changes in ambient pollution levels among 28 patients with chronic stable HF and impaired systolic function. Methods BNP was measured in whole blood at 0, 6, and 12 weeks. We used linear mixed models to evaluate the association between fine particulate matter (PM2.5, carbon monoxide, sulfur dioxide, nitrogen dioxide, ozone, and black carbon and log(BNP. Lags of 0 to 3 days were considered in separate models. We calculated the intraclass correlation coefficient and within-subject coefficient of variation as measures of reproducibility. Results We found no association between any pollutant and measures of BNP at any lag. For example, a 10 μg/m3 increase in PM2.5 was associated with a 0.8% (95% CI: -16.4, 21.5; p = 0.94 increase in BNP on the same day. The within-subject coefficient of variation was 45% on the natural scale and 9% on the log scale. Conclusion These results suggest that serial BNP measurements are unlikely to be useful in a longitudinal study of air pollution-related acute health effects. The magnitude of expected ambient air pollution health effects appears small in relation to the considerable within-person variability in BNP levels in this population.

  7. DETECTING CONGESTIVE HEART FAILURE USING HEART RATE SEQUENTIAL TREND ANALYSIS PLOT

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    SRINIVAS KUNTAMALLA,

    2010-12-01

    Full Text Available Heart rate variability analysis is gaining acceptance as a potential non-invasive means of autonomic nervous system assessment in research as well as clinical domains. In this study, a nonlinear analysis method is developed to detect congestive heart failure. The data obtained from an online and widely used public database (i.e., MIT/BIH physionet database, is used for testing the performance of the method. The method developed is based on the sequential trend analysis plot of heart rate variability and correlates well with the characteristic autonomic nervous system regulations in congestive heart failure. The proposed method can be used for screening as well as diagnosing the heart failure patients. The algorithm is computationally simple and can be implemented in a real time processing hardware. This method classifies 31 out of 32 subjects and has the highest discrimination power in terms of sensitivity, specificity and accuracy.

  8. Thyroid function in dogs with spontaneous and induced congestive heart failure.

    OpenAIRE

    Panciera, D L; Refsal, K R

    1994-01-01

    The effects of spontaneous and experimentally induced congestive heart failure on serum thyroxine (T4), 3,5,3'-triiodothyronine (T3), 3,3'5'-triiodothyronine (reverse T3), free T4, free T3 concentrations, and the serum T4 and T3 concentrations in response to administration of thyrotropin were studied. Serum thyroid hormone concentrations were not different between eight dogs with spontaneous congestive heart failure and normal age matched control dogs. Seven dogs with experimental heart failu...

  9. Prognostic Factors for Patients with Congestive Heart Failure - An Extended Evaluation of the SPICE-Study

    OpenAIRE

    Mayer, Benjamin; Holubarsch, Christian; Muche, Rainer; Gaus, Wilhelm

    2013-01-01

    Aims: Controlled clinical trials collect huge amounts of high quality data. It is a waste of information to evaluate these data only for the efficacy and safety of the investigational medication. We propose extended evaluations of large trials for scientific purposes, especially to find the most important risk factors of the disease or variables which are associated with risk to have the disease. Methodology: The SPICE study is a controlled, randomised, completely masked trial that has invest...

  10. Study on plasma levels of brain natriuretic peptide, angiotensin and aldosterone in patients with congestive heart failure

    International Nuclear Information System (INIS)

    Objective: To investigate the relationship between brain natriuretic peptide (BNP), angiotensin (AT-II), and aldosterone (ALD) levels in patients with congestive heart failure (CHF). Methods: Plasma levels of BNP (with CLIA) and Angiotensin II (AT-II), aldosterone (ALD) (with RIA) were measured in 98 patients with CHF, 76 cardiac patients without heart faclure, and 86 controls. Results: The plasma levels of BNP, AT-II and ALD in patients (with RIA) CHF were significantly higher than those in the controls. The levels of BNP, AT-II and ALD, CHF patients after therapy were markedly dropped and were significantly lower than those patients before therapy (P<0.01). BNP levels were positively correlated with AT-II and ALD in levels CHF (P<0.05). Conclusion: The over activity of RAA systems may be one of the mechanisms of heart failure. Dynamic observation of changes of BNP, AT-II and ALD may be very useful in assessment of severity and prognosis of patients with CHF. (authors)

  11. Differential number of CD34+, CD133+ and CD34+/CD133+ cells in peripheral blood of patients with congestive heart failure

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    Fritzenwanger M

    2009-03-01

    Full Text Available Abstract Background Endothelial progenitor cells (EPC which are characterised by the simulateous expression of CD34, CD133 and vascular endothelial growth receptor 2 (VEGF 2 are involved in the pathophysiology of congestive heart failure (CHF and their number and function is reduced in CHF. But so far our knowledge about the number of circulating hematopoietic stem/progenitor cells (CPC expressing the early hematopoietic marker CD133 and CD34 in CHF is spares and therefore we determined their number and correlated them with New York Heart Association (NYHA functional class. Methods CD34 and CD133 surface expression was quantified by flow cytometry in the peripheral venous blood of 41 healthy adults and 101 patients with various degrees of CHF. Results CD34+, CD133+ and CD34+/CD133+ cells correlated inversely with age. Both the number of CD34+ and of CD34+/CD133+ cells inversely correlated with NYHA functional class. The number of CD133+ cells was not affected by NYHA class. Furthermore the number of CD133+ cells did not differ between control and CHF patients. Conclusion In CHF the release of CD34+, CD133+ and CD34+/CD133+ cells from the bone marrow seems to be regulated differently. Modulating the releasing process in CHF may be a tool in CHF treatment.

  12. Successful treatment of fetal atrial flutter and congestive heart failure.

    OpenAIRE

    Hirata, K.; Kato, H.; Yoshioka, F; Matsunaga, T

    1985-01-01

    Fetal supraventricular tachycardia may cause congestive heart failure, hydrops fetalis, and intrauterine death. Tachycardia in a fetus of 34 weeks' gestation was diagnosed as atrial flutter by echocardiography, and was successfully treated by giving the mother digoxin.

  13. Atrial natriuretic factor binding sites in experimental congestive heart failure

    International Nuclear Information System (INIS)

    A quantitative in vitro autoradiographic study was performed on the aorta, renal glomeruli, and adrenal cortex of cardiomyopathic hamsters in various stages of heart failure and correlated, in some instances, with in vivo autoradiography. The results indicate virtually no correlation between the degree of congestive heart failure and the density of 125I-labeled atrial natriuretic factor [(Ser99, Tyr126)ANF] binding sites (Bmax) in the tissues examined. Whereas the Bmax was increased in the thoracic aorta in moderate and severe heart failure, there were no significant changes in the zona glomerulosa. The renal glomeruli Bmax was lower in mild and moderate heart failure compared with control and severe heart failure. The proportion of ANF B- and C-receptors was also evaluated in sections of the aorta, adrenal, and kidney of control and cardiomyopathic hamsters with severe heart failure. (Arg102, Cys121)ANF [des-(Gln113, Ser114, Gly115, Leu116, Gly117) NH2] (C-ANF) at 10(-6) M displaced approximately 505 of (Ser99, Tyr126)125I-ANF bound in the aorta and renal glomeruli and approximately 20% in the adrenal zona glomerulosa in both series of animals. These results suggest that ANF may exert a buffering effect on the vasoconstriction of heart failure and to a certain extent may inhibit aldosterone secretion. The impairment of renal sodium excretion does not appear to be related to glomerular ANF binding sites at any stage of the disease

  14. Congestive Heart Failure Consumer Information on the Web: How Accessible Is the Evidence?

    OpenAIRE

    Boren, Suzanne Austin; Gunlock, Teira L.

    2006-01-01

    The objective of this pilot study was to assess the accessibility of congestive heart failure consumer information on the web. Twenty-seven education trials involving 5589 patients with congestive heart failure were analyzed. Education topics and outcomes were abstracted. Twenty education topics were linked to outcomes. A sample of 15 websites missed 56.7% of education topics and 61.8% of technical website characteristics that have suggested accuracy, reliability, and timeliness of content.

  15. Study on clinical value of determination of plasma brain natriuretic peptide levels in patients with chronic congestive heart failure

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical value of determination of plasma brain natriuretic peptide (BNP) levels in patients with chronic congestive heart failure(CHF). Methods: The levels of plasma BNP were measured with fluorescence immunoassay in 341 patients with chronic CHF and 55 controls. Left ventricular ejection fraction (LVEF), left ventricular end systolic diameter (LVESD) and left ventricular end diastolic diameter (LVEDD) were determined with color doppler ultrasonography in CHF patients. Results: Plasma levels of BNP were significantly increased in patients with CHF as compared with those in controls (P<0.01). There were also significant differences in plasma levels of CHF patients of different clinical stages (P<0.01). There was obvious correlation between plasma levels of BNP and the values of LVEF, LVESD and LVEDD (r was-0.62, +0.54 and +0.60 respectively, P<0.01). Conclusion: Plasma level of BNP is a sensitive indicator for assessment of ventricle function in CHF patients. (authors)

  16. Oral amrinone for the treatment of chronic congestive heart failure: results of a multicenter randomized double-blind and placebo-controlled withdrawal study.

    Science.gov (United States)

    DiBianco, R; Shabetai, R; Silverman, B D; Leier, C V; Benotti, J R

    1984-11-01

    A placebo-controlled study was employed to evaluate the effects of oral amrinone in patients with congestive heart failure. After a baseline period of at least 4 weeks of standard treatment for refractory congestive heart failure, oral amrinone was added to the treatment regimen of 173 patients. Patients were predominantly male (89%), aged 24 to 76 years (mean 54), with ischemic (52%) or idiopathic (37%) dilated cardiomyopathy, in New York Heart Association functional class II (40%), III (59%) and IV (1%) and having a mean (+/- standard deviation) left ventricular ejection fraction of 25 +/- 15%. Phase 1: After the addition of amrinone (113 +/- 33 mg three times daily), 52 patients (30%) showed a maximal increase in treadmill exercise time exceeding 2 minutes (Naughton protocol), 72 (42%) had a lesser increase, 24 (14%) developed limiting adverse reactions, 20 (12%) died and 5 dropped out of the study. Fifty-two "responders" (30%) who were free of limiting side effects and had a greater than 2 minute increase in exercise time were randomized in double-blind fashion to continued amrinone or switched to placebo (each plus standard treatment) for an additional 12 weeks. Phase 2: Comparison of 31 of these 52 responders who continued to receive amrinone with the remaining 21 randomized to placebo revealed no significant differences in vital signs, indexes of left ventricular size and function, systolic time intervals or maximal exercise time. Continued follow-up study of patients receiving either amrinone or placebo revealed decreases in exercise times of 7 and 10%, respectively (both p less than 0.05 compared with before randomization). Episodes of worsened congestive heart failure severe enough to mandate termination of double-blind treatment were as frequent in patients taking placebo (4[18%] of 21) as in those taking amrinone (4[13%] of 31; p = NS). The average symptom score and functional class of each treatment group remained comparable. Adverse effects such as

  17. The Prognostic Value of Non-Linear Analysis of Heart Rate Variability in Patients with Congestive Heart Failure—A Pilot Study of Multiscale Entropy

    OpenAIRE

    Yi-Lwun Ho; Chen Lin; Yen-Hung Lin; Men-Tzung Lo

    2011-01-01

    AIMS: The influences of nonstationarity and nonlinearity on heart rate time series can be mathematically qualified or quantified by multiscale entropy (MSE). The aim of this study is to investigate the prognostic value of parameters derived from MSE in the patients with systolic heart failure. METHODS AND RESULTS: Patients with systolic heart failure were enrolled in this study. One month after clinical condition being stable, 24-hour Holter electrocardiogram was recording. MSE as well as oth...

  18. Congestive heart failure in subjects with thyrotoxicosis in a black community

    Directory of Open Access Journals (Sweden)

    R C Anakwue, B J C Onwubere

    2010-07-01

    Full Text Available R C Anakwue, B J C Onwubere, B C Anisiuba, V O Ikeh, A Mbah, S O IkeDepartment of Medicine, College of Medicine, University of Nigeria Enugu CampusIntroduction: Thyroid hormone has profound effects on a number of metabolic processes in virtually all tissues but the cardiovascular manifestations are prominent usually creating a hyperdynamic circulatory state. Thyrotoxicosis is not a common cause of congestive heart failure among black communities.Objectives: To determine the hospital prevalence, clinical characteristics and echocardiographic findings in patients with thyrotoxicosis who present with congestive heart failure (CCF in the eastern part of Nigeria.Subjects and methods: A total of 50 subjects aged 15 years and above who were diagnosed as thyrotoxic following clinical and thyroid function tests were consecutively recruited. Fifty age- and sex-matched controls with no clinical or biochemical evidence of thyrotoxicosis and no comorbidities were used as controls. Two-dimensional echocardiography was carried out on all the subjects. CCF was determined clinically and echocardiographically.Results: Eight patients (5 females and 3 males out of a total of 50 thyrotoxic patients presented with congestive heart failure.Conclusion: The study revealed that congestive heart failure can occur in thyrotoxicosis in spite of the associated hyperdynamic condition. The underlying mechanism may include direct damage by autoimmune myocarditis, congestive circulation secondary to excess sodium, and fluid retention.Keywords: thyrotoxicosis, congestive heart failure, echocardiography, black community

  19. Hemostatic biomarkers in dogs with chronic congestive heart failure

    DEFF Research Database (Denmark)

    Tarnow, Inge; Falk, Torkel; Tidholm, Anna;

    2007-01-01

    Background: Chronic congestive heart failure (CHF) in humans is associated with abnormal hemostasis, and abnormalities in hemostatic biomarkers carry a poor prognosis. Alterations in hemostatic pathways can be involved in the pathogenesis of CHF in dogs, and microthrombosis in the myocardium could...

  20. Psychobiology of depression/distress in congestive heart failure

    OpenAIRE

    York, Kaki M.; Hassan, Mustafa; Sheps, David S.

    2008-01-01

    Heart failure affects millions of Americans and new diagnosis rates are expected to almost triple over the next 30 years as our population ages. Affective disorders including clinical depression and anxiety are common in patients with congestive heart failure. Furthermore, the presence of these disorders significantly impacts quality of life, medical outcomes, and healthcare service utilization. In recent years, the literature has attempted to describe potential pathophysiologic mechanisms re...

  1. Classification tree for risk assessment in patients suffering from congestive heart failure via long-term heart rate variability

    OpenAIRE

    Melillo, Paolo; De Luca, Nicola; Bracale, Marcello; Pecchia, Leandro

    2013-01-01

    This study aims to develop an automatic classifier for risk assessment in patients suffering from congestive heart failure (CHF). The proposed classifier separates lower risk patients from higher risk ones, using standard long-term heart rate variability (HRV) measures. Patients are labeled as lower or higher risk according to the New York Heart Association classification (NYHA). A retrospective analysis on two public Holter databases was performed, analyzing the data of 12 patients suffering...

  2. The Prognostic Value of Non-Linear Analysis of Heart Rate Variability in Patients with Congestive Heart Failure—A Pilot Study of Multiscale Entropy

    Science.gov (United States)

    Ho, Yi-Lwun; Lin, Chen; Lin, Yen-Hung; Lo, Men-Tzung

    2011-01-01

    Aims The influences of nonstationarity and nonlinearity on heart rate time series can be mathematically qualified or quantified by multiscale entropy (MSE). The aim of this study is to investigate the prognostic value of parameters derived from MSE in the patients with systolic heart failure. Methods and Results Patients with systolic heart failure were enrolled in this study. One month after clinical condition being stable, 24-hour Holter electrocardiogram was recording. MSE as well as other standard parameters of heart rate variability (HRV) and detrended fluctuation analysis (DFA) were assessed. A total of 40 heart failure patients with a mea age of 56±16 years were enrolled and followed-up for 684±441 days. There were 25 patients receiving β-blockers treatment. During follow-up period, 6 patients died or received urgent heart transplantation. The short-term exponent of DFA and the slope of MSE between scale 1 to 5 were significantly different between patients with or without β-blockers (p = 0.014 and p = 0.028). Only the area under the MSE curve for scale 6 to 20 (Area6–20) showed the strongest predictive power between survival (n = 34) and mortality (n = 6) groups among all the parameters. The value of Area6–2021.2 served as a significant predictor of mortality or heart transplant (p = 0.0014). Conclusion The area under the MSE curve for scale 6 to 20 is not relevant to β-blockers and could further warrant independent risk stratification for the prognosis of CHF patients. PMID:21533258

  3. The prognostic value of non-linear analysis of heart rate variability in patients with congestive heart failure--a pilot study of multiscale entropy.

    Directory of Open Access Journals (Sweden)

    Yi-Lwun Ho

    Full Text Available AIMS: The influences of nonstationarity and nonlinearity on heart rate time series can be mathematically qualified or quantified by multiscale entropy (MSE. The aim of this study is to investigate the prognostic value of parameters derived from MSE in the patients with systolic heart failure. METHODS AND RESULTS: Patients with systolic heart failure were enrolled in this study. One month after clinical condition being stable, 24-hour Holter electrocardiogram was recording. MSE as well as other standard parameters of heart rate variability (HRV and detrended fluctuation analysis (DFA were assessed. A total of 40 heart failure patients with a mea age of 56±16 years were enrolled and followed-up for 684±441 days. There were 25 patients receiving β-blockers treatment. During follow-up period, 6 patients died or received urgent heart transplantation. The short-term exponent of DFA and the slope of MSE between scale 1 to 5 were significantly different between patients with or without β-blockers (p = 0.014 and p = 0.028. Only the area under the MSE curve for scale 6 to 20 (Area(6-20 showed the strongest predictive power between survival (n = 34 and mortality (n = 6 groups among all the parameters. The value of Area(6-2021.2 served as a significant predictor of mortality or heart transplant (p = 0.0014. CONCLUSION: The area under the MSE curve for scale 6 to 20 is not relevant to β-blockers and could further warrant independent risk stratification for the prognosis of CHF patients.

  4. Baroreflex Activation Therapy in Congestive Heart Failure: Novel Findings and Future Insights.

    Science.gov (United States)

    Grassi, Guido; Brambilla, GianMaria; Pizzalla, Daniela Prata; Seravalle, Gino

    2016-08-01

    Congestive heart failure is characterized by hemodynamic and non-hemodynamic abnormalities, the latter including an activation of the sympathetic influences to the heart and peripheral circulation coupled with an impairment of baroreceptor control of autonomic function. Evidence has been provided that both these alterations are hallmark features of the disease with a specific relevance for the disease progression as well as for the development of life-threatening cardiac arrhythmias. In addition, a number of studies have documented in heart failure the adverse prognostic role of the sympathetic and baroreflex alterations, which both are regarded as major independent determinants of cardiovascular morbidity and mortality. This represents the pathophysiological and clinical background for the use of carotid baroreceptor activation therapy in the treatment of congestive heart failure. Promising data collected in experimental animal models of heart failure have supported the recent performance of pilot small-scale clinical studies, aimed at providing initial information in this area. The results of these studies demonstrated the clinical safety and efficacy of the intervention which has been tested in large-scale clinical studies. The present paper will critically review the background and main results of the published studies designed at defining the clinical impact of baroreflex activation therapy in congestive heart failure patients. Emphasis will be given to the strengths and limitations of such studies, which represent the background for the ongoing clinical trials testing the long-term effects of the device in heart failure patients. PMID:27334011

  5. Associations between cardiac pathology and clinical, echocardiographic and electrocardiographic findings in dogs with chronic congestive heart failure

    DEFF Research Database (Denmark)

    Falk, Bo Torkel; Jönsson, Lennart; Olsen, Lisbeth Høier;

    2010-01-01

    The objective of this study was to correlate defined pathological features with clinical findings in dogs with naturally occurring congestive heart failure (CHF). Fifty-eight dogs with CHF were examined clinically and using echocardiography and electrocardiography. Detailed cardiac post...

  6. Effect of Cardiac Resynchronization Therapy on Inflammation in Congestive Heart Failure: A Review.

    Science.gov (United States)

    Lappegård, K T; Bjørnstad, H; Mollnes, T E; Hovland, A

    2015-09-01

    Congestive heart failure is associated with increased levels of several inflammatory mediators, and animal studies have shown that infusion of a number of cytokines can induce heart failure. However, several drugs with proven efficacy in heart failure have failed to affect inflammatory mediators, and anti-inflammatory therapy in heart failure patients has thus far been disappointing. Hence, to what extent heart failure is caused by or responsible for the increased inflammatory burden in the patient is still unclear. Over the past couple of decades, resynchronization therapy with a biventricular pacemaker has emerged as an effective treatment in a subset of heart failure patients, reducing both morbidity and mortality. Such treatment has also been shown to affect the inflammation associated with heart failure. In this study, we review recent data on the association between heart failure and inflammation, and in particular how resynchronization therapy can affect the inflammatory process. PMID:26099323

  7. An intriguing association between congestive heart failure and An intriguing association between congestive heart failure and diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    SHEN Wei-feng

    2010-01-01

    @@ The prevalence of type 2 diabetes is rising at an alarming rate in China due to aging of the population,increased frequency of obesity, and suboptimal nutritional habits.~1 Although many diabetic Patients now survive severe coronary lesions or myocardial infarction as a result of dramatic advances in the management of ischemic heart disease in general and acute myocardial infarction specifically,~(2,3) they are subsequently succumbing to the consequences of myocardial damage, with an increased incidence of congestive heart failure (CHF).~4

  8. Multicenter, randomized, placebo-controlled, double-blind study of the safety and efficacy of oral delapril in patients with congestive heart failure.

    Science.gov (United States)

    Circo, A; Platania, F; Mangiameli, S; Putignano, E

    1995-06-16

    A total of 101 patients (67 delapril, 34 placebo) with congestive heart failure, New York Heart Association (NYHA) classes II and III, entered a multicenter, randomized (2:1), double-blind, placebo-controlled study to determine the minimum effective and maximum tolerated doses of delapril. Patients received placebo or increasing doses of delapril. After a 2-week run-in period on placebo, patients were randomly assigned to delapril or placebo. The dose of delapril was 7.5 mg twice daily for 2 weeks, 15 mg twice daily for another 2 weeks, followed by 30 mg twice daily for 4 weeks. The dose was increased only if the patient did not present any symptoms of orthostatic hypotension. If such symptoms developed, the code was broken and an open treatment was continued on the minimum effective dose (delapril group). Patients with symptoms of orthostatic hypotension in the placebo group were withdrawn. At the end of the 8-week treatment, 36 (54.5%) patients in the delapril group completed the study on 30 mg twice daily, 12 (18.2%) on 15 mg twice daily, and 18 (27.3%) on 7.5 mg twice daily. Seven patients on placebo were withdrawn because of insufficient therapeutic response; one patient on delapril was lost to follow-up. There was a significant improvement (p < 0.01) in bicycle ergometric performance involving an increase in the exercise duration and the maximum workload tolerated in those patients completing the study on delapril 30 mg twice daily and those finishing on 15 mg twice daily.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7778529

  9. Altered neuropeptide Y Y1 responses in mesenteric arteries in rats with congestive heart failure

    DEFF Research Database (Denmark)

    Bergdahl, A; Nilsson, T; Sun, X Y;

    1998-01-01

    The aim of the present study was to elucidate if the potentiating effect of neuropeptide Y on various vasoactive agents in vitro is (1) altered in mesenteric arteries from rats with congestive heart failure and (2) mediated by the neuropeptide Y Y1 receptor. The direct vascular effects of neurope...

  10. The Impact of Family Functioning on Caregiver Burden among Caregivers of Veterans with Congestive Heart Failure

    Science.gov (United States)

    Moore, Crystal Dea

    2010-01-01

    A cross-sectional study of 76 family caregivers of older veterans with congestive heart failure utilized the McMaster model of family functioning to examine the impact of family functioning variables (problem solving, communication, roles, affective responsiveness, and affective involvement) on caregiver burden dimensions (relationship burden,…

  11. Evaluation of haemodynamic effects in computerized gamma-camera os isossorbide dinitrate in congestive heart failure

    International Nuclear Information System (INIS)

    The cardiac function by radiocargiogram before and after the oral administration of isossorbide dinitrate in 20 patients with congestive heart failure is studied, including the meantime of pulmonary circulation, the meantime of cardiac cycle, cardiac debit and the dejection fraction of left ventricle. (author)

  12. Efficacy of felodipine in chronic congestive heart failure: a placebo controlled haemodynamic study at rest and during exercise and orthostatic stress.

    Science.gov (United States)

    Kassis, E; Amtorp, O; Waldorff, S; Fritz-Hansen, P

    1987-11-01

    A vascular selective calcium antagonist, felodipine, was evaluated in a randomised, double blind, crossover trial in 18 patients with chronic congestive heart failure of ischaemic cause. Felodipine (10 mg twice daily) or a corresponding placebo was added to conventional treatment. After three weeks haemodynamic function was assessed at rest, during a standard supine leg exercise, and during 45 degrees passive upright tilt. In patients in the supine resting position, felodipine reduced the mean arterial pressure (9%) and systemic vascular resistance (24%) and increased the stroke volume (25%) and cardiac index (23%). The heart rate and right and left ventricular filling pressures were unchanged. During felodipine treatment the standard exercise was accomplished at a similar cardiac index but at a substantially lower heart rate (7%), arterial pressure (10%), systemic vascular resistance (17%), and left ventricular filling pressure (19%), and a higher stroke volume (13%). During both placebo and felodipine administration there were substantial reductions in cardiac filling pressure during upright tilting. Upright tilting during the placebo phase did not increase the heart rate. It also caused a greater fall in systemic vascular resistance while the arterial pulse pressure but not the mean pressure was maintained and the cardiac index and stroke volume increased. The reduced cardiac filling pressures during the felodipine upright tilt were accompanied by reductions in arterial pulse pressure and stroke volume and the patients were able to maintain the mean arterial pressure by an increase in both the heart rate and systemic vascular resistance. Thus three weeks treatment with felodipine improved haemodynamic function at rest and during standard exercise and normalised the baroreflex mediated haemodynamic response in patients with congestive heart failure. The haemodynamic efficacy of the drug in such patients may be associated with a baroreceptor mediated effect as

  13. Importance of congestive heart failure and interaction of congestive heart failure and left ventricular systolic function on prognosis in patients with acute myocardial infarction

    DEFF Research Database (Denmark)

    Køber, L; Torp-Pedersen, C; Pedersen, O D;

    1996-01-01

    Left ventricular (LV) systolic function and congestive heart failure (CHF) are important predictors of long-term mortality after acute myocardial infarction. The importance of transient CHF and the interaction of CHF and LV function on prognosis has not been studied in detail previously. In the......-term mortality, separate analyses were performed in patients with different levels of LV function. Risk ratio (95% confidence intervals [CI]) were determined from proportional hazard models subgrouped by wall motion index or CHF adjusted for age and gender. Heart failure was separated into transient or...

  14. Dofetilide in patients with congestive heart failure and left ventricular dysfunction: safety aspects and effect on atrial fibrillation. The Danish Investigators of Arrhythmia and Mortality on Dofetilide (DIAMOND) Study Group

    DEFF Research Database (Denmark)

    Møller, M; Torp-Pedersen, C T; Køber, L

    2002-01-01

    continuously monitored electrocardiographically for the first 3 days of the study. The primary end point was all-cause mortality and follow-up was for at least 1 year. RESULTS. In the dofetilide/placebo groups, 311/317 patients died (41%/42%). The hazard ratio for dofetilide treatment was 0.95 (95% confidence......INTRODUCTION. Atrial fibrillation is a frequent cause of worsening of symptoms in patients with congestive heart failure. The drugs currently available for maintenance of sinus rhythm all have major side effects. METHODS. In 34 Danish coronary care units, 1518 patients with congestive heart failure...... and reduced left ventricular systolic function were randomized to receive either placebo or a new class III antiarrhythmic drug, dofetilide. The dose of dofetilide was adjusted according to the presence of atrial fibrillation, the length of the QT interval, and renal function. Patients were...

  15. The progression to permanent atrial fibrillation with congestive heart failure is associated with sympathetic nerve abnormality. A study with I-123 metaiodobenzylguanidine scintigraphy

    International Nuclear Information System (INIS)

    The aim of this study was to evaluate the relationship between congestive heart failure (CHF) and atrial fibrillation (AF) using iodine-123 metaiodobenzylguanidine (MIBG) scintigraphic imaging. Ninety-two AF patients (47 male and 45 female patients; mean age, 67±13 years) who did not suffer from structural heart disease or myocardial ischemia underwent MIBG scintigraphy. Global MIBG uptake was assessed by measuring the heart-to-mediastinal ratio (H/M) and washout rate (WR) on planar images, and the abnormal score (AS) was calculated on delayed MIBG single photon emission computed tomography images. Echocardiography was performed within a week after MIBG scintigraphy, to measure left ventricular ejection fraction (EF) and deceleration time (DT). The AF patients were divided into four groups: patients with permanent AF with (n=23, group A) or without (n=19, group B) a history of CHF, and patients with paroxysmal AF with (n=19, group C) or without (n=39, group D) a history of CHF. The H/M ratio was significantly lower in group A than in other groups (2.0±0.6 vs. group B: 2.7±0.6, group C: 2.3±0.5, and group D: 2.6±0.8, P<0.05), and in group C than in group D (P<0.05). Similarly, the WR was significantly higher in group A than in groups B and C (45.9±2.0 vs. group B: 38.9±1.9 and group C: 38.4±2.3, P<0.05). The AS was the highest in group A (19.7±8.2 vs. group B: 7.1±6.6, P<0.01; group C: 11.6±10.6 and group D: 13.5±9.0, P<0.05). The DT was significantly longer in group A than in groups B and D (222.0±59.4 vs. group B: 179.5±49.1, P<0.05 and group D: 177.9±37.1, P<0.01), but did not differ between groups A and C (222.0±59.4 vs. 197.4±51.1). There was no difference in EF among the groups. Although CHF with AF is associated with diastolic dysfunction, the progression to permanent AF from paroxysmal AF with CHF might be caused mainly by sympathetic nerve abnormality. (author)

  16. Lymphocyte subpopulations and hematologic variables in dogs with congestive heart failure.

    Science.gov (United States)

    Farabaugh, Andrew E; Freeman, Lisa M; Rush, John E; George, Katherine L

    2004-01-01

    Alterations in lymphocyte subpopulations and in other hematologic variables have been documented in people with heart failure. The purpose of the current study was to compare flow cytometric and hematologic variables in dogs with congestive heart failure (CHF) to healthy controls. CD4+ peripheral blood mononuclear cells (PBMC) and CD8+ lymphocytes were analyzed by flow cytometry, and white blood cell count, platelet count, hematocrit, and hemoglobin were determined by a complete blood count. Twenty-five dogs with CHF (International Small Animal Cardiac Health Council [ISACHC] class 2 [n = 12] and ISACHC class 3a [n = 13]) and 13 healthy controls were enrolled in the study. Compared with the controls, dogs with CHF had markedly lower percentages of CD4+ PBMC, CD8+ lymphocytes, hematocrit, and hemoglobin, but markedly higher leukocytes, neutrophils, and platelets. There were no differences in these variables between dogs with dilated cardiomyopathy (n = 6) and those with chronic valvular disease (n = 19). Dogs in ISACHC class 3a had a markedly lower total lymphocyte number, CD4+ and CD8+ cells, and hematocrit, but markedly higher leukocyte and neutrophil numbers relative to the control group. CD4+ and CD8+ subpopulations and other blood cell variables are altered in dogs with CHF. Future studies to determine possible clinical implications of these changes are warranted. PMID:15320588

  17. Impact of Microvolt T-wave Alternans on Malignant Arrhythmia Occurrence and Mortality in Patients with Congestive Heart Failure: Single-Centre Study

    Directory of Open Access Journals (Sweden)

    Lubomír Křivan

    2012-08-01

    Full Text Available ABSTRACTObjectives: The aim of this study was to assess the relation between microvolt T-wave alternans (MTWA with malignant arrhythmia occurrence and mortality in patients with ventricular systolic function < 40% due to ischemic (CAD or nonischemic cardiomyopathy (DCMP.Background: The predictive value of T-wave alternans for malignant arrhythmias in patients with congestive heart failure (CHF is controversial.Methods: In a single-centre, prospective, observational study—including patients with CHF of isch- emic and nonischemic aetiology—we assessed the prognostic value of MTWA for malignant arrhyth- mias and total mortality.Results: This study included 155 patients; aetiology of CHF was CAD in 67.7%, and DCMP in 32.3%. Mean left ventricular ejection fraction (LVEF was 29%. MTWA results were 38.1% positive, 40.6% negative, and 19.4% indeterminate. Over the median follow-up of 33.8 months, 13 deaths (7 cardiac and 6 noncardiac were observed. The death rate in MTWA-negative patients did not significantly dif- fer from that in MTWA-non negative patients (p = 0.203. There was also no difference in death rate between CAD and DCMP patients (p = 0.211. In only CAD patients, nonnegative MTWA predicted significantly higher occurrence of malignant arrhythmias (p = 0.033. This correlation was not signifi- cant for the total group (p = 0.100, or for the DCMP subgroup (p = 1.000.Conclusions: The negative predictive value of MTWA for malignant arrhythmias was 79.4%. Signifi- cant reduction of malignant arrhythmias in MTWA-negative patients was valid only in the CAD sub- group. The impact of MTWA on mortality was not significant.

  18. Prognostic value of echocardiography in 190 patients with chronic congestive heart failure. A comparison with New York Heart Association functional classes and radionuclide ventriculography

    DEFF Research Database (Denmark)

    Madsen, B K; Videbaek, R; Stokholm, H; Mortensen, L S; Hansen, J F

    1996-01-01

    Survival in 190 consecutive patients with congestive heart failure, discharged from a general hospital, was studied. Sixteen patients were in New York Heart Association (NYHA) class I, 87 in II, 83 in III and 4 in IV. Median left ventricular ejection fraction (LVEF) from radionuclide ventriculogr......Survival in 190 consecutive patients with congestive heart failure, discharged from a general hospital, was studied. Sixteen patients were in New York Heart Association (NYHA) class I, 87 in II, 83 in III and 4 in IV. Median left ventricular ejection fraction (LVEF) from radionuclide...... classes III and IV survival was 68.9% for wall motion index > or = 1.3 and 39.9% when < 1.3. Addition of LVEF gave further information about survival. This study demonstrates that echocardiography is of great value in determining prognosis in congestive heart failure patients, and that wall motion index...

  19. Loss of lag-response curvilinearity of indices of heart rate variability in congestive heart failure

    Directory of Open Access Journals (Sweden)

    Smith Michael L

    2006-06-01

    Full Text Available Abstract Background Heart rate variability (HRV is known to be impaired in patients with congestive heart failure (CHF. Time-domain analysis of ECG signals traditionally relies heavily on linear indices of an essentially non-linear phenomenon. Poincaré plots are commonly used to study non-linear behavior of physiologic signals. Lagged Poincaré plots incorporate autocovariance information and analysis of Poincaré plots for various lags can provide interesting insights into the autonomic control of the heart. Methods Using Poincaré plot analysis, we assessed whether the relation of the lag between heart beats and HRV is altered in CHF. We studied the influence of lag on estimates of Poincaré plot indices for various lengths of beat sequence in a public domain data set (PhysioNet of 29 subjects with CHF and 54 subjects with normal sinus rhythm. Results A curvilinear association was observed between lag and Poincaré plot indices (SD1, SD2, SDLD and SD1/SD2 ratio in normal subjects even for a small sequence of 50 beats (p value for quadratic term 3 × 10-5, 0.002, 3.5 × 10-5 and 0.0003, respectively. This curvilinearity was lost in patients with CHF even after exploring sequences up to 50,000 beats (p values for quadratic term > 0.5. Conclusion Since lagged Poincaré plots incorporate autocovariance information, these analyses provide insights into the autonomic control of heart rate that is influenced by the non-linearity of the signal. The differences in lag-response in CHF patients and normal subjects exist even in the face of the treatment received by the CHF patients.

  20. Enhanced Ca2+-induced contractions and attenuated alpha-adrenoceptor responses in resistance arteries from rats with congestive heart failure

    DEFF Research Database (Denmark)

    Bergdahl, A; Valdemarsson, S; Sun, X Y;

    2001-01-01

    AIM: The aim of the present study was to examine the role of Ca2+-mediated contractile responses in isolated mesenteric resistance arteries from rats with congestive heart failure (CHF). METHODS: Heart failure was induced by ligation of the left coronary artery. Rats exposed to the same surgical ...

  1. Complexity in congestive heart failure: A time-frequency approach

    Science.gov (United States)

    Banerjee, Santo; Palit, Sanjay K.; Mukherjee, Sayan; Ariffin, MRK; Rondoni, Lamberto

    2016-03-01

    Reconstruction of phase space is an effective method to quantify the dynamics of a signal or a time series. Various phase space reconstruction techniques have been investigated. However, there are some issues on the optimal reconstructions and the best possible choice of the reconstruction parameters. This research introduces the idea of gradient cross recurrence (GCR) and mean gradient cross recurrence density which shows that reconstructions in time frequency domain preserve more information about the dynamics than the optimal reconstructions in time domain. This analysis is further extended to ECG signals of normal and congestive heart failure patients. By using another newly introduced measure—gradient cross recurrence period density entropy, two classes of aforesaid ECG signals can be classified with a proper threshold. This analysis can be applied to quantifying and distinguishing biomedical and other nonlinear signals.

  2. Congestive heart failure in patients with chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Poskurica Mileta

    2014-01-01

    Full Text Available Cardiovascular disorders are the most frequent cause of death (46-60% among patients with advanced chronic renal failure (CRF, and on dialysis treatment. Uremic cardiomyopathy is the basic pathophysiologic substrate, whereas ischemic heart disease (IHD and anemia are the most important contributing factors. Associated with well-know risk factors and specific disorders for terminal kidney failure and dialysis, the aforementioned factors instigate congestive heart failure (CHF. Suspected CHF is based on the anamnesis, clinical examination and ECG, while it is confirmed and defined more precisely on the basis of echocardiography and radiology examination. Biohumoral data (BNP, NT-proBNP are not sufficiently reliable because of specific volemic fluctuation and reduced natural clearance. Therapy approach is similar to the one for the general population: ACEI, ARBs, β-blockers, inotropic drugs and diuretics. Hypervolemia and most of the related symptoms can be kept under control effectively by the isolated or ultrafiltation, in conjunction with dialysis, during the standard bicarbonate hemodialysis or hemodiafiltration. In the same respect peritoneal dialysis is efficient for the control of hypervolemia symptoms, mainly during the first years of its application and in case of the lower NYHA class (II°/III°. In general, heart support therapy, surgical interventions of the myocardium and valve replacement are rarely used in patients on dialysis, whereas revascularization procedures are beneficial for associated IHD. In selected cases the application of cardiac resynchronization and/or implantation of a cardioverter defibrillator are advisable.

  3. [Congestive heart failure in patients with chronic kidney disease].

    Science.gov (United States)

    Poskurica, Mileta; Petrović, Dejan

    2014-01-01

    Cardiovascular disorders are the most frequent cause of death (46-60%) among patients with advanced chronic renal failure (CRF), and on dialysis treatment. Uremic cardiomyopathy is the basic pathophysiologic substrate, whereas ischemic heart disease (IHD) and anemia are the most important contributing factors. Associated with well-know risk factors and specific disorders for terminal kidney failure and dialysis, the aforementioned factors instigate congestive heart failure (CHF). Suspected CHF is based on the anamnesis, clinical examination and ECG, while it is confirmed and defined more precisely on the basis of echocardiography and radiology examination. Biohumoral data (BNP, NT-proBNP) are not sufficiently reliable because of specific volemic fluctuation and reduced natural clearance. Therapy approach is similar to the one for the general population: ACEI, ARBs, β-blockers, inotropic drugs and diuretics. Hypervolemia and most of the related symptoms can be kept under control effectively by the isolated or ultrafiltation, in conjunction with dialysis, during the standard bicarbonate hemodialysis or hemodiafiltration. In the same respect peritoneal dialysis is efficient for the control of hypervolemia symptoms, mainly during the first years of its application and in case of the lower NYHA class (II°/III°). In general, heart support therapy, surgical interventions of the myocardium and valve replacement are rarely used in patients on dialysis, whereas revascularization procedures are beneficial for associated IHD. In selected cases the application of cardiac resynchronization and/or implantation of a cardioverter defibrillator are advisable. PMID:25731010

  4. The pharmacokinetics of enalapril in hospitalized patients with congestive heart failure.

    OpenAIRE

    Dickstein, K.; Till, A. E.; Aarsland, T; Tjelta, K; Abrahamsen, A M; Kristianson, K; Gomez, H J; Gregg, H; Hichens, M

    1987-01-01

    The pharmacokinetics of the converting enzyme inhibitor, enalapril, were studied in an open, randomized, balanced crossover design in 12 hospitalized patients with stable, chronic congestive heart failure (CHF). Enalapril maleate is a prodrug requiring in vivo hepatic esterolysis to yield the active diacid inhibitor enalaprilat. CHF results in changes in regional blood flow that may affect the gastrointestinal absorption, hepatic hydrolysis and renal excretion of enalapril and enalaprilat. In...

  5. Wavelet Based Method for Congestive Heart Failure Recognition by Three Confirmation Functions

    OpenAIRE

    K. Daqrouq; A. Dobaie

    2016-01-01

    An investigation of the electrocardiogram (ECG) signals and arrhythmia characterization by wavelet energy is proposed. This study employs a wavelet based feature extraction method for congestive heart failure (CHF) obtained from the percentage energy (PE) of terminal wavelet packet transform (WPT) subsignals. In addition, the average framing percentage energy (AFE) technique is proposed, termed WAFE. A new classification method is introduced by three confirmation functions. The confirmation m...

  6. Multifractal properties of ECG patterns of patients suffering from congestive heart failure

    Science.gov (United States)

    Dutta, Srimonti

    2010-12-01

    The multifractal properties of two-channel ECG patterns of patients suffering from severe congestive heart failure (New York Heart Association (NYHA) classes III-IV) are studied and are compared with those for normal healthy people using the multifractal detrended fluctuation analysis methodology. Ivanov et al (1999 Nature 399 461) have studied the multifractality of human heart rate dynamics using the wavelet transformation modulus maxima (WTMM) methodology. But it has been observed by several scientists that multifractal detrended fluctuation analysis (MFDFA) works better than the WTMM method in the detection of monofractal and multifractal characteristics of the data. Galaska et al (2008 Ann. Noninvasive Electrocardiol. 13 155) have observed that MFDFA is more sensitive compared to the WTMM method in the differentiation between multifractal properties of the heart rate in healthy subjects and patients with left ventricular systolic dysfunction. In the present work the variation of two parameters of the multifractal spectrum—its width W (related to the degree of multifractality) and the value of the Hölder exponent α0—for the healthy and congestive heart failure patients is studied. α0 is a measure of the degree of correlation. The degree of multifractality varies appreciably (85-90% C.L.) for the normal and the CHF sets for channel I. For channel II no significant change in the values is observed. The degree of correlation is found to be comparatively high for the normal healthy people compared to those suffering from CHF.

  7. Multifractal properties of ECG patterns of patients suffering from congestive heart failure

    International Nuclear Information System (INIS)

    The multifractal properties of two-channel ECG patterns of patients suffering from severe congestive heart failure (New York Heart Association (NYHA) classes III–IV) are studied and are compared with those for normal healthy people using the multifractal detrended fluctuation analysis methodology. Ivanov et al (1999 Nature 399 461) have studied the multifractality of human heart rate dynamics using the wavelet transformation modulus maxima (WTMM) methodology. But it has been observed by several scientists that multifractal detrended fluctuation analysis (MFDFA) works better than the WTMM method in the detection of monofractal and multifractal characteristics of the data. Galaska et al (2008 Ann. Noninvasive Electrocardiol. 13 155) have observed that MFDFA is more sensitive compared to the WTMM method in the differentiation between multifractal properties of the heart rate in healthy subjects and patients with left ventricular systolic dysfunction. In the present work the variation of two parameters of the multifractal spectrum—its width W (related to the degree of multifractality) and the value of the Hölder exponent α0—for the healthy and congestive heart failure patients is studied. α0 is a measure of the degree of correlation. The degree of multifractality varies appreciably (85–90% C.L.) for the normal and the CHF sets for channel I. For channel II no significant change in the values is observed. The degree of correlation is found to be comparatively high for the normal healthy people compared to those suffering from CHF

  8. Study on the Traffic Congestion in Beijing

    OpenAIRE

    Ma Xiaofei

    2013-01-01

    As the the rapid growth of city economy, a traffic congestion has become a common sight in almost every big city. On the surface, the infrastructure construction is incompatible with the rapid expansion of the city cars. In fact,the root cause lies in the careless and easy style of management of traffic which leads to the low traffic efficiency. This study mainly describes the traffic system, the causes of traffic congestion, discussing on the optimization to ...

  9. Responsiveness of the Chinese Quality of Life Instrument in Patients with Congestive Heart Failure

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Objective:The Chinese Quality of Life Instrument (ChQOL) was developed as a valid generic health status instrument based on the well-established theory of health in Chinese medicine.Psychometric properties of the ChQOL were good.In the present study,the responsiveness of the ChQOL in patients with congestive heart failure (CHF) were investigated and compared with two generic questionnaires,the Medical Outcomes Study Short Form 36-item Health Survey (SF-36) and World Health Organization Quality of Life Assessment (WHOQOL-BREF),as well as one disease-specific questionnaire,the Minnesota Living with Heart Failure Questionnaire (MLHF).Methods:Thirty-nine in-patients with CHF who had undergone treatment with integrative medicine were recruited.The health status measurements were performed at enrolment and after a 4-week treatment.The following responsiveness indices were used:the effect size (ES) and standardized response mean (SRM).All patients were classified into those groups with stable measures and those groups with changes after a 4-week treatment,based upon both the doctor's global rating of changes in heart function tests,and the patient's global rating of changes in overall quality of life.Results:All domains of the ChQOL showed significant improvement.In the comparison of the responsiveness indices,the ChQOL was regarded as more responsive than the WHOQOL-BREF or SF-36 utility,but it was less responsive than the MLHF.Conclusions:The ChQOL was better in sensitivity and responsiveness for assessing congestive heart failure as a generic measure than the SF-36 and WHOQOL-BREF.The ChQOL is considered suitable as an outcome measure for clinical trials in patients with congestive heart failure.

  10. [Congestive heart failure with frequent hospital readmissions in the elderly].

    Science.gov (United States)

    Pentimone, F; Del Corso, L

    1993-03-01

    Ten elderly patients with heart failure and frequent hospital readmission within 12 months before the study, were submitted to clinical radiologic, electrocardiographic and echocardiographic evaluation in order to find the causes of readmission. The most frequent factors were found to be non compliance with drug prescriptions and therapy inadequate for the etiology of the heart failure and the kind of cardiac dysfunction. PMID:8482059

  11. Effects of bucindolol on neurohormonal activation in congestive heart failure

    International Nuclear Information System (INIS)

    To examine the effects of beta-adrenergic blockade on neurohormonal activation in patients with congestive heart failure, 15 men had assessments of hemodynamics and supine peripheral renin and norepinephrine levels before and after 3 months of oral therapy with bucindolol, a nonselective beta antagonist. At baseline, plasma renin activity did not correlate with any hemodynamic parameter. However, norepinephrine levels had a weak correlation with left ventricular end-diastolic pressure (r = 0.74, p less than 0.01), stroke volume index (r = 0.61, p less than 0.02) and pulmonary vascular resistance (r = 0.54, p less than 0.05). Plasma renin decreased with bucindolol therapy, from 11.6 +/- 13.4 to 4.3 +/- 4.1 ng/ml/hour (mean +/- standard deviation; p less than 0.05), whereas plasma norepinephrine was unchanged, from 403 +/- 231 to 408 +/- 217 pg/ml. A wide diversity of the norepinephrine response to bucindolol was observed with reduction of levels in some patients and elevation in others. Although plasma norepinephrine did not decrease, heart rate tended to decrease (from 82 +/- 20 vs 73 +/- 11 min-1, p = 0.059) with beta-adrenergic blockade, suggesting neurohormonal antagonism at the receptor level. No changes in I-123 metaiodobenzylguanidine uptake occurred after bucindolol therapy, suggesting unchanged adrenergic uptake of norepinephrine with beta-blocker therapy. Despite reductions in plasma renin activity and the presence of beta blockade, the response of renin or norepinephrine levels to long-term bucindolol therapy did not predict which patients had improved in hemodynamic status (chi-square = 0.37 for renin, 0.82 for norepinephrine)

  12. Breathing disorders in congestive heart failure: gender, etiology and mortality

    Directory of Open Access Journals (Sweden)

    R.S. Silva

    2008-03-01

    Full Text Available We investigated the relationship between sleep-disordered breathing (SDB and Cheyne-Stokes respiration (CSR while awake as well as mortality. Eighty-nine consecutive outpatients (29 females with congestive heart failure (CHF; left ventricular ejection fraction, LVEF 5 and >15, respectively. CHF etiologies were similar according to the prevalence of SDB and sleep pattern. Males and females were similar in age, body mass index, and LVEF. Males presented more SDB (P = 0.01, higher apnea-hypopnea index (P = 0.04, more light sleep (stages 1 and 2; P < 0.05, and less deep sleep (P < 0.001 than females. During follow-up (25 ± 10 months, 27% of the population died. Non-survivors had lower LVEF (P = 0.01, worse New York Heart Association (NYHA functional classification (P = 0.03, and higher CSR while awake (P < 0.001 than survivors. As determined by Cox proportional model, NYHA class IV (RR = 3.95, 95%CI = 1.37-11.38, P = 0.011 and CSR while awake with a marginal significance (RR = 2.96, 95%CI = 0.94-9.33, P = 0.064 were associated with mortality. In conclusion, the prevalence of SDB and sleep pattern of patients with Chagas' disease were similar to that of patients with CHF due to other etiologies. Males presented more frequent and more severe SDB and worse sleep quality than females. The presence of CSR while awake, but not during sleep, may be associated with a poor prognosis in patients with CHF.

  13. Takayasu Arteritis with Rheumatic Heart Disease with Congestive Cardiac Failure mimicking as having Infective Endocarditis

    OpenAIRE

    Upadhyay, Piyush

    2013-01-01

    Takayasu Arteritis (TA) is a chronic, idiopathic and granulomatous vasculitis of the large arteries. It involves primarily the aorta, especially aortic proximal branches, and occasionally the pulmonary arteries. We report a 10 year old boy with Takayasu arteritis with Rheumatic heart disease who developed congestive heart failure with valvular heart disease mimicking as having infective endocarditis. Complete aortogram revealed narrowing of abdominal aorta, superior ...

  14. Iodine-123 metaiodobenzylguanidine imaging of the heart in idiopathic congestive cardiomyopathy and cardiac transplants

    International Nuclear Information System (INIS)

    Iodine-123 metaiodobenzylguanidine ([123I]MIBG) is a norepinephrine analog which can be used to image the sympathetic innervation of the heart. In this study, cardiac imaging with [123I]MIBG was performed in patients with idiopathic congestive cardiomyopathy and compared to normal controls. Initial uptake, half-time of tracer within the heart, and heart to lung ratios were all significantly reduced in patients compared to normals. Uptake in lungs, liver, salivary glands, and spleen was similar in controls and patients with cardiomyopathy indicating that decreased MIBG uptake was not a generalized abnormality in these patients. Iodine-123 MIBG imaging was also performed in cardiac transplant patients to determine cardiac nonneuronal uptake. Uptake in transplants was less than 10% of normals in the first 2 hr and nearly undetectable after 16 hr. The decreased uptake of MIBG suggests cardiac sympathetic nerve dysfunction while the rapid washout of MIBG from the heart suggests increased cardiac sympathetic nerve activity in idiopathic congestive cardiomyopathy

  15. Recompensation of Heart and Kidney Function after Treatment with Peritoneal Dialysis in a Case of Congestive Heart Failure

    OpenAIRE

    Andrew Remppis; Christian Zugck; Vinzent Hankel; Kihm, Lars P; Vedat Schwenger

    2011-01-01

    We report the case of a 57-year-old woman suffering from congestive heart failure. Due to refractory congestions despite optimised medical treatment, the patient was listed for heart transplantation and peritoneal dialysis was initiated. Peritoneal dialysis led to a significant weight loss, reduction of hyperhydration and extracellular water obtained by bioimpedance measurement, and a significant improvement in clinical and echocardiographic examination. Furthermore, residual kidney function ...

  16. Pharmacogenetic risk stratification in angiotensin-converting enzyme inhibitor-treated patients with congestive heart failure

    DEFF Research Database (Denmark)

    Nelveg-Kristensen, Karl Emil; Busk Madsen, Majbritt; Torp-Pedersen, Christian;

    2015-01-01

    SNPs of the angiotensin-converting enzyme gene (rs4343) and ABO blood group genes (rs495828 and rs8176746). METHODS: Danish patients with CHF enrolled in the previously reported Echocardiography and Heart Outcome Study were included. Subjects were genotyped and categorized according to pharmacogenetic......BACKGROUND: Evidence for pharmacogenetic risk stratification of angiotensin-converting enzyme inhibitor (ACEI) treatment is limited. Therefore, in a cohort of ACEI-treated patients with congestive heart failure (CHF), we investigated the predictive value of two pharmacogenetic scores that...... previously were found to predict ACEI efficacy in patients with ischemic heart disease and hypertension, respectively. Score A combined single nucleotide polymorphisms (SNPs) of the angiotensin II receptor type 1 gene (rs275651 and rs5182) and the bradykinin receptor B1 gene (rs12050217). Score B combined...

  17. The change of plasma leptin level and its correlation study with insulin resistance or TNF-αin patients with congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    张金国; 杨娜; 高东升; 王学忠; 宋光耀; 王智华

    2004-01-01

    Objectives To determine the change of plasma leptin levels and the correlation between hyperleptinaemia and insulin resistance or TNF-o in patients with congestive heart failure (CHF). Methods The levels of plasma leptin, fasting plasma insulin (FINS) and TNF-α in 64 male patients with CHF and 30 healthy male people were measured by ELISA. Body mass index (BMI), waist/hip ratio (WHR) and insulin resistance index (Homa-IR) were calculated respectively. Results The plasma leptin levels in CHF group were higher compared with control group (P<0.001). There was a increased trend of plasma leptin levels in CHF group with the increase of NYHA class (rs=0.884, P<0.001); according to different etiology ,there was no significant difference of plasma leptin levels in CHF group (P>0.05); FINS,Homa-IR and TNF-o levels in CHF group were higher than in control group (all P<0.001); in CHF group plasma leptin levels correlated with FINS (r=0.652,P<0.001),Homa-IR (r=0.561,P<0.001) and TNF-α (r=0.629,P<0.001); in multiple stepwise regression analysis BMI, FINS and TNF-α were isolated factors affecting plasma leptin levels in CHF group, Y=-3.466+0.456 (BMI)+ 0.162 (FINS)+4.487(TNF-α), F=38.405,P<0.001. Conclusions plasma leptin levels were raised and correlated with disease severity in patients with CHF; FINS and TNF-α were isolated factor affecting plasma leptin level in CHF patients; hyperleptinaemia may play a role in the pathophysiology of CHF such as catabolic process and activation of neurohormonal.

  18. Increased plasma levels and blunted effects of brain natriuretic peptide in rats with congestive heart failure.

    Science.gov (United States)

    Hoffman, A; Grossman, E; Keiser, H R

    1991-07-01

    The hemodynamic and renal effects of brain natriuretic peptide (BNP) were studied in conscious rats with experimental congestive heart failure (CHF) produced by an aortocaval fistula. The peptide had potent hypotensive, diuretic, and natriuretic effects in control rats, all of which were abolished in CHF. Plasma levels of BNP increased time-dependently during the development of CHF, and were more than four-fold higher in sodium retaining rats than in control rats. The data suggest that BNP secretion from the atria is increased in CHF, and that resistance to BNP, in addition to the relative resistance to atrial natriuretic factor, may contribute to sodium retention in CHF. PMID:1831369

  19. Renal and cardiac function during alpha1-beta-blockade in congestive heart failure

    DEFF Research Database (Denmark)

    Heitmann, M; Davidsen, U; Stokholm, K H;

    2002-01-01

    The kidney and the neurohormonal systems are essential in the pathogenesis of congestive heart failure (CHF) and the physiologic response. Routine treatment of moderate to severe CHF consists of diuretics, angiotensin-converting enzyme (ACE) inhibition and beta-blockade. The need for control of...... renal function during initiation of ACE-inhibition in patients with CHF is well known. The aim of this study was to investigate whether supplementation by a combined alpha1-beta-blockade to diuretics and ACE-inhibition might improve cardiac function without reducing renal function....

  20. Determination of hepatic blood flow through radioactive colloidal gold in congestive heart foilure

    International Nuclear Information System (INIS)

    Hepatic blood flow as derermined by radioactive colloidal gold and its correlation with total blood valume are studied in 13 patients with predominantly right-side congestive heart failure. During the phase of cardiac compensation, the following events occur: 1) significant decrease of the half-life of the clearance of radioactive colloidal gold and of the total blood volume; 2) increase of the clearance constant of the radioactive substance and of hepatic blood flow; 3) significantion correlation between the clearance constant and the total blood volume

  1. The Administration and Effect of Sodium Nitroprusside in the Treatment of Chronic Congestive Heart Failure

    Institute of Scientific and Technical Information of China (English)

    Sun Ming; Wang Wenmeng; Wu Qiong

    2000-01-01

    To prove the effectiveness and safety of sodium nitroprusside (SNP) in the treatment of chronic congestive heart failure, 58 patients with heart failure and normal renal and hepatic function were selected and divided into 3 groups and treated differently. Group A was treated with routine vasodilators; Group B was treaeted intermittently with SNP (12.5 -75mg/24hrs);Group C was treated continuously with SNP (continuous infusion of 100-300mg/24hrs) Positively inotropie agents and diuretic agents were used in each group.The results showed that the highly effective rates of the three groups were 46.9% (15/32), 90.5% (19/21)and 100% (12/12) respectively. The effective rates were 81.3% (26/32), 100% (21/21), 100%(12/12) respectively. The highly effective rates of group B and C were much higher than that of group A (P<0.005, P< 0.005) . The reduction of blood pressure of group B and C was greater than that of group A ( P < 0. 025) . Among the patients we studied, no body had severe side effects. We concluded that the use of SNP in the treatment of chronic congestive heart failure is safe, with better effect than routine treatment,and continous infusion of SNP is the best choice.

  2. Congestive heart failure. Correlation between functional class and systolic and diastolic functions assessed by Doppler echocardiography

    Directory of Open Access Journals (Sweden)

    Kamel Cesar Selem

    2001-01-01

    Full Text Available OBJECTIVE: To evaluate the influence of systolic or diastolic dysfunction, or both on congestive heart failure functional class. METHODS: Thirty-six consecutive patients with a clinical diagnosis of congestive heart failure with sinus rhythm, who were seen between September and November of 1998 answered an adapted questionnaire about tolerance to physical activity for the determination of NYHA functional class. The patients were studied with transthoracic Doppler echocardiography. Two groups were compared: group 1 (19 patients in functional classes I and II and group 2 (17 patients in functional classes III and IV. RESULTS: The average ejection fraction was significantly higher in group 1 (44.84%±8.04% vs. 32.59%±11.48% with p=0.0007. The mean ratio of the initial/final maximum diastolic filling velocity (E/A of the left ventricle was significantly smaller in group 1 (1.07±0.72 vs. 1.98±1.49 with p=0.03. The average maximum systolic pulmonary venous velocity (S was significantly higher in group 1 (53.53cm/s ± 12.02cm/s vs. 43.41cm/s ± 13.55cm/s with p=0.02. The mean ratio of maximum systolic/diastolic pulmonary venous velocity was significantly higher in group 1 (1.52±0.48 vs. 1.08±0.48 with p=0.01. A predominance of pseudo-normal and restrictive diastolic patterns existed in group 2 (58.83% in group 2 vs. 21.06% in group 1 with p=0.03. CONCLUSION: Both the systolic dysfunction index and the patterns of diastolic dysfunction evaluated by Doppler echocardiography worsened with the evolution of congestive heart failure.

  3. Improved Cardiac Contractility of Human Recombinant Growth Hormone on the Congestive Heart Failure of Pig

    Institute of Scientific and Technical Information of China (English)

    Yang Ping; He Yu-quan; Zeng Hong; Ni Jin-song; Yun Qing-jun; Huang Xiao-ping; Li Shu-mei

    2005-01-01

    The enhanced cardiac contractility effect of human recombinant growth hormone (hr-GH) on the congestive heart failure (CHF) was studied on the pig. To build a pig model of congestive heart failure, a temporary artificial cardiac pacemaker was implanted in the pig's body and paced at 220 beats to 240 beats per minute for 1 week. After the model of congestive heart failure was successfully set up, the frequency of the pacemaker was changed to 150 beats to 180 beats per minute to maintain the CHF model stable. Pigs were divided into three groups: The hr-GH group in which 0.5 mg/kg per day of hr-GH was administrated intramuscularly for 15 days, the injection control group in which an equal amount of physiological saline was injected intramuscularly, and a normal control group. The left ventricular diastolic end pressure was (10.60±2.41 ) mmHg in the hr-GH group, but (19.00±3.81) mmHg in the saline control group (P<0.01); Cardiac output was (1.86±0.13) L/min in the hr-GH group, but (1.56 ±0.18) L/min in the saline control group (P<0.05); Peripheral min) -1 in the saline control group (P<0.05); ± dp/dtmax was (2900 ±316.23) and (2280 ±286.36) in the hr-HG group and the saline control group respectively (P<0.05). The results show that hr-GH enhances myocardial contractility of CHF, and the CHF model built by a temporary artificial cardiac pacemaker at a high rate of stimulation is reasonable and applicable.

  4. Impact of congestive heart failure and left ventricular systolic function on the prognostic significance of atrial fibrillation and atrial flutter following acute myocardial infarction

    DEFF Research Database (Denmark)

    Pedersen, Ole Dyg; Bagger, Henning; Køber, Lars;

    2005-01-01

    BACKGROUND: Reports on the prognostic importance of atrial fibrillation following myocardial infarction have provided considerable variation in results. Thus, this study examined the impact of left ventricular systolic function and congestive heart failure on the prognostic importance of atrial...... congestive heart failure were prospectively collected. Mortality was followed for 5 years. RESULTS: In patients with left ventricular ejection fraction<0.25, atrial fibrillation/atrial flutter was associated with an increased in-hospital mortality (OR=1.8 (1.1-3.2); p<0.05) but not an increased 30-day...... mortality. In patients with 0.250.35. In patients with congestive heart failure, atrial fibrillation/atrial flutter was associated with an increased in-hospital mortality (OR=1.5 (1.2-1.9); p<0.001) and increased 30-day mortality (OR=1.4 (1.1-1.7); p<0.001) but not in patients without congestive heart...

  5. ACE inhibitors and calcium antagonists in the treatment of congestive heart failure

    DEFF Research Database (Denmark)

    Hansen, J F

    1995-01-01

    The increased mortality after myocardial infarction is related to the risk of reinfarction, sudden death, and the development and progression of heart failure; in congestive heart failure it is due to the progression of heart failure and sudden death. ACE inhibitors have been proven to prevent...... cardiovascular events, especially the progression of heart failure, in postinfarct patients with reduced ejection fraction and heart failure in the SAVE and AIRE trials. In patients with congestive heart failure, ACE inhibitor treatment has prevented cardiovascular death and reduced morbidity due to progressive...... by prevention of reinfarction and sudden death. Combination treatment with both verapamil, which has pronounced antiischemic properties and prevents sudden death and reinfarction, and an ACE inhibitor, which prevents the progression of heart failure, is a possibility for future cardiovascular therapy...

  6. Fluid Volume Overload and Congestion in Heart Failure: Time to Reconsider Pathophysiology and How Volume Is Assessed.

    Science.gov (United States)

    Miller, Wayne L

    2016-08-01

    Volume regulation, assessment, and management remain basic issues in patients with heart failure. The discussion presented here is directed at opening a reassessment of the pathophysiology of congestion in congestive heart failure and the methods by which we determine volume overload status. Peer-reviewed historical and contemporary literatures are reviewed. Volume overload and fluid congestion remain primary issues for patients with chronic heart failure. The pathophysiology is complex, and the simple concept of intravascular fluid accumulation is not adequate. The dynamics of interstitial and intravascular fluid compartment interactions and fluid redistribution from venous splanchnic beds to central pulmonary circulation need to be taken into account in strategies of volume management. Clinical bedside evaluations and right heart hemodynamic assessments can alert clinicians of changes in volume status, but only the quantitative measurement of total blood volume can help identify the heterogeneity in plasma volume and red blood cell mass that are features of volume overload in patients with chronic heart failure and help guide individualized, appropriate therapy-not all volume overload is the same. PMID:27436837

  7. Mammographic and sonographic findings of unilateral breast edema in congestive heart failure : a case report

    International Nuclear Information System (INIS)

    Unilateral breast edema has many causes, though among these, congestive heart failure is rare. We report mammographic and sonographic findings of unilateral breast edema due to congestive heart failure. Mammography showed diffuse increase density and skin thickening but no evidence of mass or calcification. Ultrasonography showed skin thickening and increased echogenicity in the subcutaneous fat layer, while in the dermal layer, with tubular and reticular anechoic structures suggestive of dilated lymphatics were seen. After treatment of the heart failure, resolution of the abnormalities seen on mammogram established that these were secondary findings

  8. Paradox of circulating advanced glycation end product concentrations in patients with congestive heart failure and after heart transplantation

    OpenAIRE

    A. Heidland; Šebeková, K.; Frangiosa, A; De Santo, L S; Cirillo, M.; Rossi, F.; Cotrufo, M.; Perna, A; Klassen, A; Schinzel, R; De Santo, N G

    2004-01-01

    Objectives: To analyse circulating concentrations of advanced glycation end products (AGEs) in patients with severe congestive heart failure (CHF) and after heart transplantation; to identify the potential contribution of kidney function to plasma AGE concentrations; and to determine whether AGE concentrations and parameters of oxidative stress are interrelated.

  9. Recompensation of heart and kidney function after treatment with peritoneal dialysis in a case of congestive heart failure.

    Science.gov (United States)

    Kihm, Lars P; Hankel, Vinzent; Zugck, Christian; Remppis, Andrew; Schwenger, Vedat

    2011-01-01

    We report the case of a 57-year-old woman suffering from congestive heart failure. Due to refractory congestions despite optimised medical treatment, the patient was listed for heart transplantation and peritoneal dialysis was initiated. Peritoneal dialysis led to a significant weight loss, reduction of hyperhydration and extracellular water obtained by bioimpedance measurement, and a significant improvement in clinical and echocardiographic examination. Furthermore, residual kidney function increased during the long-term followup, and subsequently peritoneal dialysis was ceased. Pulmonary artery pressure and left ventricular ejection fraction remained stable and the patient did well. This case demonstrates the possibility of treating hyperhydration due to congestive heart failure with peritoneal dialysis resulting in recompensation of both heart and kidney functions. PMID:22162698

  10. Recompensation of Heart and Kidney Function after Treatment with Peritoneal Dialysis in a Case of Congestive Heart Failure

    Directory of Open Access Journals (Sweden)

    Lars P. Kihm

    2011-01-01

    Full Text Available We report the case of a 57-year-old woman suffering from congestive heart failure. Due to refractory congestions despite optimised medical treatment, the patient was listed for heart transplantation and peritoneal dialysis was initiated. Peritoneal dialysis led to a significant weight loss, reduction of hyperhydration and extracellular water obtained by bioimpedance measurement, and a significant improvement in clinical and echocardiographic examination. Furthermore, residual kidney function increased during the long-term followup, and subsequently peritoneal dialysis was ceased. Pulmonary artery pressure and left ventricular ejection fraction remained stable and the patient did well. This case demonstrates the possibility of treating hyperhydration due to congestive heart failure with peritoneal dialysis resulting in recompensation of both heart and kidney functions.

  11. Plasma renin activity and its association with ischemic heart disease, congestive heart failure, and cerebrovascular disease in a large hypertensive cohort

    OpenAIRE

    Sim, John J.; Shi, Jiaxiao; Al-Moomen, Rushdy; Behayaa, Hind; Kalantar-Zadeh, Kamyar; Jacobsen, Steven J.

    2014-01-01

    Plasma renin activity (PRA) may be a surrogate for vascular damage. We hypothesize that PRA is associated with cardiovascular and cerebrovascular disease. Cross sectional study (1/1/1998–12/31/2009) on hypertensive individuals >/=18yrs using multivariable logistic regression models to estimate odds ratios (OR) for ischemic heart disease (IHD), congestive heart failure (CHF), and cerebrovascular disease (CED) based on PRA quartiles controlling for age, sex, race, diabetes mellitus (DM), and me...

  12. Ultrasound lung comets for serial assessment of pulmonary congestion in heart failure

    OpenAIRE

    Gargani, Luna; Frassi, Francesca; Prado, Aldo; Tesorio, Tullio; Soldati, Gino; Viola, Umberto; Porcari, Alberto; Mottola, Gaetano; Picano, Eugenio

    2007-01-01

    Background: Serial chest radiographs are too insensitive and therefore NOT recommended for monitoring pulmonary congestion in heart failure patients (AHA/ACC guidelines 2006). Ultrasound lung comets (ULCs) are a simple, quantitative chest sonography sign of pulmonary congestion, originating from water-thickened interlobular septa, and might represent a convenient alternative to chest x-ray in this clinical setting. Aim: To assess whether dynamic changes in ULCs could mirror variations in clin...

  13. A history of arterial hypertension does not affect mortality in patients hospitalised with congestive heart failure

    DEFF Research Database (Denmark)

    Gustafsson, F; Torp-Pedersen, C; Seibaek, M;

    2006-01-01

    OBJECTIVES: To evaluate the importance of a history of hypertension on long-term mortality in a large cohort of patients hospitalised with congestive heart failure (CHF). DESIGN: Retrospective analysis of 5491 consecutive patients, of whom 24% had a history of hypertension. 60% of the patients ha...... studies, could not be confirmed. CONCLUSION: A history of arterial hypertension did not affect mortality in patients hospitalised with CHF.......OBJECTIVES: To evaluate the importance of a history of hypertension on long-term mortality in a large cohort of patients hospitalised with congestive heart failure (CHF). DESIGN: Retrospective analysis of 5491 consecutive patients, of whom 24% had a history of hypertension. 60% of the patients had...... with a history of hypertension. 72% of the patients died during follow up. A hypertension history did not affect mortality risk (hazard ratio (HR) 0.99, 95% confidence interval (CI) 0.92 to 1.07). Correction for differences between the normotensive and hypertensive groups at baseline in a multivariate...

  14. Cardiac encephalopathy and congestive heart failure: a hypothesis about the relationship.

    Science.gov (United States)

    Caplan, Louis R

    2006-01-10

    Many patients with congestive heart failure develop neurologic dysfunction. This may take the form of a cardiac encephalopathy that shares clinical features with other metabolic encephalopathies. The causes are multiple. There is a particular, previously unreported, syndrome that occasionally develops in some patients with congestive heart failure that resembles the findings in patients with normal pressure hydrocephalus. This syndrome is characterized by apathy and abulia with preserved alertness; it is caused by fluid retention within the cranial cavity. The syndrome may also develop in patients with other conditions that cause anasarca, e.g., severe liver or kidney disease or hypoalbuminemia. Because patients with these conditions are often quite ill, it has been difficult to verify the pathophysiologic aspects of the syndrome so that its mechanism must remain a hypothesis that awaits more definitive study in a series of patients. I have not seen this syndrome discussed in any cardiology or neurology texts or reports, and it seems to be completely unknown to cardiologists and neurologists. I have recognized about one patient per year with this syndrome. PMID:16401854

  15. Patient medication adherence and physician prescribing among congestive heart failure patients of Yemen

    Directory of Open Access Journals (Sweden)

    K M Alakhali

    2013-01-01

    Full Text Available Congestive heart failure has been associated with high morbidity and mortality requiring hospitalisation and is further complicated by noncompliance and under prescriptions. We aim to determine medication adherence and percentage deviation among Asians population in general and Yemenis in particular. A cross-sectional, prospective observational study with purposive sampling was conducted at two cardiac outpatient centers in 70 congestive heart failure patients for a period of 3 months. An Arabic translated Morisky 4 item scale assessed the adherence of patients. Deviation in prescribing was determined by chart review. All 70 patients had mean age of 56.6΁16 years. Morisky 4 item scale predicted low adherence (n=33; 47.1% and overall nonadherencerate (n=38; 54.2% was slightly higher than adherence. Percentage nonadherence versus adherence was high with diuretics (53 vs. 46% and, digoxin (40 vs. 29%. The adherence percentage of angiotensin receptor blockers (9% and beta blockers (8% was low. Diuretics were the most prescribed drugs (n=69; 99%, followed by angiotensin converting enzyme inhibitors (n=51; 73%, cardiac glycoside (n=48; 69%, few patients were on angiotensin receptor blockers (n=8; 11% and (n=9; 13% beta blockers. The maximum prescribing rate deviation was seen with angiotensin receptor blockers (−89% and beta blockers (−87% followed by nitrates (−77%. Digoxin (−31% and angiotensin converting enzymes (−27% deviated comparatively less. Prescribing as well as utilisation rates generally were low resulting in nonachievement of therapeutic goals which could be resolved using multimodel approach.

  16. Quality of life in patients with chronic congestive heart failure

    Directory of Open Access Journals (Sweden)

    Anca D. Farcaş

    2011-12-01

    Full Text Available Objective: Quality of life (QOL is severely decreased in patients with chronic heart failure (CHF. Our study aims to identify the factors affecting the evaluation of QOL. Material and Methods: Clinical, demographic, social and economic data was collected from patients with CHF in NYHA class III and IV as part of a complex workup. The Minnesota Living with Heart Failure Questionnaire (MLHFQ was used to evaluate QOL. Results: QOL decreases as the NYHA class increases. Women evaluate their QOL as more severely affected than men. Age, social and economic factors modulate the perception of QOL. Conclusion: Combining demographic, social and economic data and evaluation of QOL can provide valuable and useful information for the medical management of patients with CHF.

  17. 循环血液中内皮祖细胞在充血性心力衰竭患者中的表达%Expression of endothelial progenitor cells with the blood circulation in congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    余东彪; 吴继雄

    2012-01-01

    目的 研究内皮祖细胞在充血性心力衰竭患者中的表达情况,并进一步研究其与心衰严重程度的相关性.方法 选择心衰患者96例(纽约心功能分级:Ⅰ级22例,Ⅱ级25例,Ⅲ级26例,Ⅳ级23例)及健康正常人25例(对照组),以CD34、CD45为表面标记,用流式细胞仪测量外周血中的内皮祖细胞数,并同时测量脑钠肽(BNP).结果 心衰患者较对照组BNP水平升高(P<0.01),且心衰的严重程度与BNP呈正相关;在心功能Ⅰ级、Ⅱ级心衰患者中,内皮祖细胞较健康对照组明显升高(P<0.01);心功能Ⅲ级、Ⅳ级患者较健康对照组降低(P<0.05或<0.01).结论 内皮祖细胞在心衰患者中呈现一个双向性改变,即在心衰晚期阶段外周血内皮祖细胞表达较对照组明显下降,而在心衰早期阶段较对照组明显升高,提示受损的内皮祖细胞招募可能参与严重心衰患者的病理生理过程.%Objective To investigate the pattern of endothelial progenitor cells during congestive heart failure and their correlation with the severity. Methods 96 patients with heart failure (NYHA Class Ⅰ: 22 cases, Ⅱ: 25 cases, Ⅲ: 26 cases, Ⅳ: 23 cases) and 25 cases of normal control group were measured CD34, CD45, peripheral blood endothelial progenitor cells number with flow cytometric and simultaneously measured brain natriuretic peptide (BNP) level. Results The heart failure patients increased significantly BNP levels than the control group, and the severity of the heart failure with BNP was positively correlated. Endothelial progenitor cells were increased in NYHA Class I and NYHA Class Ⅱ compared with that in controls ( P < 0. 01 ). Endothelial progenitor cells were significantly decreased in NYHA Class Ⅳ and NYHA Class Ⅲ compared with that in controls (P < 0.05 or P < 0.01). Conclusions Endothelial progenitor cells in the heart failure patients show a biphasic response, with elevation and depression in the early and

  18. Determination of the survival rate in patients with congestive heart failure stratified by 123I-MIBG imaging. A meta-analysis from the studies performed in Japan

    International Nuclear Information System (INIS)

    The goals of this meta-analysis were to determine survival rates in patients with heart failure (HF) assessed by 123I-metaiodobenzylguanidine (MIBG) imaging results using recently published studies and to determine the prognostic value of 123I-MIBG imaging. We reviewed published cohort studies carried out in Japan that compared the prognosis of patients with their 123I-MIBG activity quantified as late heart-to-mediastinum ratio (H/M) or washout rate by performing a PubMed search for articles in English up to December 2006. Studies were selected if they analyzed a clearly defined lethal outcome (cardiovascular death) using life tables to estimate the odds ratio at 24 months after enrollment. Of 158 articles related to cardiac 123I-MIBG, seven referred to studies that met the inclusion criteria: 5 evaluated H/M via 123I-MIBG in a total of 866 patients and 4 calculated washout rate in a total of 491 patients. A low H/M indicated a high risk of cardiac death: pooled odds ratio, 5.2; 95% confidence interval (CI) of 3.1-5.7. A high washout was also associated with lethal events with a pooled odds ratio of 2.8 (CI: 1.6-5.0). The association between washout and cardiac death was heterogeneous (Chi-square=11.0, P123I-MIBG studies conducted in Japan indicated that both a decreased cardiac 123I-MIBG activity (H/M) and an increased washout rate are indicative of a poor prognosis in patients with chronic heart failure. (author)

  19. Supplying sodium and chlorine is effective on patients with congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    Yu Li; Changcong Cui

    2005-01-01

    Objective: To analyze the relationship of severity of heart failure and the concentration of serum sodium(Na + ) and chlorine(Cl- ) and to explore the effect of supplying sodium and chlorine on patients with Congestive heart failure. Methods: 80 patients with congestive heart failure were divided into two groups, namely supplying and control group. Serum sodium and chlorine were measured in all these patients. All treatments but supplying sodium and chlorine were same between the supplying and control groups. Results:According to NYHA, patients who were in class Ⅳ had lower level of serum sodium and chlorine than those in class Ⅱ ( P < 0.05). The heart function was improved after the level of serum sodium and chlorine were raised. Conclusions: The concentration of serum sodium and chlorine relates to the severity of heart failure. The therapy of supplying sodium and chlorine is an effective way to decrease death rate.

  20. Phlegmonous enteritis in a patient with congestive heart failure and colon cancer

    Energy Technology Data Exchange (ETDEWEB)

    Namkung, Sook; Yoo, Yoon Sik; Hwang, Im Kyung; Kim, Bong Soo; Bae, Sang Hoon; Choi, Young Hee [Hallym University, Chuncheon (Korea, Republic of)

    2001-12-01

    Phlegmonous enteritis is a rare infective inflammatory disease of the intestine, predominantly involving the submucosal layer. It is difficult to diagnose and often fatal. Its association with alcoholism and various liver diseases, although rarely reported, is well documented. We report a case of phlegmonous enteritis in a male patient with congestive heart failure and colon cancer, and describe the ultrasonographic and CT findings.

  1. Classification tree for risk assessment in patients suffering from congestive heart failure via long-term heart rate variability.

    Science.gov (United States)

    Melillo, Paolo; De Luca, Nicola; Bracale, Marcello; Pecchia, Leandro

    2013-05-01

    This study aims to develop an automatic classifier for risk assessment in patients suffering from congestive heart failure (CHF). The proposed classifier separates lower risk patients from higher risk ones, using standard long-term heart rate variability (HRV) measures. Patients are labeled as lower or higher risk according to the New York Heart Association classification (NYHA). A retrospective analysis on two public Holter databases was performed, analyzing the data of 12 patients suffering from mild CHF (NYHA I and II), labeled as lower risk, and 32 suffering from severe CHF (NYHA III and IV), labeled as higher risk. Only patients with a fraction of total heartbeats intervals (RR) classified as normal-to-normal (NN) intervals (NN/RR) higher than 80% were selected as eligible in order to have a satisfactory signal quality. Classification and regression tree (CART) was employed to develop the classifiers. A total of 30 higher risk and 11 lower risk patients were included in the analysis. The proposed classification trees achieved a sensitivity and a specificity rate of 93.3% and 63.6%, respectively, in identifying higher risk patients. Finally, the rules obtained by CART are comprehensible and consistent with the consensus showed by previous studies that depressed HRV is a useful tool for risk assessment in patients suffering from CHF. PMID:24592473

  2. Prevalence of isolated atrial amyloidosis in young patients affected by congestive heart failure.

    Science.gov (United States)

    Millucci, Lia; Ghezzi, Lorenzo; Bernardini, Giulia; Braconi, Daniela; Tanganelli, Piero; Santucci, Annalisa

    2012-01-01

    Atrial natriuretic peptide (ANP), whose amyloid is responsible of isolated atrial amyloidosis (IAA), is known to play an important role in the pathophysiology of congestive heart failure (CHF). We provide here the microscopic examination of atrial biopsies from 36 young (mean 40 years) CHF patients distinguished in idiopathic dilated cardiomyopathy (DC) affected and hypertrophic Cardiomyopathy (HC) affected, endorsing the presumptive association of early CHF with IAA. We utilized a multiple method, using Congo red (CR) staining, CR fluorescence (CRF), and immunohistochemistry to assess the presence of IAA in CHF. Immunostaining showed a moderate deposition of IAA in the atrium surrounding working myocardium with small intracellular deposits. Our findings suggest a monitoring of young CHF cases for the development of IAA. Our study also demonstrated how the concurrent use of immunohistochemistry, CR, and CRF may greatly enhance the detection of low-grade amyloid deposits. PMID:22536133

  3. A NEW APPROACH TO DETECT CONGESTIVE HEART FAILURE USING DETRENDED FLUCTUATION ANALYSIS OF ELECTROCARDIOGRAM SIGNALS

    Directory of Open Access Journals (Sweden)

    CHANDRAKAR KAMATH

    2015-02-01

    Full Text Available The aim of this study is to evaluate how far the detrended fluctuation analysis (DFA approach helps to characterize the short-term and intermediate-term fractal correlations in the raw electrocardiogram (ECG signals and thereby discriminate between normal and congestive heart failure (CHF subjects. The DFA-1 calculations were performed on normal and CHF short-term ECG segments, of the order of 20 seconds duration. Differences were found in shortterm and intermediate-term correlation properties and the corresponding scaling exponents of the two groups (normal and CHF. The statistical analyses show that short-term fractal scaling exponent alone is sufficient to distinguish between normal and CHF subjects. The receiver operating characteristic curve (ROC analysis confirms the robustness of this new approach and exhibits an average accuracy that exceeds 98.2%, average sensitivity of about 98.4%, positive predictivity of 98.00%, and average specificity of 98.00%.

  4. Percutaneous Cell Delivery Into the Heart Using Hydrogels Polymerizing In Situ

    OpenAIRE

    Martens, Timothy P.; Godier, Amandine F. G.; Parks, Jonathan J.; Wan, Leo Q.; Koeckert, Michael S; Eng, George M.; Hudson, Barry I.; Sherman, Warren; Vunjak-Novakovic, Gordana

    2009-01-01

    Heart disease is the leading cause of death in the US. Following an acute myocardial infarction, a fibrous, noncontractile scar develops, and results in congestive heart failure in more than 500,000 patients in the US each year. Muscle regeneration and the induction of new vascular growth to treat ischemic disorders of the heart can have significant therapeutic implications. Early studies in patients with chronic ischemic SLVD using skeletal myoblasts or bone marrow-derived cells report impro...

  5. Long-term survival in patients hospitalized with congestive heart failure: relation to preserved and reduced left ventricular systolic function

    DEFF Research Database (Denmark)

    Gustafsson, Finn; Torp-Pedersen, Christian; Brendorp, Bente;

    2003-01-01

    AIMS: The purpose of this study was to evaluate the influence of left ventricular systolic function on the survival in a large consecutive cohort of patients hospitalized with congestive heart failure and to determine how left ventricular systolic function interacts with co-morbid conditions in t...... (1 year mortality, 19%). CONCLUSION: In hospitalized heart failure patients, particularly in younger patients with ischemic heart disease, mortality risk is inversely related to left ventricular systolic function.......AIMS: The purpose of this study was to evaluate the influence of left ventricular systolic function on the survival in a large consecutive cohort of patients hospitalized with congestive heart failure and to determine how left ventricular systolic function interacts with co-morbid conditions in...... terms of prognosis. METHODS AND RESULTS: Analysis of survival data from 5491 patients admitted for new or worsening heart failure to 34 departments of cardiology or internal medicine in Denmark from 1993-1996 was carried out. A standardized echocardiogram was available for 95% of the patients, and left...

  6. Pioglitazone-induced congestive heart failure and pulmonary edema in a patient with preserved ejection fraction

    Directory of Open Access Journals (Sweden)

    Vaneet Jearath

    2016-01-01

    Full Text Available Pioglitazone-induced heart failure is known in patients with underlying heart disease, but is not well documented in patients with normal left ventricular function. Pioglitazone has been very popular as it is an insulin sensitizer and insulin resistance is prevalent among Indians. Fluid retention exacerbates pre-existing heart failure or precipitates heart failure in a patient with underlying left ventricular dysfunction. However, pathogenesis of heart failure in a patient with normal left ventricular function is not known. Probably it is due to dose-related effect on pulmonary endothelial permeability, rather than alterations in left ventricular mass or ejection fraction. We report a patient who developed congestive heart failure and pulmonary edema with normal left ventricular function within 1 year of starting pioglitazone therapy. We have to be careful in monitoring all possible side effects during followup when patients are on pioglitazone therapy.

  7. Prognosis of emergency room stabilization of decompensated congestive heart failure with high dose lasix

    Directory of Open Access Journals (Sweden)

    Mahboob Pouraghaei

    2015-06-01

    Full Text Available Objective: Congestive heart failure (CHF has become one of the most important health care problems in western countries. This article focuses on the outpatient diagnosis and management of heart failure. We want to compare the outcome of patients who were treated with high dose diuretics in the emergency department (ED without admission with patients who were admitted to hospital for standard treatment. Methods: This was a randomized prospective clinical trial study. The patients who came to the ED from March 20, 2008 up to August 20, 2008 were divided into two groups randomly. The length of ED stay in the experimental group was documented. Also, readmission and mortality in 6 months and satisfaction in both groups were taken into consideration. All data were analyzed using SPSS 15.0. Results: In experimental group, the rate of recurrent admission, expiration, discharge, clinic visit, and clinic admission was 8%, 4%, 29%, 18%, and 0% respectively. On the other hand, in control group it was 16%, 40%, 18%, 22%, and 2% respectively. Additionally, there was a significant difference between these groups (P = 0.00. Conclusion: This study is the first regional prospective trial to comprehensively examine the therapeutic management in patients with CHF. This study, comparing the high dose diuretic efficacy in the decreasing of hospital stay and readmission; and decreasing mortality rate with routine therapy, showed that there was a significant difference between these two strategies in the mortality rate, readmission, and length of hospital stay (P = 0.00.

  8. Optimal timing in screening patients with congestive heart failure and healthy subjects during circadian observation.

    Science.gov (United States)

    Jong, Tai-Lang; Chang, Ben; Kuo, Cheng-Deng

    2011-02-01

    Congestive heart failure (CHF) is a major medical challenge in developed countries. In order to screen patients with CHF and healthy subjects during circadian observation, accurate judgment and fast response are imperative. In this study, optimal timing during circadian observation via the heart rate variability (HRV) was sought. We tested 29 CHF patients and 54 healthy subjects in the control group from the interbeat interval databases of PhysioBank. By invoking the α1 parameter in detrended fluctuation analysis of HRV, we found that it could be used as an indicator to screen the patients with CHF and subjects in normal sinus rhythm (NSR) under Kruskal-Wallis test. By invoking Fano factor, the optimal timing to screen CHF patients and healthy subjects was found to be from 7 PM to 9 PM during the circadian observation. In addition, this result is robust in a sense that the same result can be achieved by using different ECG recording lengths of 2, 5, 10, … , and 120 min, respectively. Furthermore, a support vector machine was employed to classify CHF and NSR with α1 parameter of a moving half-hour ECG recordings via leave-one-out cross validation. The results showed that the superlative screening performance was obtained in the 7 pm-9 pm period during circadian observation. It is believed that this result of optimal timing will be helpful in the non-invasive monitoring and screening of CHF patients and healthy subjects in the clinical practice. PMID:20953708

  9. Clinical significance of I-123 MIBG myocardial scintigraphy for evaluating the severity of congestive heart failure

    International Nuclear Information System (INIS)

    We studied the significance of I-123 MIBG (metaiodobenzylguanidine) myocardial scintigraphy for evaluating the severity of congestive heart failure (CHF). I-123 MIBG scintigraphy was performed in 7 patients with CHF of NYHA class I-III (6 with dilated cardiomyopathy and 1 with adriamycine cardiomyopathy) and in 2 normals. The SPECT and anterior planar myocardial images were obtained 15 minutes after (initial images) and 4 hours after (delayed images) an injection of I-123 MIBG (111 MBq). Compared with normals, patients with CHF demonstrated (1) low myocardial uptake and (2) rapid myocardial washout of I-123 MIBG, indicating myocardial sympathetic disarrangement. Then, quantitating these abnormalities with the heart to upper mediastinum uptake ratio (H/B) and the percent washout rate (%WR) during 4 hours, respectively, we compared these two indices with LV ejection fraction (EF) at rest measured by echocardiography and exercise capacity (max VO2 and VO2 at anaerobic threshold (AT)) determined with respiratory gas exchange analysis during maximal bicycle exercise. H/B was lower and %WR was greater in patients with CHF than in normals. H/B correlated with EF (r=0.77, p2 (r=-0.74, p<0.05) and AT (r=-0.81, p<0.05). Thus, H/B and %WR were closely related to the severity of CHF. These results suggest that I-123 MIBG myocardial scintigraphy and the quantitative analysis of I-123 MIBG myocardial uptake provide useful information about the severity of CHF. (author)

  10. 31P-NMR analysis of congestive heart failure in the SHHF/Mcc-facp rat heart.

    Science.gov (United States)

    Michael O'Donnell, J; Narayan, P; Bailey, M Q; Abduljalil, A M; Altschuld, R A; McCune, S A; Robitaille, P M

    1998-02-01

    31P-NMR was used to monitor myocardial bioenergetics in compensated and failing SHHF/MCC-fa(cp) (SHF) rat hearts. The SHHF/Mcc-fa(cp) (spontaneous hypertension and heart failure) rat is a relatively new genetic model in which all individuals spontaneously develop congestive heart failure, most during the second year of life. Failing SHF rat hearts displayed a pronounced decrease in resting PCr:ATP ratios (Ppressure products (RRP, mmHg X beats/min) from 44.5+/-1.4 to 66.6+/-3. 4 K with dobutamine infusion, whereas hearts in end-stage failure were able to increase their RPP from baseline values of 27+/-4 K to only 37+/-7 K. The data indicate that a pronounced decline in PCr and total creatine signals the transition from compensatory hypertrophy to decompensation and failure in the SHF rat model of hypertensive cardiomyopathy. PMID:9515000

  11. A multi-layer monitoring system for clinical management of Congestive Heart Failure

    OpenAIRE

    Guidi, Gabriele; Pollonini, Luca; Dacso, Clifford C; Iadanza, Ernesto

    2015-01-01

    Background Congestive Heart Failure (CHF) is a serious cardiac condition that brings high risks of urgent hospitalization and death. Remote monitoring systems are well-suited to managing patients suffering from CHF, and can reduce deaths and re-hospitalizations, as shown by the literature, including multiple systematic reviews. Methods The monitoring system proposed in this paper aims at helping CHF stakeholders make appropriate decisions in managing the disease and preventing cardiac events,...

  12. A case report of primary cardiac myxofibrosarcoma presenting with severe congestive heart failure

    OpenAIRE

    Ujihira, Kosuke; Yamada, Akira; Nishioka, Naritomo; Iba, Yutaka; Maruyama, Ryushi; Nakanishi, Katsuhiko; Shimizu, Ai; Hatanaka, Kanako C.; Mitsuhashi, Tomoko; Shinohara, Toshiya; Ueda, Hatsue Ishibashi

    2016-01-01

    Background Primary cardiac sarcomas are extremely rare. Furthermore, the myxofibrosarcomas are one of the rarest forms of cardiac sarcomas, and its prognosis is known to be quite poor. Case presentation This is a case of a 23-year-old man who presented with acute severe congestive heart failure caused by almost complete obstruction of the mitral valve due to a large left atrial tumor. The patient required endotracheal intubation before his arrival to the hospital, and underwent an emergent su...

  13. Disparities in Patterns of Health Care Travel Among Inpatients Diagnosed With Congestive Heart Failure, Florida, 2011

    OpenAIRE

    Jia, Peng; Xierali, Imam M.

    2015-01-01

    Introduction Congestive heart failure (CHF) is a major public health problem in the United States and is a leading cause of hospitalization in the elderly population. Understanding the health care travel patterns of CHF patients and their underlying cause is important to balance the supply and demand for local hospital resources. This article explores the nonclinical factors that prompt CHF patients to seek distant instead of local hospitalization. Methods Local hospitalization was defined as...

  14. Impact of Telehealth on Healthcare Utilization by Congestive Heart Failure Patients

    OpenAIRE

    Craig A. Lehmann; Nancy Mintz; Jean Marie Giacini

    2006-01-01

    Background: Advances in telehealth are proving to be extremely conducive to effective management of congestive heart failure (CHF) and other disease states, particularly in ambulatory settings. In order to assess the impact of telehealth on healthcare utilization in CHF patients, telehealth technology was introduced into a demonstration project established by the Secretary of Health and Human Services. Demonstration projects examine health delivery factors that encourage the delivery of impro...

  15. Pulmonary Congestion at Rest and Abnormal Ventilation During Exercise in Chronic Systolic Heart Failure

    OpenAIRE

    G. Malfatto; Caravita, S; Giglio, A.; Rossi, J.; Perego, G.; Facchini, M.; Parati, G.

    2015-01-01

    Background In patients with chronic heart failure, abnormal ventilation at cardiopulmonary testing (expressed by minute ventilation-to-carbon dioxide production, or VE/VCO2 slope, and resting end-tidal CO2 pressure) may derive either from abnormal autonomic or chemoreflex regulation or from lung dysfunction induced by pulmonary congestion. The latter hypothesis is supported by measurement of pulmonary capillary wedge pressure, which cannot be obtained routinely but may be estimated noninvasiv...

  16. Enhanced acetylcholine and P2Y-receptor stimulated vascular EDHF-dilatation in congestive heart failure

    DEFF Research Database (Denmark)

    Malmsjö, M; Bergdahl, A; Zhao, Xin; Sun, X Y; Hedner, T; Edvinsson, L; Erlinge, D

    1999-01-01

    OBJECTIVE: Congestive heart failure (CHF) is accompanied by impaired peripheral blood flow and endothelial dysfunction with decreased release of nitric oxide (NO). Strong evidence supports the existence of another vasodilatory substance, endothelium derived hyperpolarising factor (EDHF), which has...

  17. Thoracic endovascular aortic repair for patent ductus arteriosus in an elderly patient with congestive heart failure.

    Science.gov (United States)

    Kato, Gentaro; Nakai, Mikizo; Tokunaga, Noriyuki; Shimizu, Shuji; Okada, Masahiro

    2016-05-01

    In elderly patients, open surgery for patent ductus arteriosus (PDA) is more difficult than that in children and often requires a cardiopulmonary bypass. We report the case of a 67-year-old patient with a PDA that was successfully treated with thoracic endovascular aortic repair (TEVAR). The patient was diagnosed with congestive heart failure (ejection fraction, 36 %) and PDA (9.7 mm in diameter). TEVAR was successfully performed to exclude the PDA. After TEVAR, the patient's heart failure was well controlled by diuretics. TEVAR may be a good alternative to open surgery. PMID:25056455

  18. Heterobilharzia americana infection and congestive heart failure in a llama (Lama glama).

    Science.gov (United States)

    Corapi, W V; Eden, K B; Edwards, J F; Snowden, K F

    2015-05-01

    The schistosome Heterobilharzia americana infects several mammalian species in the southeastern United States, including horses, but infections have not been reported in camelids. This is a report of H. americana infection in a 6-year-old llama with extensive cardiac pathology and congestive heart failure. Parasite-induced granulomas were widely disseminated and included overwhelming involvement of the lungs and liver. Microscopic lesions in the heart included myofiber degeneration and necrosis, with extensive replacement fibrosis. Polymerase chain reaction amplification and sequencing confirmed the presence of H. americana in the lungs. PMID:24964922

  19. Mediastinal lymphadenopathy in congestive heart failure: a sequential CT evaluation with clinical and echocardiographic correlations

    Energy Technology Data Exchange (ETDEWEB)

    Chabbert, Valerie; Canevet, Guillaume; Otal, Philippe; Joffre, Francis [Department of Radiology, University of Toulouse, Avenue Jean-Poulhes, 31403, Toulouse (France); Baixas, Cecile; Galinier, Michel [Department of Cardiology, University of Toulouse, Avenue Jean-Poulhes, 31403, Toulouse (France); Deken, Valerie; Duhamel, Alain [Department of Medical Statistics, University of Lille, Place de Verdun, 59037, Lille Cedex (France); Remy, Jacques; Remy-Jardin, Martine [Department of Radiology, Hospital Calmette, University Center of Lille, Boulevard Jules Leclerc, 59037, Lille Cedex (France)

    2004-05-01

    The aim of this study was to evaluate the frequency and evolution after treatment of mediastinal lymphadenopathy associated with congestive left heart failure on CT scans in correlation with clinical and echocardiographic findings. Thirty-one consecutive patients with subacute left heart failure underwent a clinical evaluation using the NYHA classification, a CT examination, and transthoracic echocardiography at the time of initial presentation (T1). After initiation of medical treatment (T2), follow-up CT scans were systematically obtained together with a clinical evaluation. At T1, all patients showed severe (type III: n=12, 39%; type IV: n=12, 39%) to moderate (type I, n=1, 3%; type II, n=6, 19%) dyspnea with a mean ejection fraction of 39% (range 22-74%). On initial CT scans, enlarged mediastinal lymph nodes were seen in 13 patients (42%) with blurred contours in 5 patients (16%) and hazy mediastinal fat in 1 patient (3%). Significant decrease in the size of lymphadenopathy was observed between T1 and T2 (T1, n=13, 42% vs T2, n=10, 32%; p<0.05) with a concurrent decrease in the severity of dyspnea (grade III-IV dyspnea at T1, n=24, 78% vs grade I-II dyspnea at T2, n=26, 83.5%). Patients with enlarged lymph nodes at T1 showed: (a) a significantly lower ejection fraction at echocardiography than those without lymphadenopathy (mean{+-}SD value: 34{+-}12.9 vs 43{+-}13.8%; p=0.04); (b) a significantly larger diameter of the right superior pulmonary vein (mean{+-}SD value: 17{+-}2.75 vs 14{+-}3.9 mm; p=0.04); and (c) a higher frequency of abnormal peribronchovascular thickening (n=5 vs n=1; p=0.06). Mediastinal lymphadenopathy associated with subacute left heart failure was observed in 13 patients (42%), showing regression after initiation of treatment in 8 of 13 patients (62%). (orig.)

  20. Sarcopenia, cachexia and congestive heart failure in the elderly.

    Science.gov (United States)

    Zamboni, Mauro; Rossi, Andrea P; Corzato, Francesca; Bambace, Clara; Mazzali, Gloria; Fantin, Francesco

    2013-03-01

    Skeletal muscle abnormalities and loss are frequently present in patients with mild or moderate cardiac heart failure (CHF) and may contribute to fatigue and dyspnea. These muscle abnormalities may be associated with age related body composition changes, such as sarcopenia. Muscle damage has also been observed in subjects with cardiac cahexia, a serious CHF complication, associated with poor prognosis independently of functional disease severity, age, and measures of exercise capacity and cardiac function. Loss of muscle mass is a feature of cachexia, whereas most sarcopenic subjects are not cachectic. Individuals with no weight loss, no anorexia, and no measurable systemic inflammatory response may be sarcopenic. Patients with severe CHF show multiple marked histological abnormalities of skeletal muscle, such as muscle fiber atrophy. These abnormalities are different in sarcopenia and cachexia. The majority of mechanisms involved in sarcopenia play a role even in the determination of cachexia and they are amplified in cachexia where they may induce both muscle damage as well as other abnormalities, such as fat and weight loss, through activation of lypolisis or anorexia. To distinguish cachexia and sarcopenia in CHF patients, even if not easy, should be clinically relevant, because no specific treatment is available for cachectic patients whereas treatment options are possible for sarcopenia. PMID:23369138

  1. Evaluation of skeletal muscle metabolism in patients with congestive heart failure using phosphorus nuclear magnetic

    International Nuclear Information System (INIS)

    Patients with congestive heart failure are frequently limited by muscular fatigue due skeletal muscle underperfusion and deconditioning. Muscle underperfusion and deconditioning both produce distinctive changes in metabolic parameters which are readily measured by phosphorus nuclear magnetic resonance (NMR). Therefore, phosphorus NMR should provide a useful noninvasive method of assessing muscle performance in heart failure. This chapter describes a protocol which allows detection of forearm muscle metabolic abnormalities in patients with heart failure, abnormalities that seem to be caused by muscle deconditioning. In the future, it is anticipated that this approach may prove to be an extremely useful method for objectively assessing muscle fatigue in patients with heart failure and for monitoring the effects on therapeutic interventions designed to treat this fatigue

  2. Comparative Study on New AQM Mechanisms for Congestion Control

    Directory of Open Access Journals (Sweden)

    Ramakrishna B B

    2013-09-01

    Full Text Available As usage of network goes increasing day by day, managing network traffic becomes a very difficult task. It is important to avoid high packet loss rates in the Internet. Congestion is the one of the major issue in the present networks. Congestion Control is one of the solutions adopted to solve the congestion issue and to control it. Numbers of queue management algorithms are proposed for congestion control and to reduce high packet loss rates. Active Queue Management (AQM is one such mechanism which provides better control over congestion. In this paper a study is made on recent load based AQM techniques that are proposed and its merits and shortfall is presented.

  3. Effects of spironolactone on electrical and structural remodeling of atrium in congestive heart failure dogs

    Institute of Scientific and Technical Information of China (English)

    YANG Shu-sen; XIU Chun-hong; LI Wei-min; HAN Wei; ZHOU Hong-yan; DONG Guo; WANG Bai-chun; HUO Hong; WEI Na; CAO Yong; ZHOU Guo

    2008-01-01

    Background Renin-angiotensin-aldosterone System has been demonstrated to be associated with both congestive heart failure (CHF) and atrial fibrillation (AF). This study investigated the effects of spironolactone, a kind of aldosterone antagonist, on atrial electrical remodeling and fibrosis in CHF dogs induced by chronic rapid ventricular pacing. Methods Twenty one dogs were randomly divided into sham-operated group, control group, and spironolactone group. In control group and spironolactone group, dogs were ventricular paced at 220 beats per minute for 6 weeks. Additionally, spironolactone at 15 mg·kg-1·d-1 was given to dogs 1 week before rapid ventricular pacing until pacing stopped. Transthoracic and transoesophageal echocardiographic examinations were performed to detect structural and functional changes of the atrium. Swan2 Ganz floating catheters were used to measure hemadynamics variances. Atrial effective refractory period (AERP), AERP dispersion (AERPd), intra- and inter-atrium conduction time (CT) and intra-atrium conduction velocity (CV) were determined. The inducibility and duration of AF were also measured in all groups. Finally, atrial fibrosis was quantified with Massen staining.Results AERP did not change significantly after dogs were ventricular paced for 6 weeks. However, AERPd, intra- and inter-atrium CT increased significantly, and CV decreased apparently, which was negatively correlated to the atrial fibrosis (r=-0.74, P<0.05). Simultaneously, left atriums were enlarged and cardiac hemadynamics worsened in pacing dogs. Although spironolactone could not affect cardiac hemadynamics effectively, it can obviously improve left atrial ejection fraction (P<0.05). Spironolactone treatment did not alter AERP duration, but this medicine dramatically decreased AERPd (P<0.05), shortened intra- and inter-atrium conduction time (P<0.05), and increased atrium CV. Moreover, spironolactone decreased the inducibility and duration of AF (P<0.05),as

  4. Wavelet Based Method for Congestive Heart Failure Recognition by Three Confirmation Functions

    Directory of Open Access Journals (Sweden)

    K. Daqrouq

    2016-01-01

    Full Text Available An investigation of the electrocardiogram (ECG signals and arrhythmia characterization by wavelet energy is proposed. This study employs a wavelet based feature extraction method for congestive heart failure (CHF obtained from the percentage energy (PE of terminal wavelet packet transform (WPT subsignals. In addition, the average framing percentage energy (AFE technique is proposed, termed WAFE. A new classification method is introduced by three confirmation functions. The confirmation methods are based on three concepts: percentage root mean square difference error (PRD, logarithmic difference signal ratio (LDSR, and correlation coefficient (CC. The proposed method showed to be a potential effective discriminator in recognizing such clinical syndrome. ECG signals taken from MIT-BIH arrhythmia dataset and other databases are utilized to analyze different arrhythmias and normal ECGs. Several known methods were studied for comparison. The best recognition rate selection obtained was for WAFE. The recognition performance was accomplished as 92.60% accurate. The Receiver Operating Characteristic curve as a common tool for evaluating the diagnostic accuracy was illustrated, which indicated that the tests are reliable. The performance of the presented system was investigated in additive white Gaussian noise (AWGN environment, where the recognition rate was 81.48% for 5 dB.

  5. Wavelet Based Method for Congestive Heart Failure Recognition by Three Confirmation Functions.

    Science.gov (United States)

    Daqrouq, K; Dobaie, A

    2016-01-01

    An investigation of the electrocardiogram (ECG) signals and arrhythmia characterization by wavelet energy is proposed. This study employs a wavelet based feature extraction method for congestive heart failure (CHF) obtained from the percentage energy (PE) of terminal wavelet packet transform (WPT) subsignals. In addition, the average framing percentage energy (AFE) technique is proposed, termed WAFE. A new classification method is introduced by three confirmation functions. The confirmation methods are based on three concepts: percentage root mean square difference error (PRD), logarithmic difference signal ratio (LDSR), and correlation coefficient (CC). The proposed method showed to be a potential effective discriminator in recognizing such clinical syndrome. ECG signals taken from MIT-BIH arrhythmia dataset and other databases are utilized to analyze different arrhythmias and normal ECGs. Several known methods were studied for comparison. The best recognition rate selection obtained was for WAFE. The recognition performance was accomplished as 92.60% accurate. The Receiver Operating Characteristic curve as a common tool for evaluating the diagnostic accuracy was illustrated, which indicated that the tests are reliable. The performance of the presented system was investigated in additive white Gaussian noise (AWGN) environment, where the recognition rate was 81.48% for 5 dB. PMID:26949412

  6. A randomized clinical trial of hospital-based, comprehensive cardiac rehabilitation versus usual care for patients with congestive heart failure, ischemic heart disease, or high risk of ischemic heart disease (the DANREHAB trial) - design, intervention, and population

    DEFF Research Database (Denmark)

    Zwisler, A.D.O.; Schou, O.; Soja, A.M.B.;

    2005-01-01

    randomized clinical trial to clarify whether hospital-based comprehensive CR is superior to usual care for patients with congestive heart failure, ischemic heart disease, or high risk for ischemic heart disease. A combined primary outcome measure included total mortality, myocardial infarction, or...... management, and clinical assessment. Study Population Of 5060 discharged patients, 1614 (32%) were eligible for the trial and 770 patients were randomized (47% of those eligible). Participants were younger (P < .001) and had less comorbidity than nonparticipants (P < .03). Conclusion Our trial shows that a...

  7. A randomized clinical trial of hospital-based, comprehensive cardiac rehabilitation versus usual care for patients with congestive heart failure, ischemic heart disease, or high risk of ischemic heart disease (the DANREHAB trial)--design, intervention, and population

    DEFF Research Database (Denmark)

    Zwisler, Ann-Dorthe Olsen; Soja, Anne Merete Boas; Brønnum-Hansen, Henrik;

    2005-01-01

    randomized clinical trial to clarify whether hospital-based comprehensive CR is superior to usual care for patients with congestive heart failure, ischemic heart disease, or high risk for ischemic heart disease. A combined primary outcome measure included total mortality, myocardial infarction, or...... management, and clinical assessment. STUDY POPULATION: Of 5060 discharged patients, 1614 (32%) were eligible for the trial and 770 patients were randomized (47% of those eligible). Participants were younger (P < .001) and had less comorbidity than nonparticipants (P < .03). CONCLUSION: Our trial shows that a...

  8. Norepinephrine, β-adrenoceptor and 123I-MIBG myocardial scintigram in patients with congestive heart failure

    International Nuclear Information System (INIS)

    Authors studied the relationships of norepinephrine (NE), β-adrenoceptor and 123I-MIBG (meta-iodo-benzylguanidine) uptake in 26 patients with dilated cardiomyopathy or valvulitis. Blood NE concentrations were determined by high performance liquid chromatography in those patients and 10 healthy volunteers, and myocardial NE, in 7 patients and 5 cases without the congestive heart failure. The amounts of beta-receptors in lymphocytes of 21 patients and 7 volunteers and in myocardium obtained at autopsy of 3 patients and 3 other cases were estimated by the radioligand binding assay. Planar and SPECT images were taken at 15 min and 3 hr post intravenous administration of 111 MBq of 123I-MIBG. In the planar and SPECT images, the ratio heart/mediastinum (H/M) and MIBG uptake were computed respectively. Blood flow was evaluated by 201Tl scintigraphy. In patients with congestive heart failure, blood NE concentration was elevated and the number of lymphocytic and myocardial receptors was decreased. The H/M ratio was low. Low MIBG uptake was seen at the posterior to lateral wall. (K.H.)

  9. Associations between ambient air pollution and daily mortality among persons with congestive heart failure

    International Nuclear Information System (INIS)

    We conducted a mortality time series study to investigate the association between daily mortality for congestive heart failure (CHF), and dail concentrations of particles and gaseous pollutants in the ambient air o Montreal, Quebec, during the period 1984-1993. In addition, using data fro the universal Quebec Health Insurance Plan, we identified individuals ≥6 years of age who, one year before death, had a diagnosis of CHF. Fixed-sit air pollution monitors in Montreal provided daily mean levels of pollutants We regressed the logarithm of daily counts of mortality on the daily mean levels of each pollutant, after accounting for seasonal and subseasonal fluctuations in the mortality time series, non-Poisson dispersion, weather variables, and other gaseous and particle pollutants. Using cause of deat information, we did not find any associations between daily mortality for CH and any air pollutants. The analyses of CHF defined from the medical record showed positive associations with coefficient of haze, the extinction coefficient, SO2, and NO2. For example, the mean percent increase in dail mortality for an increase in the coefficient of haze across the interquartile range was 4.32% (95% CI: 0.95-7.80%) and for NO2 it was 4.08% (95% CI 0.59-7.68%). These effects were generally higher in the warm season

  10. Effects of kaliuretic peptide on sodium and water excretion in persons with congestive heart failure.

    Science.gov (United States)

    Nasser, A; Dietz, J R; Siddique, M; Patel, H; Khan, N; Antwi, E K; San Miguel, G I; McCormick, M T; Schocken, D D; Vesely, D L

    2001-07-01

    Kaliuretic peptide, a 20-amino acid peptide hormone synthesized in the heart, enhances urine flow twofold, whereas atrial natriuretic peptide (ANP) enhances urine flow four- to 11-fold in healthy persons. The present investigation was designed to (1) determine whether kaliuretic peptide may have beneficial diuretic effects in persons with congestive heart failure (CHF), and (2) compare its beneficial effects with ANP in the treatment of CHF. Kaliuretic peptide (100 ng/kg body weight/min) given intravenously for 60 minutes to subjects with New York Heart Association class III CHF increased urine flow fourfold (p hypotensive. None became hypotensive secondary to kaliuretic peptide. These data indicate that the diuretic properties of kaliuretic peptide in persons with CHF, as opposed to those of ANP, are not diminished (but rather are increased) compared with their effects in healthy persons. In patients with CHF, kaliuretic peptide causes a natriuresis-a feature not observed in those without sodium retention. PMID:11423053

  11. A study on factors affecting the relationship between congestion impacts and congestion performance measures in area-road networks

    OpenAIRE

    Moran, Carlos

    2012-01-01

    Congestion performance measures (CPMs) are a key part of decision making. There are several aspects they have to fulfill in order to be useful tools for performance based planning. The relevance aspect corresponds to the capacity of a CPM to capture the impacts of congestion. Previous studies have identified factors that can impact the relevance of the indicators. Additionally, current congestion performance measures use the output of long term planning models. This made the indicators insens...

  12. Diagnosis and treatment of congestive heart failure secondary to dilated cardiomyopathy in a hedgehog.

    Science.gov (United States)

    Delk, K W; Eshar, D; Garcia, E; Harkin, K

    2014-03-01

    A one-year-old African pygmy hedgehog (Atelerix albiventris) was evaluated for severe respiratory distress. Physical examination findings included marked dyspnoea, cyanosis and tachypnoea. Radiographic findings included an enlarged heart and pulmonary oedema, and dilated cardiomyopathy was confirmed via echocardiogram. The patient was treated for congestive heart failure because of dilated cardiomyopathy with furosemide, enalapril, pimobendan and l-carnitine. Within 24 hours of treatment, the pulmonary oedema and cyanosis had resolved. Following discharge, clinical improvement was noted by the owner and echocardiogram confirmed improved fractional shortening. Cardiomyopathy has been reported at post-mortem examination in hedgehogs, but there are no reports of ante-mortem diagnosis and treatment. Performing baseline cardiac assessment in hedgehogs is recommended, and treatment with l-carnitine and pimobendan may improve outcome, as carnitine deficiency is a possible cause of cardiomyopathy in hedgehogs. Successful emergency treatment of congestive heart failure in the hedgehog of this report may be effective for other hedgehogs presented with similar clinical signs. PMID:24372164

  13. 血浆catestatin、VEGF、MMP及TIMP水平与充血性心力衰竭的关系%Study on the Correction between the Plasma Catestatin,VEGF,MMP,TIMP and Congestive Heart Failure

    Institute of Scientific and Technical Information of China (English)

    许涛; 赵楚敏; 宋月霞; 李莉; 徐爱茹

    2014-01-01

    Objective To investigate and analyze the correction between the plasma catestatin,VEGF, MMP,TIMP and congestive heart failure. Methods 48 patients with congestive heart failure in our hospital from September 2011 to August 2013 were selected as observation group,48 healthy persons with the same age were the control group,then the plasma catestatin,VEGF,MMP and TIMP of two groups were detected and compared,then the detection levels of observation group with different cardiac functional grading were compared too,and the correction between the detection indexes and disease was analyzed by Logistic analy-sis. Results The plasma catestatin,VEGF,MMP-2,MMP-9 and TIMP-1 of observation group were all higher than those of control group,and the detection levels of patients with higher cardiac functional grading were all higher than those of patients with lower cardiac functional grading(P<0. 05). Logistic analysis showed that the 5 indicators were predictive factors for congestive heart failure(P<0. 05). Conclusion The plasma cat-estatin,VEGF,MMP and TIMP of patients with congestive heart failure all show increasing trend,and the car-diac functional grading higher,the detection levels higher.%目的:探讨分析血浆儿茶酚抑素( catestatin)、血管内皮生长因子( VEGF)、基质金属蛋白酶(MMP)及基质金属蛋白酶组织抑制剂(TIMP)水平与充血性心力衰竭的关系。方法选取2011年9月至2013年8月唐山市人民医院收治的48例充血性心力衰竭患者为观察组,并选取同龄的48例健康人员作为对照组,检测并比较两组及观察组中不同心功能分级的血浆catestatin、VEGF、MMP、TIMP水平,采用Logistic分析检测指标与疾病的关系。结果观察组血浆catestatin、VEGF、MMP-2、MMP-9及TIMP-1均高于对照组,且观察组心功能分级较高者的检测水平高于心功能较低者( P<0.05);Logistic回归分析显示:血浆catestatin、VEGF、MMP-2、MMP-9及TIMP-1均是充血性心

  14. 123I-meta-iodo-benzyl-guanidine myocardial scintigraphy and congestive heart failure: current data and perspective

    International Nuclear Information System (INIS)

    Congestive heart failure is often associated with an impairment of the sympathetic nervous system, i.e., global hyperactivity and regional impairment of the adrenergic system. Cardiac 123I-MIBG scintigraphy is a radionuclide technique which can explore the presynaptic adrenergic function. Myocardial MIBG fixation is decreased in congestive heart failure, reflecting a reduction of norepinephrine uptake by the myocardial presynaptic nerve endings. The impairment of presynaptic function occurs early in the disease and is actually involved in the pathogenesis of cardiac failure. Cardiac MIBG scintigraphy is a useful tool to explore the myocardial adrenergic stores in patients with congestive heart failure. It could be proposed in patients with severe ventricular dysfunction in order to assist physicians in setting-up the timing of heart transplantation. (authors)

  15. A Rare Cause of Crazy-Paving and Mediastinal Lymphadenopathy: Congestive Heart Failure

    Directory of Open Access Journals (Sweden)

    Aysegul Senturk

    2013-01-01

    Full Text Available Crazy-paving sign is a pattern seen on multislice computed tomography images of the lungs. It is characterized by a reticular pattern superimposed on ground-glass opacity. It was first described in the late 1980s in patients with pulmonary alveolar proteinosis, but has now been described in some other diseases of the lung. Enlarged mediastinal lymph nodes can be seen in infectious and specific inflammatory diseases and malignancies. The present report describes a case of a 44-year-old man in whom congestive heart failure presented with a crazy-paving appearance and enlarged lymph nodes of the lungs on the chest computed tomography scan.

  16. Cost Effectiveness of Intensive Lipid-Lowering Treatment for Patients with Congestive Heart Failure and Coronary Heart Disease in the US

    OpenAIRE

    Virginia M. Rosen; Douglas C.A. Taylor; Hemangi Parekh; Ankur Pandya; David Thompson; Andreas Kuznik; Waters, David D.; Michael Drummond; Weinstein, Milton C.

    2010-01-01

    Background: A recent study found fewer hospitalizations for congestive heart failure (CHF) patients receiving high-dose versus low-dose statin therapy. Objective: To examine the cost effectiveness of high-dose versus low-dose statin therapy in CHF patients. Methods: Two scenarios (literature-based [base-case scenario] vs trial-based post-event mortality [alternative scenario]) assessed the cost effectiveness of atorvastatin 80 mg/day (A80) versus atorvastatin 10 mg/day (A1...

  17. Designing a technology enhanced practice for home nursing care of patients with congestive heart failure.

    Science.gov (United States)

    Casper, Gail R; Karsh, Ben-Tzion; Or, Calvin K L; Carayon, Pascale; Grenier, Anne-Sophie; Brennan, Patricia F

    2005-01-01

    This paper describes the process we used to design the HeartCare website to support Technology Enhanced Practice (TEP) for home care nurses engaged in providing care for patients with Congestive Heart Failure (CHF). Composed of communication, information, and self-monitoring functions, the HeartCare website is aimed at supporting best practice nursing care for these patients. Its unique focus is professional practice, thus the scope of this project is greater and more abstract than those focusing on a task or set of activities. A modified macroergonomic analysis, design work system analysis, and focus groups utilizing participatory design methodology were undertaken to characterize the nursing practice model. Design of the HeartCare website required synthesizing the extant practice model and the agency's evidence-based heart failure protocols, identifying aspects of practice that could be enhanced by supporting technology, and delineation of functional requirements of the Enhanced HeartCare technology. Validation and refinement of the website and planning for user training activities will be accomplished through a two-stage usability testing strategy. PMID:16779013

  18. Relationship between N-terminal probrain natriuretic peptide level and cardiac function in patients with congestive heart failure

    International Nuclear Information System (INIS)

    To study the relationship between N-temrina probarin natriuretic peptide (NT-proBNP) level and cardiac functions in patients with congestive heart failure (CHF), the plasma level of NT-proBNP in 108 patients with CHF and 30 healthy controls were measured by electrochemiluminescence immunoassay (ECLIA) and left ventricular ejection fraction (LVEF) was measured by echocardiography. The results showed that the NT-proBNP level in patients with CHF was significantly higher compared with healthy controls (P<0.01). The NT-proBNP levels increased gradually with NYHA heart function classes increased by degrees (P<0.01). There was negatively correlation between NT-proBNP level and LVEF (r=-0.633, P<0.01). There was a good correlation between the plasma NT-proBNP level and cardiac function. The plasma NT-proBNP level could be as a biochemical marker of cardiac function in CHF patients. (authors)

  19. Compromised Global and Regional Cerebral Blood Flow in Congestive Heart Failure

    Energy Technology Data Exchange (ETDEWEB)

    Kim, J. S.; Kim, J. J.; Im, K. C.; Moon, D. H. [College of Medicine, Univ. of Ulsan, Seoul (Korea, Republic of)

    2003-07-01

    It has been known that cerebral perfusion is maintained in patients with congestive heart failure (CHF) by a complex series of compensatory mechanisms. However cognitive impairment is a common problem experienced by patients with CHF and may result from deranged cerebral perfusion. We prospectively investigated the global and regional CBF of patients with CHF and compared the results with that of normal controls. Thirty two patients (M/F: 22/10, 4211 yr) with CHF (LVEF=218.1%) and 10 healthy controls (M/F: 6/4, 398 yr) were prospectively studied. No patients had cerebrovascular disease or other disease affecting cognitive function. All patients and normal controls underwent radionuclide angiography including cerebral hemispheres and aortic arch, and brain perfusion SPECT using Tc-99m ECD. Global CBF was measured non-invasively by the application of Patlak plot graphical analysis. Quantitative rCBF images were obtained from SPECT image using global CBF values, regional/global count ratios, and Lassen's linearization correction algorithm. Difference of regional CBF between CHF and normal control were assessed using a SPM99 without global count normalization (uncorrected p<0.0001, extent threshold>100 voxels). Global CBF (41.54.7 ml/min/100g) of the patients with CHF were significantly lower than those (49.15.7 ml/min/100g) of controls (p<0.001). Regional CBF was significantly decreased in frontal, temporal and parietal neocortex of both cerebral hemispheres compared to normal controls. Regional rCBF of basal ganglia, thalamus, and brain stem were preserved, even though global CBF was variably compromised. Our study show that global CBF is significantly decreased in CHF and regional CBF of frontal, parietal and temporal neocortex is compromised preferentially. Further studies would be needed to investigate the relationship of rCBF change and cognitive impairment in patients with CHF.

  20. Compromised Global and Regional Cerebral Blood Flow in Congestive Heart Failure

    International Nuclear Information System (INIS)

    It has been known that cerebral perfusion is maintained in patients with congestive heart failure (CHF) by a complex series of compensatory mechanisms. However cognitive impairment is a common problem experienced by patients with CHF and may result from deranged cerebral perfusion. We prospectively investigated the global and regional CBF of patients with CHF and compared the results with that of normal controls. Thirty two patients (M/F: 22/10, 4211 yr) with CHF (LVEF=218.1%) and 10 healthy controls (M/F: 6/4, 398 yr) were prospectively studied. No patients had cerebrovascular disease or other disease affecting cognitive function. All patients and normal controls underwent radionuclide angiography including cerebral hemispheres and aortic arch, and brain perfusion SPECT using Tc-99m ECD. Global CBF was measured non-invasively by the application of Patlak plot graphical analysis. Quantitative rCBF images were obtained from SPECT image using global CBF values, regional/global count ratios, and Lassen's linearization correction algorithm. Difference of regional CBF between CHF and normal control were assessed using a SPM99 without global count normalization (uncorrected p100 voxels). Global CBF (41.54.7 ml/min/100g) of the patients with CHF were significantly lower than those (49.15.7 ml/min/100g) of controls (p<0.001). Regional CBF was significantly decreased in frontal, temporal and parietal neocortex of both cerebral hemispheres compared to normal controls. Regional rCBF of basal ganglia, thalamus, and brain stem were preserved, even though global CBF was variably compromised. Our study show that global CBF is significantly decreased in CHF and regional CBF of frontal, parietal and temporal neocortex is compromised preferentially. Further studies would be needed to investigate the relationship of rCBF change and cognitive impairment in patients with CHF

  1. Safety and predictors of adherence of a new rehabilitation program for older women with congestive heart failure

    OpenAIRE

    Azad, Nahid A.; Bouchard, Kathy; Mayhew, Alain; Carter, Maureen; Molnar, Frank J.

    2012-01-01

    Objectives To assess the safety of a cardiac rehabilitation program for older women with Congestive Heart Failure (CHF) and determine if certain factors influence adherence. Methods Women over the age of 65 with CHF attended an exercise program supervised by a physiotherapist. Quality of life was measured by the Minnesota Living with Heart Failure Questionnaire (MLHFQ) and severity of disease by the New York Heart Association (NYHA) Class. Subjects were classified into those who attended 90% ...

  2. Body composition changes in congestive heart failure before and after treatment

    International Nuclear Information System (INIS)

    The body composition of 50 elderly and 20 middle-aged people presenting the symptoms and signs of congestive heart failure was determined by multiple-isotope method (3H2O; 22Na; 35S; 131I-HSA). In both sexes independently of age the extracellular fluids (extracellular volume ECV; interstitial volume ISV) except plasma volume (PV) were enhanced comparing to controls. The total body water (TBW) did not change, but the intracellular water diminished. The majority of these patients received a combined treatment of diuretics and digitalis, but only a few of them received only digitalis. In the first group, the authors observed a significant diminution of PV, TBW and a less marked diminution of ECV and ISV. Interestingly the ICV diminished further. In the group treated by digitalis alone, the PB did not change, while the TVW, ECV, and ISV enhanced further and the ICV normalized. After 2 weeks of digitalis treatment the ECV and ISV normalized also, while TBW showing a tendency to decrease without normalization. A good correlation was found between the body composition changes and hormonal changes mainly in the case of aldosterone and plasma renin activity. These investigations show that: congestive heart failure cases a redistribution of fluids in favor of extracellular fluids; the combined treatment of diuretics and digitalis is very effective, but if applied too quickly could cause further imbalance in the body composition, and the digitalis treatment alone approach to normal body composition is the best candidates for this type of treatment

  3. Efficacy of adaptive servoventilation in patients with congestive heart failure and Cheyne-Stokes respiration

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Background Congestive heart failure (CHF) is associated with Cheyne-Stokes respiration (CSR), which may hasten CHF. Adaptive servoventilation (ASV) is a novel method of ventilatory support designed for removal of CSF in CHF patients. This study compares the efficacy of ASV in patients with CHF and CSR with the efficacy of oxygen therapy. Methods Fourteen patients with CHF and CSR were recruited. During sleep, nasal oxygen therapy and ASV treatment were each performed for two weeks. Comparison before and after each treatment was made for the following items: a) parameters of sleep respiration, sleep structure and quality; b) left ventricle ejection fraction (LVEF) and 6-minute walk distance. Results Compared with the baseline levels of apnoea hypopnoea index of 34.5±6.1 before treatment, the apnoea hypopnoea index significantly decreased following oxygen therapy to 27.8±8.2, P 0.05). LVEF was significantly higher on day 14 of ASV treatment (37.2±4.1)% than on day 14 of oxygen therapy (33.2±5.1)% and before treatment (30.2±4.6)% (all P<0.05). Six-minute walk distance was the shortest before treatment (226±28) m, longer on day 14 of oxygen therapy (289±26) m, and the longest on day 14 of ASV treatment (341±27) m (all P < 0.01). Conclusion ASV treatment is of better efficacy and greater clinical significance in improvement of CHF by eliminating CSR than oxygen therapy.

  4. Computerized lung sound analysis following clinical improvement of pulmonary edema due to congestive heart failure exacerbations

    Institute of Scientific and Technical Information of China (English)

    WANG Zhen; XIONG Ying-xia

    2010-01-01

    Background Although acute congestive heart failure (CHF) patients typically present with abnormal auscultatory findings on lung examination, lung sounds are not normally subjected to rigorous analysis. The goals of this study were to use a computerized analytic acoustic tool to evaluate lung sound patterns in CHF patients during acute exacerbation and after clinical improvement and to compare CHF profiles with those of normal individuals.Methods Lung sounds throughout the respiratory cycle was captured using a computerized acoustic-based imaging technique. Thirty-two consecutive CHF patients were imaged at the time of presentation to the emergency department and after clinical improvement. Digital images were created, geographical area of the images and lung sound patterns were quantitatively analyzed.Results The geographical areas of the vibration energy image of acute CHF patients without and with radiographically evident pulmonary edema were (67.9±4.7) and (60.3±3.5) kilo-pixels, respectively (P <0.05). In CHF patients without and with radiographically evident pulmonary edema (REPE), after clinical improvement the geographical area of vibration energy image of lung sound increased to (74.5±4.4) and (73.9±3.9) kilo-pixels (P <0.05), respectively. Vibration energy decreased in CHF patients with REPE following clinical improvement by an average of (85±19)% (P <0.01). Conclusions With clinical improvement of acute CHF exacerbations, there was more homogenous distribution of lung vibration energy, as demonstrated by the increased geographical area of the vibration energy image. Lung sound analysis may be useful to track in acute CHF exacerbations.

  5. Mechanical analysis of congestive heart failure caused by bundle branch block based on an electromechanical canine heart model

    Energy Technology Data Exchange (ETDEWEB)

    Dou Jianhong; Xia Ling; Zhang Yu; Shou Guofa [Department of Biomedical Engineering, Zhejiang University, Hangzhou 310027 (China); Wei Qing; Liu Feng; Crozier, Stuart [School of Information Technology and Electrical Engineering, University of Queensland, St Lucia, Brisbane, Queensland 4072 (Australia)], E-mail: xialing@zju.edu.cn

    2009-01-21

    understanding of the mechanical implications of congestive heart failure (CHF) caused by BBB.

  6. Mechanical analysis of congestive heart failure caused by bundle branch block based on an electromechanical canine heart model

    International Nuclear Information System (INIS)

    understanding of the mechanical implications of congestive heart failure (CHF) caused by BBB.

  7. Prolonged signal-averaged P wave duration as a prognostic marker for morbidity and mortality in patients with congestive heart failure

    DEFF Research Database (Denmark)

    Dixen, Ulrik; Wallevik, Laura; Hansen, Maja;

    2003-01-01

    To evaluate the prognostic roles of prolonged signal-averaged P wave duration (SAPWD), raised levels of natriuretic peptides, and clinical characteristics in patients with stable congestive heart failure (CHF).......To evaluate the prognostic roles of prolonged signal-averaged P wave duration (SAPWD), raised levels of natriuretic peptides, and clinical characteristics in patients with stable congestive heart failure (CHF)....

  8. Research on Analysis Method of Traffic Congestion Mechanism Based on Improved Cell Transmission Model

    OpenAIRE

    Hongzhao Dong; Shuai Ma; Mingfei Guo; Dongxu Liu

    2012-01-01

    To analyze the spreading regularity of the initial traffic congestion, the improved cell transmission model (CTM) is proposed to describe the evolution mechanism of traffic congestion in regional road grid. Ordinary cells and oriented cells are applied to render the crowd roads and their adjacent roads. Therefore the traffic flow could be simulated by these cells. Resorting to the proposed model, the duration of the initial traffic congestion could be predicted and the subsequent secondary co...

  9. Infantile Hepatic Hemangioendothelioma Associated With Congestive Heart Failure: Two Case Reports With Different Outcomes.

    Science.gov (United States)

    Wang, Tao; Wang, Yibin; Liang, Yun; Lu, Guoyan

    2015-12-01

    Infantile hepatic hemangioendothelioma (IHH) is rare which can regress spontaneously. Arteriovenous shunts within hemangiomas, however, may result in pulmonary artery hypertension (PAH) and congestive heart failure (CHF).The authors report 2 young infants suffering from multifocal IHH associated with CHF were both treated with glucocorticoid and transcatheter arterial embolization (TAE), but had different outcomes. The PAH decreased immediately and the symptoms of CHF were alleviated after TAE for both of them. For the Tibetan infant, the development was normal with tumor regression by follow-up. For the Han ethnic neonate, PAH increased again in the seventh day with progressive cardiovascular insufficiency. Ultrasound showed a persisting perfusion caused by collateralization around occluded main feeders. Furthermore, a pulmonary infection occurred and ventilation was performed. As a result, the infant died from multiorgan failure caused by CHF and infection.TAE is a treatment of reducing shunting for hemangiomas. Fistula recanalization in multifocal IHH, however, might be an important risk factor affecting the outcome of TAE. TAE should be further evaluated with special attention to anatomy of feeding and draining vessels, and cardiopulmonary conditions. In addition, the patients were susceptible to secondary pulmonary infection because of lung congestion. As well, the infant from the high altitude area showed better adaptability to hypoxia. PMID:26717373

  10. Digital perfusion images for estimating redistribution of pulmonary perfusion in patients with congestive heart failure

    International Nuclear Information System (INIS)

    For estimating redistribution of pulmonary perfusion in congestive heart failure (CHF), Tc-99m MAA pulmonary perfusion images were computerized to digital perfusion images (DPLs), and 100%-70% discount area was defined as hyperperfusion area (H). Various types of DPI were obtained from patients with various degree of CHF; however, they were simply classified into six types according to patterns of H, that is, from basal triangle to apical circle. DPIs changed according to aggravation and improvement of CHF. Patients without H in the lower zone suffered from refractory CHF, and their 2-year mortality was high (59%; 13 of 22). DPIs were useful for determining therapeutic policy and estimating prognosis of patients with CHF

  11. CONGESTIVE HEART FAILURE IN DOGS IS ASSOCIATED WITH INCREASED PLATELET LEUKOCYTE AGGREGATION MEASURED BY FLOW CYTOMETRY

    DEFF Research Database (Denmark)

    Tarnow, Inge; Andreasen, Susanne SH; Olsen, Lisbeth Høier; Moesgaard, Sophia Gry; Rasmussen, Caroline Elisabeth; Kristensen, Annemarie Thuri; Falk, Bo Torkel

    2010-01-01

    binding),monocyte-platelet (MPAs) and neutrophil-platelet aggregates (NPAs) defined as leukocytes positive for CD61 were measured by whole blood flow cytometry asmarkers of platelet activation. For every dog platelet activation was assessed in unstimulated samples, and in response to exogenously added......CONGESTIVE HEART FAILURE IN DOGS IS ASSOCIATED WITH ENHANCED PLATELET-LEUKOCYTE AGGREGATES - A MARKER FOR PLATELET ACTIVATION. I Tarnow1, LH Olsen2, SHS Andreasen2, SG Moesgaard2, CE Rasmussen2, AT Kristensen1, T Falk2. 1Departments of Small Animal Clinical Sciences and 2Animal and Veterinary Basic...... adenosine diphosphate (ADP), thrombin and a synthetic thromboxane A2 analogue 1 epinephrine. Complete blood count and biochemical screening were performed in all dogs. Dogs with CHF had higher MPAs (p 5 0.014) and NPAs ( p 5 0.021) compared to controls (2-way analysis of variance for repeated measurements)....

  12. INSUFICIENCIA CARDÍACA CONGESTIVA O COR PULMONALE Congestive heart failure or Cor Pulmonale

    Directory of Open Access Journals (Sweden)

    Oscar Ernesto Amarís Peña

    2006-06-01

    Full Text Available La insuficiencia cardíaca es una de las principales causas de muerte cardiovascular y se presenta como consecuencia, en más del 70 por ciento de los casos, de las dos enfermedades cardiovasculares de mayor prevalencia: la hipertensión arterial y la enfermedad coronaria. La disnea y el edema en los miembros inferiores son los dos criterios más usados para el diagnóstico de insuficiencia cardíaca congestiva y estos son, justamente, las principales manifestaciones de los pacientes con Cor Pulmonale. Este documento propone algunos criterios para el diagnóstico diferencial de las dos entidades.Heart failure is one of the most important causes of cardiovascular death, as consequence of arterial hypertension or coronary heart disease. Dyspnea and legs edema are the commonest symptoms of congestive heart failure, but there are important symptoms in Cor Pulmonale, too. This paper propose some distinctive clues to differential diagnosis.

  13. The Role of Atrial Fibrillation Catheter Ablation in Patients with Congestive Heart Failure: “Burning”for a Cure

    OpenAIRE

    Dimpi Patel; Mohammed Khan

    2011-01-01

    Atrial Fibrillation (AF) and congestive heart failure (CHF) often co-exist. Catheter ablation is increasingly used to cure AF related to CHF.Clinical evidence supports the feasibil- ity of catheter ablation as a treatment option in drug refractory AF patients with CHF.Investiga- tors have reported an improvement in ejection fraction, quality of life, and functional capacity

  14. New auxiliary indicators for the differential diagnosis of functional cardiorespiratory limitation in patients with chronic obstructive pulmonary disease and congestive heart failure

    OpenAIRE

    Cesar Marcelo de Castro; Camelier Aquiles; Jardim José Roberto; Montesano Fábio Tadeu; Tebexreni Antonio Sérgio; Barros Turíbio Leite de

    2003-01-01

    OBJECTIVE: To differentiate the nature of functional cardiorespiratory limitations during exercise in individuals with chronic obstructive pulmonary disease (COPD) or congestive heart failure (CHF) and to determine indicators that may help their classifications. METHODS: The study comprised 40 patients: 23 with COPD and 17 with CHF. All individuals underwent maximal cardiopulmonary exercise testing on a treadmill. RESULTS: The values of peak gas exchange ratio (R peak), peak carbon dioxide pr...

  15. Pharmacoeconomic analysis of valsartan for the treatment of chronic congestive heart failure in Italy

    Directory of Open Access Journals (Sweden)

    Sergio Iannazzo

    2008-09-01

    Full Text Available Objective: to evaluate pharmacoeconomic implications of the use of valsartan, an angiotensin II antagonist in addition to standard therapy for the treatment of chronic congestive heart failure (CHF. Methods: the study was conducted performing cost-utility and budget impact (B.I. analyses by means of a cohort simulation based on a probabilistic Markov model and projecting 23-months follow-up results in the Val-HeFT trial study over a 10-years time horizon. The model included four states (class NYHA I, II and III and death, and had a cycle of 1 year. Two probabilistic simulations (varying first patients parameters and after model parameters were performed using WinBUGS, a software for bayesian analysis. The distributions of patients parameters (sex, age, use of ACE inhibitors corresponding to Val-HeFT inclusion criteria in the simulated population were derived from the Italian CHF patients population. Individual mortality was derived from general mortality by adjusting with a NYHA state-specific HR, and the probability of changing NYHA class from Val-HeFT. Costs were calculated in the perspective of the Italian NHS and account for drugs and CHF hospitalizations. Quality of life weights were obtained by elaborating published HRQoL data of CHF patients. A 3.5% annual discount rate was applied; probabilistic sensitivity analysis was performed on each parameter using original-source 95% CI, or a ±10% range where it was unavailable. Results: in the 10 years horizon, patients were estimated to live an average of 4.4 years or 3.2 QALYs, with slight increases in the valsartan group. In this group, hospitalizations are predicted to be sensitively reduced and overall costs decreased by about 500 €/pz. In subgroup analysis, valsartan loses dominance in NYHAII and ACE-using patients, for which ICURs are 17,330 and 27,000 €/QALY, respectively. B.I. analysis predicts a saving of about 172 millions €. Conclusions: valsartan in addition to standard therapy

  16. Incidence and predictors of ischemic stroke during hospitalization for congestive heart failure.

    Science.gov (United States)

    Hamatani, Yasuhiro; Iguchi, Moritake; Nakamura, Michikazu; Ohtani, Ryo; Yamashita, Yugo; Takagi, Daisuke; Unoki, Takashi; Ishii, Mitsuru; Masunaga, Nobutoyo; Ogawa, Hisashi; Hamatani, Mio; Abe, Mitsuru; Akao, Masaharu

    2016-07-01

    Heart failure (HF) increases the risk of ischemic stroke. Data regarding the incidence and predictors of ischemic stroke during hospitalization for HF are limited. The study population of this retrospective cohort study consisted of patients with congestive HF, consecutively admitted to our center from October 2010 to April 2014. We excluded patients complicated with acute myocardial infarction, infective endocarditis, and takotsubo cardiomyopathy. We also excluded those with dialysis or mechanical circulatory support. We investigated the incidence of ischemic stroke during hospitalization for HF. Thereafter, we divided the patients without oral anticoagulants at admission into two groups: patients with ischemic stroke and those without it, and explored the predictors of ischemic stroke. A total of 558 patients (287 without atrial fibrillation (AF), 271 with AF) were enrolled. The mean age was 76.8 ± 12.3 years, and 244 patients (44 %) were female. The mean left-ventricular ejection fraction was 47.4 %. Oral anticoagulants were prescribed in 147 patients (8 without AF, 139 with AF). During hospitalization (median length 18 days), symptomatic ischemic stroke (excluding catheter-related) occurred in 15 patients (2.7 % of the total, 8 without AF, 7 with AF). Predictors significantly associated with increased risk of ischemic stroke in patients without oral anticoagulants were as follows; short-term increases in blood urea nitrogen after admission (at day 3; odds ratio (per 1 md/dl): 1.06, 95 % confidence interval (CI) 1.01-1.11, p = 0.02, and at day 7; odds ratio: 1.03, 95 % CI 1.00-1.07, p = 0.03, respectively), and previous stroke (odds ratio; 3.33, 95 % CI 1.01-11.00, p = 0.04). The incidence of ischemic stroke during hospitalization for HF was high, even in patients without AF. Previous stroke and short-term increases in blood urea nitrogen was significantly associated with the incidence of ischemic stroke. PMID:26219729

  17. Safety and predictors of adherence of a new rehabilitation program for older women with congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    Nahid A. Azad; Kathy Bouchard; Alain Mayhew; Maureen Carter; Frank J. Molnar

    2012-01-01

    Objectives To assess the safety of a cardiac rehabilitation program for older women with Congestive Heart Failure (CHF) anddetermine if certain factors influence adherence. Methods Women over the age of 65 with CHF attended an exercise program supervisedby a physiotherapist. Quality of life was measured by the Minnesota Living with Heart Failure Questionnaire (MLHFQ) and severity ofdisease by the New York Heart Association (NYHA) Class. Subjects were classified into those who attended 90% or more of the sessionsand those who attended less than 90% of the sessions. Results Fifty-one subjects were studied. Eight subjects did not attend any sessions.Of the 43 attendees, the average percentage of sessions attended was 87%. There were no significant differences between the two groups inage, MLHFQ or NYHA Class. There was only one adverse event out of 280 participant attendances. Conclusions The program had a highlevel of adherence in this population. Age, MLHFQ or NYHA Class did not impact on session attendance. Our data suggests this program issafe for this population. Further research is needed to determine other predictors of attendance and the examination of safety issues andlong-term adherence to exercise in this population.

  18. Dopaminergic drugs in congestive heart failure: hemodynamic and neuroendocrine responses to ibopamine, dopamine, and dihydroergotoxine.

    Science.gov (United States)

    Metra, M; Missale, C; Spano, P F; Cas, L D

    1995-05-01

    Ibopamine has hemodynamic and neurohumoral effects potentially useful for the treatment of congestive heart failure (CHF), but its mechanism of action is not completely clear. To evaluate the role of dopaminergic receptor stimulation in the hemodynamic and neurohumoral activity of ibopamine, we compared the effects of ibopamine, 100 mg orally (p.o.) with those of the dopamine 2, 4, and 6 micrograms/kg/min intravenously (i.v.) and of the DA2 agonist dihydroergotoxine 6 micrograms/kg i.v. in 13 patients with chronic CHF [left ventricular ejection fraction (LVEF) index (CI) with a 23 and 25% increase in stroke volume (SV) and stroke work indexes (SWI), respectively, and an 18% reduction in systemic vascular resistance (SVR). Similar changes were observed after DA infused at the doses of 2 and 4 micrograms/kg/min, whereas with the dose of 6 micrograms/kg/min heart rate (HR) increased by 23% and SV index (SVI) did not change further. Dihydroergotoxine administration induced only a significant 9% decrease in mean arterial pressure (MAP), with a 13% reduction in SVR.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7630152

  19. Elderly women's experiences of support when living with congestive heart failure

    OpenAIRE

    Sundin, Karin; Bruce, Elisabeth; Barremo, Ann-Sofi

    2010-01-01

    Heart failure is a chronic syndrome that has physiological, psychological and social effects. The aim of the study was to illuminate the meanings of support as experienced by elderly women with chronic heart failure. Narrative interviews were conducted with five elderly women with chronic heart failure. A phenomenological hermeneutic method of interpretation was used. The meanings of support were experienced by the women out of two perspectives, that is, when support is present and when there...

  20. A hospital based study on causes peculiar of congestive car-diac failure (CCF)

    Institute of Scientific and Technical Information of China (English)

    Hamzullah Khan; Hikmatullah Jan; Mohammad Hafizullah; Mahmoodul Hassan; Adnan Gul

    2008-01-01

    Objective:To determine the frequency of risk factors of congestive cardiac failure in a tertiary care hospital of Peshawar.Methods:This retrospective observational study was conducted in department of Cardiology,Post-graduate Medical Institute,Lady Reading Hospital Peshawar,from March 2005 to September 2007.Relevant information regarding the risk factors of congestive cardiac failure were recorded on questionnaire prepared in accordance with the objectives of the study.Results:1 019 patients with established diagnosis of cardiac fail-ure (based on clinical findings and relevant investigations) were included.Out of total sampling 583 (57.12%)were males and 436(42.78%)were females.The age range of the patients was from 6 years to 82 years with mean age of 48.5 years and mode of age was 45 years.The distribution of causative factors of CCF was:ischemic heart disease (IHD)36.31%,hypertension 26.30%,dilated cardiomyopathy 10.10%,obstr-uctve and restrictive cardiomyopathies 5.39%,valvular heart diseases (VHD)9.32%,congenital heart dis-ease like ventricular septal defects (VSD)4.41%,atrial septal defects (ASD)0.58%,atrial fibrillation (AF)2.25%,constrictive pericardidtis 1.07%,Pericardial effusion 0.68%,chronic obstructive pulmonary disease and pulmonary hypertension 1.47%,thyrotoxicosis 0.68%,complete heart block 0.29% and paget disease in 0.09% cases.Conclusion:Ischemic heart disease,hypertension,cardiomypathies,valvular heart disease and congenital heart disease are major contributor to CCF in our patients.

  1. Estimating clinical morbidity due to ischemic heart disease and congestive heart failure: the future rise of heart failure

    OpenAIRE

    Bonneux, Luc; Barendregt, Jan,; Meeter, K.J.; Bonsel, Gouke; Maas, Paul

    1994-01-01

    textabstractOBJECTIVES. Many developed countries have seen declining mortality rates for heart disease, together with an alleged decline in incidence and a seemingly paradoxical increase in health care demands. This paper presents a model for forecasting the plausible evolution of heart disease morbidity. METHODS. The simulation model combines data from different sources. It generates acute coronary event and mortality rates from published data on incidences, recurrences, and lethalities of d...

  2. Exploring feasibility of home telemanagement in African Americans with congestive heart failure.

    Science.gov (United States)

    Finkelstein, Joseph; Cha, Eunme; Dennison, Cheryl R

    2010-01-01

    Existing telemonitoring systems provide limited support in implementing personalized treatment plans. We developed a Home Automated Telemanagement (HAT) system for patients with congestive heart failure (CHF) to provide support in following individualized treatment plans as well as to monitor symptoms, weight changes, and quality of life, while educating the patient on their disease. The system is designed to be placed in the patient's home and to communicate all patient data to a central server implementing real-time clinical decision support. The system questions the patient daily on their condition, monitors their weight, and provides the patient with instant feedback on their condition in the form of a 3-zone CHF action plan. Their medication regimen and suggested actions are determined by their care management team and integrated into the system, keeping a personalized approach to disease management while taking advantage of the technology available. The system is designed to be as simple as possible, making it usable by patients with no prior computer experience. A feasibility assessment in African American patients with CHF and without prior computer experience demonstrated high level of acceptance of the CHF HAT system. PMID:20841744

  3. Direct and indirect assessment of skeletal muscle blood flow in chronic congestive heart failure

    Energy Technology Data Exchange (ETDEWEB)

    LeJemtel, T.H.; Scortichini, D.; Katz, S.

    1988-09-09

    In patients with chronic congestive heart failure (CHF), skeletal muscle blood flow can be measured directly by the continuous thermodilution technique and by the xenon-133 clearance method. The continuous thermodilution technique requires retrograde catheterization of the femoral vein and, thus, cannot be repeated conveniently in patients during evaluation of pharmacologic interventions. The xenon-133 clearance, which requires only an intramuscular injection, allows repeated determination of skeletal muscle blood flow. In patients with severe CHF, a fixed capacity of the skeletal muscle vasculature to dilate appears to limit maximal exercise performance. Moreover, the changes in peak skeletal muscle blood flow noted during long-term administration of captopril, an angiotensin-converting enzyme inhibitor, appears to correlate with the changes in aerobic capacity. In patients with CHF, resting supine deep femoral vein oxygen content can be used as an indirect measurement of resting skeletal muscle blood flow. The absence of a steady state complicates the determination of peak skeletal muscle blood flow reached during graded bicycle or treadmill exercise in patients with chronic CHF. Indirect assessments of skeletal muscle blood flow and metabolism during exercise performed at submaximal work loads are currently developed in patients with chronic CHF.

  4. Framework for Estimating Congestion performance measures : from data collection to reliability analysis: case study of Stockholm

    OpenAIRE

    Morán Toledo, Carlos A.

    2008-01-01

    For operational and planning purposes it is important to observe and predict the traffic performance of congested urban road links and networks. Congestion can be defined as traffic conditions caused by a downstream bottleneck or excess in travel time from what is incurred during light or free-flow travel conditions. Factors affecting definitions of congestion for specific studies are reviewed and an inventory of proposed congestion performance measures is presented for both definitions of co...

  5. A Natural Language Processing System to Extract and Code Concepts Relating to Congestive Heart Failure from Chest Radiology Reports

    OpenAIRE

    Friedlin, Jeff; McDonald, Clement J.

    2006-01-01

    We have developed a natural language processing system for extracting and coding clinical data from free text reports. The system is designed to be easily modified and adapted to a variety of free text clinical reports such as admission notes, radiology and pathology reports, and discharge summaries. This report presents the results of this system to extract and code clinical concepts related to congestive heart failure from 39,000 chest radiology reports. The system detects the presence or a...

  6. Particulate Air Pollution and the Rate of Hospitalization for Congestive Heart Failure among Medicare Beneficiaries in Pittsburgh, Pennsylvania.

    OpenAIRE

    Wellenius, Gregory A.; Bateson, Thomas F.; Mittleman, Murray A.; Schwartz, Joel

    2005-01-01

    We used a case-crossover approach to evaluate the association between ambient air pollution and the rate of hospitalization for congestive heart failure (CHF) among Medicare recipients (age ≥ 65) residing in Allegheny County (Pittsburgh area), PA, during 1987–1999. We also explored effect modification by age, gender, and specific secondary diagnoses. During follow-up, there were 55,019 admissions with a primary diagnosis of CHF. We found that particulate matter with aerodynamic diameter ≤ 10 ...

  7. Specialist Nurse-Led Intervention in Outpatients with Congestive Heart Failure: Impact on Clinical and Economic Outcomes

    OpenAIRE

    Palmer, Nicholas D.; Barbara Appleton; Erwin A. Rodrigues

    2003-01-01

    Congestive heart failure (CHF) encompasses a spectrum of clinical syndromes and presentations. It affects 1-2% of the population in the UK and is associated with significant mortality which is comparable to most cancers. It accounts for more than 5% of adult medical admissions in the UK, with significant annual re-admission rates. Improved understanding of the pathophysiology of CHF has resulted in significant advancements in CHF management. Current pharmacologic agents, such as ACE inhibitor...

  8. Reversible renal failure after combined treatment with enalapril and frusemide in a patient with congestive heart failure.

    OpenAIRE

    Funck-Brentano, C; Chatellier, G.; Alexandre, J. M.

    1986-01-01

    A patient with congestive heart failure and moderate renal insufficiency developed severe reversible non-oliguric renal failure while on frusemide and enalapril. Renal failure developed when enalapril was given in the presence of pronounced sodium depletion. When positive sodium balance was restored the plasma creatinine concentration began to fall while angiotensin converting enzyme inhibition remained effective and blood pressure was stable. These observations suggest that the degree of sod...

  9. Effectiveness of chest radiography, lung ultrasound and thoracic computed tomography in the diagnosis of congestive heart failure

    OpenAIRE

    Cardinale, Luciano; Priola, Adriano Massimiliano; Moretti, Federica; Volpicelli, Giovanni

    2014-01-01

    Hydrostatic pulmonary edema is as an abnormal increase in extravascular water secondary to elevated pressure in the pulmonary circulation, due to congestive heart failure or intravascular volume overload. Diagnosis of hydrostatic pulmonary edema is usually based on clinical signs associated to conventional radiography findings. Interpretation of radiologic signs of cardiogenic pulmonary edema are often questionable and subject. For a bedside prompt evaluation, lung ultrasound (LUS) may assess...

  10. Transmission economic expansion and congestion relief : a case study

    International Nuclear Information System (INIS)

    Transmission capacity additions have lagged behind load growth and generation expansion in the United States. This paper provided an economic analysis of various transmission upgrade options designed to address anticipated congestion of the electricity grid. A market-based transmission planning method was used to assess the economics of transmission expansion. The analysis accounted for the minimum costs of generation dispatch to satisfy transmission constraints, as well as a locational marginal price for each bus in the system. Marginal congestion costs for all major transmission facilities were monitored and recorded. Hourly simulations of load, generation, and transmission system interactions were conducted. Contract costs and economic measures were then calculated for each scenario run. A case study for the Sunrise Powerlink project was used to demonstrate the efficacy of the method. The study demonstrated that the Sunrise Powerlink project will eliminate significant congestion in California load centers. Results also showed that the analytical method provided critical information for decision-makers in weighing the costs with benefits for transmission projects. 5 refs., 2 tabs., 1 fig

  11. Potential benefits of cell therapy in coronary heart disease.

    Science.gov (United States)

    Grimaldi, Vincenzo; Mancini, Francesco Paolo; Casamassimi, Amelia; Al-Omran, Mohammed; Zullo, Alberto; Infante, Teresa; Napoli, Claudio

    2013-11-01

    Cardiovascular disease is the leading cause of morbidity and mortality in the world. In recent years, there has been an increasing interest both in basic and clinical research regarding the field of cell therapy for coronary heart disease (CHD). Several preclinical models of CHD have suggested that regenerative properties of stem and progenitor cells might help restoring myocardial functions in the event of cardiac diseases. Here, we summarize different types of stem/progenitor cells that have been tested in experimental and clinical settings of cardiac regeneration, from embryonic stem cells to induced pluripotent stem cells. Then, we provide a comprehensive description of the most common cell delivery strategies with their major pros and cons and underline the potential of tissue engineering and injectable matrices to address the crucial issue of restoring the three-dimensional structure of the injured myocardial region. Due to the encouraging results from preclinical models, the number of clinical trials with cell therapy is continuously increasing and includes patients with CHD and congestive heart failure. Most of the already published trials have demonstrated safety and feasibility of cell therapies in these clinical conditions. Several studies have also suggested that cell therapy results in improved clinical outcomes. Numerous ongoing clinical trials utilizing this therapy for CHD will address fundamental issues concerning cell source and population utilized, as well as the use of imaging techniques to assess cell homing and survival, all factors that affect the efficacy of different cell therapy strategies. PMID:23834957

  12. Use of sympathomimetic drugs leads to increased risk of hospitalization for arrhythmias in patients with congestive heart failure

    DEFF Research Database (Denmark)

    Bouvy, M L; Heerdink, E R; De Bruin, M L;

    2000-01-01

    BACKGROUND: Sympathomimetic agents have a direct positive chronotropic effect on heart rate and may cause hypokalemia, even when administered by inhalation. In selected patients (e.g., patients with congestive heart failure [CHF]) this can lead to arrhythmias. Despite the potential adverse effects...... hospital discharge diagnosis of CHF, we identified 149 cases with a readmission for arrhythmias, and compared these in a nested matched case-control design with 149 controls from the remainder of the cohort with no hospital readmission for any cardiac cause. Conditional logistic regression was used to...

  13. Chronic congestive heart failure. Description and survival of 190 consecutive patients with a diagnosis of chronic congestive heart failure based on clinical signs and symptoms

    DEFF Research Database (Denmark)

    Madsen, B K; Hansen, J F; Stokholm, K H; Brøns, J; Husum, D; Mortensen, L S

    1994-01-01

    independent, significant prognostic information, (hazard ratios for death in brackets): ln (natural logarithm) (LVEF) (3.19), NYHA class III+IV (2.72), plasma urea > 7.6 mmol.l-1 (2.22), serum creatinine > 121 mumol.l-1 (2.05), serum sodium < or = 137 mmol.l-1 (2.03), pulmonary congestion on X-ray (1.86), and...

  14. Usefulness of verapamil for congestive heart failure associated with abnormal left ventricular diastolic filling and normal left ventricular systolic performance

    International Nuclear Information System (INIS)

    Normal left ventricular systolic performance with impaired left ventricular diastolic filling may be present in a substantial number of patients with congestive heart failure (CHF). To evaluate the effect of oral verapamil in this subset, 20 men (mean age 68 +/- 5 years) with CHF, intact left ventricular function (ejection fraction greater than 45%) and abnormal diastolic filling (peak filling rate less than 2.5 end-diastolic volumes per second [edv/s]) were studied in a placebo-controlled, double-blind 5-week crossover trial. All patients underwent echocardiography to rule out significant valvular disease, and thallium-201 stress scintigraphy to exclude major active ischemia. Compared to baseline values, verapamil significantly improved exercise capacity by 33% (13.9 +/- 4.3 vs 10.7 +/- 3.4 minutes at baseline) and peak filling rate by 30% (2.29 +/- 0.54 vs 1.85 +/- 0.45 edv/s at baseline) (all p less than 0.05). Placebo values were 12.3 +/- 4.0 minutes and 2.16 +/- 0.48 edv/s, respectively (difference not significant for both). Improvement from baseline in an objective clinico-radiographic heart failure score (scale 0 to 13) was significantly greater with verapamil compared to placebo (median improvement in score: 3 vs 1, p less than 0.01). Mean ejection fraction and systolic blood pressure were unchanged from baseline; diastolic blood pressure and heart rate decreased to a small degree. Verapamil may have therapeutic efficacy in patients with CHF, preserved systolic function and impaired diastolic filling

  15. New approach for new target: adaptive servo-ventilation on Cheyne-Stokes respiration in congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    @@ Cheyne-Stokes respiration with central sleep apnea (CSR-CSA) occurs when periods of hyperventilation with waxing/waning tidal volume alternated with periods of central hypopnea/apnea. It is present in approximately 40 percent of patients with severe congestive heart failure (CHF). CSR-CSA may contribute to the progression of heart failure by causing repetitive arterial oxygen desaturation, sleep fragmentation, increased left ventricular afterload, activation of sympathetic nervous system, and oscillations in heart rate and blood pressure. There are evidences indicating that CSR-CSA is associated with a remarkable increase in mortality and is also an independent risk factor for cardiac transplantation; furthermore, treatment of CSR-CSA in combination with optimal medical therapy may influence the course of chronic heart failure, improve quality of life and the survival of patients.1 The paper by Zhang et al2 highlights the importance of recognizing this pathological breathing pattern as a potential therapeutic target.

  16. Prognostic value of myocardial 123I-BMIPP imaging in patients with congestive heart failure without coronary artery disease

    International Nuclear Information System (INIS)

    We performed 123I-BMIPP (BMIPP) imaging in order to clarify the characteristics of fatty acid metabolism and its effect on prognosis in patients with congestive heart failure (CHF) without coronary artery disease. We studied 15 normal subjects and 42 patients with CHF (idiopathic dilated cardiomyopathy; 24, hypertensive heart disease; 12, valvular heart disease; 6). We obtained cardiac imaging with BMIPP and 201Tl at rest on separate days before discharge. Using whole body imaging, the ratio of cardiac uptake of the isotope to total injected dose was calculated (%Uptake). We calculated the cardiac uptake ratio of BMIPP (%Uptake of BMIPP divided by %Uptake of 201Tl), percent washout of BMIPP from the heart over 3 hours and unhomogeneity of myocardial distribution of BMIPP (coefficient of variation of BMIPP, CV) as scintigraphic parameters. Cardiac events were defined as cardiac death or deterioration of CHF which requiring readmission. Uptake ratio (CHF; 0.91±0.17, normal; 1.10±0.09, p=0.0000) and CV (CHF; 20±5, normal; 16±5, p=0.0385) were different significantly between CHF and normal subjects. During the follow-up period of 27.2±14.4 months (4.5-53.5 months) cardiac events developed in 15 patients (cardiac death; 8, deterioration of CHF; 7). In univariate analysis, % uptake of 201Tl, uptake ratio, % FS, serum norepinephrine level and serum renin activity were different significantly between event and event-free groups. Cox proportional hazard analysis showed that the uptake ratio (p=0.0000) and age (p=0.018) were independent predictors of cardiac events. In patients with uptake ratio less than 0.88, relative risks of cardiac events was 23.7 times greater than in patients with uptake ratio more than 0.89. These data suggested that in patients with CHF fatty acid metabolism was deteriorated and cardiac uptake of BMIPP was a strong and independent predictor of long-term prognosis in patients with heart failure. (author)

  17. Utility of brain natriuretic peptide in diagnosis of congestive heart failure and comparison with trans-thoracic echocardiography: a multicenter analysis in south asian and arabian population

    International Nuclear Information System (INIS)

    Objective: To evaluate serum Brain Natriuretic Peptide levels (BNP) as a screening test in the diagnosis of congestive heart failure. Study Design: Comparative cross-sectional study. Place and Duration of Study: Prince Salman Heart Center, King Fahad Medical City, Riyadh, Saudi Arabia between December 2010 to January 2012 and Nishtar Hospital, Multan, Pakistan, from February to August 2006. Methodology: A total of 80 patients with clinical diagnosis of Congestive Heart Failure (CHF) underwent measurement of serum BNP and had a trans-thoracic echocardiography to measure Ejection Fraction (EF). The normal limit for serum BNP levels, provided by the manufacturer of the kit was applied as a cut-off value for BNP. EF of > 45% was considered normal. Results: Forty seven patients (94%) had an EF < 45%. BNP levels were elevated in 36 patients (72%). Sensitivity and specificity of BNP was found to be 80% and 66% respectively and accuracy was 80%. Conclusion: BNP measurements as a screening tool for CHF has good sensitivity and accuracy when compared to echocardiography. (author)

  18. Hospital-based comprehensive cardiac rehabilitation versus usual care among patients with congestive heart failure, ischemic heart disease, or high risk of ischemic heart disease

    DEFF Research Database (Denmark)

    Zwisler, Ann-Dorthe Olsen; Soja, Anne Merete Boas; Rasmussen, Søren; Frederiksen, Marianne; Abadini, Sadollah; Appel, Jon; Rasmussen, Hanne; Gluud, Christian; Iversen, Lars; Sigurd, Bjarne; Madsen, Mette; Fischer-Hansen, Jørgen; Group, DANREHAB

    2008-01-01

    BACKGROUND: Current guidelines broadly recommend comprehensive cardiac rehabilitation (CCR), although evidence for this is still limited. We investigated the 12-month effect of hospital-based CCR versus usual care (UC) for a broadly defined group of cardiac patients within the modern therapeutic ...... Depression Scale did not differ significantly. CONCLUSION: At 12 months, the CCR and UC groups did not differ regarding the primary composite outcome. Comprehensive cardiac rehabilitation significantly reduced length of hospital stay and improved cardiac risk factors.......BACKGROUND: Current guidelines broadly recommend comprehensive cardiac rehabilitation (CCR), although evidence for this is still limited. We investigated the 12-month effect of hospital-based CCR versus usual care (UC) for a broadly defined group of cardiac patients within the modern therapeutic......, risk profile, and quality of life. The trial included 770 participants (20-94 years) with congestive heart failure (12%), ischemic heart disease (58%), or high risk of ischemic heart disease (30%). Comprehensive cardiac rehabilitation is composed of 6 weeks of intensive intervention and systematic...

  19. Usefulness of running wheel for detection of congestive heart failure in dilated cardiomyopathy mouse model.

    Directory of Open Access Journals (Sweden)

    Masami Sugihara

    Full Text Available BACKGROUND: Inherited dilated cardiomyopathy (DCM is a progressive disease that often results in death from congestive heart failure (CHF or sudden cardiac death (SCD. Mouse models with human DCM mutation are useful to investigate the developmental mechanisms of CHF and SCD, but knowledge of the severity of CHF in live mice is necessary. We aimed to diagnose CHF in live DCM model mice by measuring voluntary exercise using a running wheel and to determine causes of death in these mice. METHODOLOGY/PRINCIPAL FINDINGS: A knock-in mouse with a mutation in cardiac troponin T (ΔK210 (DCM mouse, which results in frequent death with a t(1/2 of 70 to 90 days, was used as a DCM model. Until 2 months of age, average wheel-running activity was similar between wild-type and DCM mice (approximately 7 km/day. At approximately 3 months, some DCM mice demonstrated low running activity (LO: 5 km/day. In the LO group, the lung weight/body weight ratio was much higher than that in the other groups, and the lungs were infiltrated with hemosiderin-loaded alveolar macrophages. Furthermore, echocardiography showed more severe ventricular dilation and a lower ejection fraction, whereas Electrocardiography (ECG revealed QRS widening. There were two patterns in the time courses of running activity before death in DCM mice: deaths with maintained activity and deaths with decreased activity. CONCLUSIONS/SIGNIFICANCE: Our results indicate that DCM mice with low running activity developed severe CHF and that running wheels are useful for detection of CHF in mouse models. We found that approximately half of ΔK210 DCM mice die suddenly before onset of CHF, whereas others develop CHF, deteriorate within 10 to 20 days, and die.

  20. Policy expectations and reality of telemedicine - a critical analysis of health care outcomes, costs and acceptance for congestive heart failure.

    Science.gov (United States)

    Achelrod, Dmitrij

    2014-05-01

    A critical review of evidence was carried out to discover whether the actual performance of telemedicine fulfils the expectations of German policy-makers. The analysis was conducted using the example of telemedicine for congestive heart failure (CHF). It was based on both German and international evidence. The PubMed, MEDLINE, Google Scholar and Cochrane Library databases were searched, as well as public sources from the German Federal Ministry of Health. Forty-five studies reporting patient outcomes, costs or acceptance of telemedicine for CHF were included in the review, of which 28 were interventional. The policy expectations of telemedicine generally are: high technology acceptance and improved patient outcomes at lower costs. However, in the field of CHF, policy-makers underestimate the complexity of telemedicine and the technology has not yet lived up to its expectations. Although some studies show improvements in all-cause mortality and CHF-related hospitalisations, there is excessive study heterogeneity and vagueness in the areas of costs and acceptance. Methodological insufficiencies as well as the scarcity of evidence in the German context do not allow definite conclusions to be drawn. Policy-makers and other stakeholders should increase their efforts to consolidate isolated telemedicine projects, establish guidelines for clinical treatment procedures and economic evaluations, and define industry/technical device standards to enhance the comparability of interventions. Imposing the use of telemedicine on patients and physicians is not likely to be fruitful. A successful adaptation requires an analysis of needs and continuous education on both sides. PMID:24803273

  1. Bilateral basal Xe-133 retention and ventilation/perfusion patterns in mild and subclinical congestive heart failure

    International Nuclear Information System (INIS)

    The Xe-133 ventilation pattern in congestive heart failure (CHF) was assessed using 24 inpatient ventilation/perfusion studies performed to rule out pulmonary embolism. Patients with histories of CHF, myocardial infarction (MI), and cardiomyopathy were included in the study. Frank pulmonary edema, pulmonary embolism, and other known lung diseases such as chronic obstructive lung disease, tumor, and pneumonia were excluded. Fifteen of the 24 patients had abnormal ventilation scans. Twelve of the 15 showed bilateral basal Xe-133 retention on washout; the remaining 3 showed diffuse, posterior regional retention. On perfusion scans, 14 of the 15 abnormal ventilation patients showed evidence of CHF such as inverted perfusion gradient, enlarged cardiac silhouette, or patchy perfusion, and all of them had a history of CHF or cardiac disease. Nine of the 24 patients had normal ventilation scans, including normal washout patterns. Seven of the nine had normal perfusion (p less than 0.01). Four of the nine normal ventilation patients had a history of cardiac disease or CHF but no recent acute MI. Bilateral basal regional Xe-133 retention, coupled with perfusion scan evidence of CHF such as inverted perfusion gradient, enlarged cardiac silhouette, and patchy perfusion pattern, appears to be a sensitive and characteristic ventilation/perfusion finding in mild or subclinical CHF

  2. Multicenter randomized trial of cell therapy in cardiopathies – MiHeart Study

    Directory of Open Access Journals (Sweden)

    Oliveira Sérgio A

    2007-01-01

    Full Text Available Abstract Background Cardiovascular diseases are the major cause of death in the world. Current treatments have not been able to reverse this scenario, creating the need for the development of new therapies. Cell therapies have emerged as an alternative for cardiac diseases of distinct causes in experimental animal studies and more recently in clinical trials. Method/Design We have designed clinical trials to test for the efficacy of autologous bone marrow derived mononuclear cell therapies in four different cardiopathies: acute and chronic ischemic heart disease, and Chagasic and dilated cardiomyopathy. All trials are multicenter, randomized, double-blind and placebo controlled. In each trial 300 patients will be enrolled and receive optimized therapy for their specific condition. Additionally, half of the patients will receive the autologous bone marrow cells while the other half will receive placebo (saline with 5% autologous serum. For each trial there are specific inclusion and exclusion criteria and the method for cell delivery is intramyocardial for the chronic ischemic heart disease and intracoronary for all others. Primary endpoint for all studies will be the difference in ejection fraction (determined by Simpson's rule six and twelve months after intervention in relation to the basal ejection fraction. The main hypothesis of this study is that the patients who receive the autologous bone-marrow stem cell implant will have after a 6 month follow-up a mean increase of 5% in absolute left ventricular ejection fraction in comparison with the control group. Discussion Many phase I clinical trials using cell therapy for cardiac diseases have already been performed. The few randomized studies have yielded conflicting results, rendering necessary larger well controlled trials to test for efficacy of cell therapies in cardiopathies. The trials registration numbers at the NIH registry are the following: Chagasic cardiomyopathy (NCT00349271

  3. Multicenter randomized trial of cell therapy in cardiopathies – MiHeart Study

    Science.gov (United States)

    Tura, Bernardo R; Martino, Helena F; Gowdak, Luis H; dos Santos, Ricardo Ribeiro; Dohmann, Hans F; Krieger, José E; Feitosa, Gilson; Vilas-Boas, Fábio; Oliveira, Sérgio A; Silva, Suzana A; Bozza, Augusto Z; Borojevic, Radovan; de Carvalho, Antonio C Campos

    2007-01-01

    Background Cardiovascular diseases are the major cause of death in the world. Current treatments have not been able to reverse this scenario, creating the need for the development of new therapies. Cell therapies have emerged as an alternative for cardiac diseases of distinct causes in experimental animal studies and more recently in clinical trials. Method/Design We have designed clinical trials to test for the efficacy of autologous bone marrow derived mononuclear cell therapies in four different cardiopathies: acute and chronic ischemic heart disease, and Chagasic and dilated cardiomyopathy. All trials are multicenter, randomized, double-blind and placebo controlled. In each trial 300 patients will be enrolled and receive optimized therapy for their specific condition. Additionally, half of the patients will receive the autologous bone marrow cells while the other half will receive placebo (saline with 5% autologous serum). For each trial there are specific inclusion and exclusion criteria and the method for cell delivery is intramyocardial for the chronic ischemic heart disease and intracoronary for all others. Primary endpoint for all studies will be the difference in ejection fraction (determined by Simpson's rule) six and twelve months after intervention in relation to the basal ejection fraction. The main hypothesis of this study is that the patients who receive the autologous bone-marrow stem cell implant will have after a 6 month follow-up a mean increase of 5% in absolute left ventricular ejection fraction in comparison with the control group. Discussion Many phase I clinical trials using cell therapy for cardiac diseases have already been performed. The few randomized studies have yielded conflicting results, rendering necessary larger well controlled trials to test for efficacy of cell therapies in cardiopathies. The trials registration numbers at the NIH registry are the following: Chagasic cardiomyopathy (NCT00349271), dilated cardiomyopathy (NCT

  4. Right ventricular ejection fraction: an indicator of increased mortality in patients with congestive heart failure associated with coronary artery disease

    International Nuclear Information System (INIS)

    The predictive value of radionuclide ventriculography was studied in 34 patients with depressed left ventricular ejection fraction (less than 40%) and clinically evident congestive heart failure secondary to atherosclerotic coronary artery disease. In addition to left ventricular ejection fraction, right ventricular ejection fraction and extent of left ventricular paradox were obtained in an attempt to identify a subgroup at increased risk of mortality during the ensuing months. The 16 patients who were alive after a 2 year follow-up period had a higher right ventricular ejection fraction and less extensive left ventricular dyskinesia. When a right ventricular ejection fraction of less than 35% was used as a discriminant, mortality was significantly greater among the 21 patients with a depressed right ventricular ejection fraction (71 versus 23%), a finding confirmed by a life table analysis. It appears that the multiple factors contributing to the reduction in right ventricular ejection fraction make it a useful index not only for assessing biventricular function, but also for predicting patient outcome

  5. Relationship Between Serum Leptin Concentration and Lipids & Body Mass Index in Patients With Chronic Congestive Heart Failure

    Institute of Scientific and Technical Information of China (English)

    Li Gang; Yan Qingbo; Wei Liangming

    2006-01-01

    Objectives To investigate the relationship of serum leptin concentration with the lipids and body mass index (BMI) in patients with chronic congestive heart failure(CHF). Methods The serum concentration of leptin in 39 patients with CHF (14 in cardiac function class Ⅱ , 21 in class Ⅲ , 4 in class Ⅳ , NYHA) and in 46 patients with cardiac function class Ⅰ (NYHA) were assessed by radioimmunoassay. Results The serum concentration of leptin were 9.018±4.519μg/l in CHF group (cardiac function class Ⅱ 11.492±5.649 μg/l, class Ⅲ 7.763±3.321 μg/l, class Ⅳ 6.100±2.657 μg/l);11.674±6.911 μg/l in class Ⅰ group. The serum concentrations of leptin were significantly lower in CHF group, as compared with class Ⅰ group (P<0.05). Moreover, the decrease of serum leptin concentration was significantly correlated with the decreased serum concentrations of total cholesterol, triglyceride, body mass index and left ventricular ejection fraction in CHF group, respectively (P<0.05). Conclusions The significance of the decrease in serum leptin in CHF patients needs further study.

  6. Impact of collaborative care on survival time for dogs with congestive heart failure and revenue for attending primary care veterinarians.

    Science.gov (United States)

    Lefbom, Bonnie K; Peckens, Neal K

    2016-07-01

    OBJECTIVE To assess the effects of in-person collaborative care by primary care veterinarians (pcDVMs) and board-certified veterinary cardiologists (BCVCs) on survival time of dogs after onset of congestive heart failure (CHF) and on associated revenue for the attending pcDVMs. DESIGN Retrospective cohort study. ANIMALS 26 small-breed dogs treated for naturally occurring CHF secondary to myxomatous mitral valve disease at a multilocation primary care veterinary hospital between 2008 and 2013. PROCEDURES Electronic medical records were reviewed to identify dogs with confirmed CHF secondary to myxomatous mitral valve disease and collect information on patient care, survival time, and pcDVM revenue. Data were compared between dogs that received collaborative care from the pcDVM and a BCVC and dogs that received care from the pcDVM alone. RESULTS Dogs that received collaborative care had a longer median survival time (254 days) than did dogs that received care from the pcDVM alone (146 days). A significant positive correlation was identified between pcDVM revenue and survival time for dogs that received collaborative care (ie, the longer the dog survived, the greater the pcDVM revenue generated from caring for that patient). CONCLUSIONS AND CLINICAL RELEVANCE Findings suggested that collaborative care provided to small-breed dogs with CHF by a BCVC and pcDVM could result in survival benefits for affected dogs and increased revenue for pcDVMs, compared with care provided by a pcDVM alone. PMID:27308884

  7. Dilatory responses to acetylcholine, calcitonin gene-related peptide and substance P in the congestive heart failure rat

    DEFF Research Database (Denmark)

    Bergdahl, A; Valdemarsson, S; Nilsson, T; Sun, X Y; Hedner, T; Edvinsson, L

    1999-01-01

    It was examined to what extent congestive heart failure (CHF) in rats, induced by ligation of the left coronary artery, affects the vascular responses to the vasodilatory substances acetylcholine (ACh), calcitonin gene-related peptide (CGRP), and substance P (SP). After induction of CHF status, the...... basilar, mesenteric and renal arteries and the iliac vein were studied in vitro. Dilatory responses were determined in relation to pre-contraction by the thromboxane mimetic U46619. Sham-operated animals (Sham) served as controls. U46619 induced stronger contraction in CHF basilar and renal arteries...... artery of CHF rats compared with Sham (pEC50: 8.1 +/- 0.2 vs. 9.5 +/- 0.3, P < 0.01). In the CHF iliac vein, CGRP was more potent compared with Sham (pEC50: 9.7 +/- 0.4 vs. 8.3 +/- 0.4, P < 0.05). It can be concluded CHF is accompanied by alterations in the vascular response to the dilatory substances...

  8. Sleeping and resting respiratory rates in dogs and cats with medically-controlled left-sided congestive heart failure.

    Science.gov (United States)

    Porciello, F; Rishniw, M; Ljungvall, I; Ferasin, L; Haggstrom, J; Ohad, D G

    2016-01-01

    Sleeping and resting respiratory rates (SRR and RRR, respectively) are commonly used to monitor dogs and cats with left-sided cardiac disease and to identify animals with left-sided congestive heart failure (L-CHF). Dogs and cats with subclinical heart disease have SRRmean values RRR in dogs and cats with CHF that is well controlled with medical therapy. In this study, SRR and RRR were measured by the owners of 51 dogs and 22 cats with stable, well-controlled CHF. Median canine SRRmean was 20 breaths/min (7-39 breaths/min); eight dogs were ≥25 breaths/min and one dog only was ≥30 breaths/min. Canine SRRmean was unrelated to pulmonary hypertension or diuretic dose. Median feline SRRmean was 20 breaths/min (13-31 breaths/min); four cats were ≥25 breaths/min and only one cat was ≥30 breaths/min. Feline SRRmean was unrelated to diuretic dose. SRR remained stable during collection in both species with little day-to-day variability. The median canine RRRmean was 24 breaths/min (12-44 breaths/min), 17 were ≥25 breaths/min, seven were ≥30 breaths/min, two were >40 breaths/min. Median feline RRRmean was 24 breaths/min (15-45 breaths/min); five cats had RRRmean ≥25 breaths/min; one had ≥30 breaths/min, and two had ≥40 breaths/min. These data suggest that most dogs and cats with CHF that is medically well-controlled and stable have SRRmean and RRRmean <30 breaths/min at home. Clinicians can use these data to help determine how best to control CHF in dogs and cats. PMID:26639825

  9. Cardiac status assessment with a multi-signal device for improved home-based congestive heart failure management.

    Science.gov (United States)

    Muehlsteff, Jens; Carvalho, Paulo; Henriques, Jorge; Paiva, Rui P; Reiter, Harald

    2011-01-01

    State-of-the-Art disease management for Congestive Heart Failure (CHF) patients is still based on easy-to-acquire measures such as heart rate (HR), weight and blood pressure (BP). However, these measures respond late to changes of the patient health status and provide limited information to personalize and adapt medication therapy. This paper describes our concept called "Cardiac Status Assessment" we have been investigating within the European project "HeartCycle" towards next-generation home-based disease management of CHF. In our concept we analyze non-invasive surrogate measures of the cardio-vascular function in particular systolic time intervals and pulse wave characteristics to estimate Cardiac Output (CO) and Systemic Vascular Resistance (SVR) both are established clinical measures. We discuss the underlying concept, a developed measurement system and first results. PMID:22254450

  10. Cardiac MRI and Transthoracic Echocardiography of Left Ventricular Myocardial Noncompaction in A Patient with Congestive Heart Failure: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Eui Min; Byun, Joo Nam [Chosun University Hospital College of Medicine, Gwangju (Korea, Republic of); Kim, Dong Hun [Soonchunhyang University Hospital Bucheon College of Medicine, Bucheon (Korea, Republic of)

    2010-11-15

    We report a case of a 38-year-old male presenting with new-onset dyspnea, that was diagnosed as left ventricular noncompaction by transthoracic echocardiographic and cardiac MR. The tests revealed left ventricular systolic dysfunction with prominent trabeculations associated with deep intertrabecular recesses and an enddiastolic noncompacted to compacted ratio of 2.5 in the whole apical wall and mid-ventricular anterolateral and inferolateral walls. Delayed gadolinium contrast-enhanced MRI revealed subepicardial mid-wall hyperenhancement of the midventricular anteroseptal and inferoseptal walls, which suggested myocardial fibrosis. We review the pathophysiology, clinical characteristics, and diagnostic approach of the left ventricular noncompaction associated with congestive heart failure

  11. Cardiac MRI and Transthoracic Echocardiography of Left Ventricular Myocardial Noncompaction in A Patient with Congestive Heart Failure: A Case Report

    International Nuclear Information System (INIS)

    We report a case of a 38-year-old male presenting with new-onset dyspnea, that was diagnosed as left ventricular noncompaction by transthoracic echocardiographic and cardiac MR. The tests revealed left ventricular systolic dysfunction with prominent trabeculations associated with deep intertrabecular recesses and an enddiastolic noncompacted to compacted ratio of 2.5 in the whole apical wall and mid-ventricular anterolateral and inferolateral walls. Delayed gadolinium contrast-enhanced MRI revealed subepicardial mid-wall hyperenhancement of the midventricular anteroseptal and inferoseptal walls, which suggested myocardial fibrosis. We review the pathophysiology, clinical characteristics, and diagnostic approach of the left ventricular noncompaction associated with congestive heart failure

  12. Qt dispersion has no prognostic information for patients with advanced congestive heart failure and reduced left ventricular systolic function

    DEFF Research Database (Denmark)

    Brendorp, B; Elming, H; Jun, L;

    2001-01-01

    .55), or cardiac arrhythmic mortality (risk ratio 1.00, 95% CI 0.99 to 1.01; P=0.38). CONCLUSIONS: QT dispersion has no prognostic value regarding all-cause mortality, cardiac mortality, or cardiac arrhythmic mortality for patients with advanced CHF and reduced left ventricular systolic function.......BACKGROUND: QT dispersion is a potential prognostic marker of tachyarrhythmic events and death, but it is unclear whether this applies to patients with congestive heart failure (CHF). METHODS AND RESULTS: Of the 1518 patients with advanced CHF and left ventricular dysfunction enrolled in the Danish...

  13. Combined effects of ramipril and angiotensin Ⅱ receptor blocker TCV116 on rat congestive heart failure after myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    TAO Ze-wei; HUANG Yuan-wei; XIA Qiang; XU Qi-wen

    2005-01-01

    Background Congestive heart failure (CHF) is a major cause of morbidity and mortality worldwide and angiotensin converting-enzyme inhibitor (ACEI) is the cornerstone in its treatment. However, CHF continues to progress despite this therapy, perhaps because of production of angiotensin Ⅱ (Ang Ⅱ) by alternative pathways. The present study was conducted to examine the combined effects of a chronic ACEI, ramipril, and a chronic Ang Ⅱ type 1 receptor blocker, TCV116, on rat CHF after myocardial infarction (MI). Methods Congestive heart failure was caused by MI in rats, which was induced by ligating the left anterior descending coronary artery. The experiment protocol included sham-operated rats (Sham), MI-control rats (MI-control), MI rats treated with ramipril 3 mg/kg (MI-ramipril) or TCV116 2 mg/kg (MI-TCV116) per day, half dosage (MI-1/2R&T) or full dosage (MI-R&T) combination of the two. At 22 weeks, cardiac hemodynamic parameters such as mean arterial pressure (MAP), left ventricular systolic pressure (LVSP), maximal rate of left ventricule pressure development and decline (LV dP/dtmax) and left ventricular end diastolic pressure (LVEDP), and cardiac morphometric parameters such as heart weight (HW), left ventricular weight (LVW) and left ventricular cavity area (LVCA) were measured, mRNA expressions of cardiac molecule genes such as β myosin heavy chain (βMHC), B-type natriuretic peptide (BNP), transforming growth factor-β1 (TGF-β1), collagen I and Ⅲ were quantified with reverse transcription polymerase chain reaction (RT-PCR) in the surviving septum myocardium, and survival rates were calculated. Results There were no significant differences in MI sizes (%) among each MI related experimental groups (33±13, 34±14, 33±13, 35±13 and 33±14 for MI-control, MI-ramipril, MI-TCV116, MI-1/2R&T and MI-R&T, respectively, no statistical significance for all). Compared with sham-operated rats, MI rats without therapy showed significant increases in

  14. PULMONARY ARTERIAL DISEASE ASSOCIATED WITH RIGHT-SIDED CARDIAC HYPERTROPHY AND CONGESTIVE HEART FAILURE IN ZOO MAMMALS HOUSED AT 2,100 M ABOVE SEA LEVEL.

    Science.gov (United States)

    Juan-Sallés, Carles; Martínez, Liliana Sofía; Rosas-Rosas, Arely G; Parás, Alberto; Martínez, Osvaldo; Hernández, Alejandra; Garner, Michael M

    2015-12-01

    Subacute and chronic mountain sickness of humans and the related brisket disease of cattle are characterized by right-sided congestive heart failure in individuals living at high altitudes as a result of sustained hypoxic pulmonary hypertension. Adaptations to high altitude and disease resistance vary among species, breeds, and individuals. The authors conducted a retrospective survey of right-sided cardiac hypertrophy associated with pulmonary arterial hypertrophy or arteriosclerosis in zoo mammals housed at Africam Safari (Puebla, México), which is located at 2,100 m above sea level. Seventeen animals with detailed pathology records matched the study criterion. Included were 10 maras (Dolichotis patagonum), 2 cotton-top tamarins (Saguinus oedipus oedipus), 2 capybaras (Hydrochaeris hydrochaeris), and 1 case each of Bennet's wallaby (Macropus rufogriseus), nilgai antelope (Boselaphus tragocamelus), and scimitar-horned oryx (Oryx dammah). All had right-sided cardiac hypertrophy and a variety of arterial lesions restricted to the pulmonary circulation and causing arterial thickening with narrowing of the arterial lumen. Arterial lesions most often consisted of medial hypertrophy or hyperplasia of small and medium-sized pulmonary arteries. All maras also had single or multiple elevated plaques in the pulmonary arterial trunk consisting of fibrosis, accompanied by chondroid metaplasia in some cases. Both antelopes were juvenile and died with right-sided congestive heart failure associated with severe pulmonary arterial lesions. To the authors' knowledge, this is the first description of cardiac and pulmonary arterial disease in zoo mammals housed at high altitudes. PMID:26667539

  15. Tinnitus in elderly patients and prognosis of mild-to-moderate congestive heart failure: a cross-sectional study with a long-term extension of the clinical follow-up

    Directory of Open Access Journals (Sweden)

    Cicero Arrigo FG

    2011-06-01

    Full Text Available Abstract Background The complex mechanism responsible for tinnitus, a symptom highly prevalent in elderly patients, could involve an impaired control of the microcirculation of the inner ear, particularly in patients with poor blood pressure control and impaired left ventricular (LV function. Methods In order to define the relationship between the presence of tinnitus and the severity and clinical prognosis of mild-to-moderate chronic heart failure (CHF in a large population of elderly patients (N = 958, a cross-sectional study was conducted with a long-term extension of the clinical follow-up. Blood pressure, echocardiographic parameters, brain natriuretic peptide (BNP, hospitalization, and mortality for CHF were measured. Multivariate logistic regression analysis was used to assess the association between the presence of tinnitus and some of the prognostic determinants of heart failure. Results The presence of tinnitus was ascertained in 233 patients (24.3%; mean age 74.9 ± 6 years and was associated with reduced systolic and diastolic blood pressure (123.1 ± 16/67.8 ± 9 vs 125.9 ± 15/69.7 ± 9; P = .027/P = .006, reduced LV ejection fraction (LVEF%; 43.6 ± 15 vs 47.9 ± 14%, P = .001, and increased BNP plasma levels (413.1 ± 480 vs 286.2 ± 357, P = .013 in comparison to patients without symptoms. The distribution of CHF functional class was shifted toward a greater severity of the disease in patients with tinnitus. Combined one-year mortality and hospitalization for CHF (events/year was 1.43 ± 0.2 in patients with tinnitus and 0.83 ± 0.1 in patients without tinnitus, with an adjusted hazard ratio (HR of 0.61 (95% confidence interval (CI: 0.37 to 0.93, P Conclusions Our preliminary data indirectly support the hypothesis that tinnitus is associated with a worse CHF control in elderly patients and can have some important clinical implications for the early identification of patients who deserve a more aggressive management of CHF.

  16. A multi-step standard-cell placement algorithm of optimizing timing and congestion behavior

    Institute of Scientific and Technical Information of China (English)

    侯文婷; 洪先龙; 吴为民; 蔡懿慈

    2002-01-01

    The timing behavior and congestion behavior are two important goals in the performance-driven standard-cell placement. In this paper, we analyze the relationship between the timing and congestion behavior. We bring up a multi-step placement algorithm to reach the two goals. First, the timing-driven placement algorithm is used to find the global optimal solution. In the second step, the algorithm tries to decrease the maximum congestion while not deteriorating the timing behavior. We have implemented our algorithm and tested it with real circuits. The results show that the maximum delay can decrease by 30% in our timing-driven placement and in the second step the maximum congestion will decrease by 10% while the timing behavior is unchanged.

  17. Comparison of Ventricular Electrophysiological Effects of Amiodarone in Canine Models With Congestive Heart Failure and Normal Dogs

    Institute of Scientific and Technical Information of China (English)

    Shuxian Zhou; Yuling Zhang; Juan Lei; Wei Wu; Xuming Zhang

    2008-01-01

    Objectives This study compared the effects of amiodarone on ventricular electrophysiological properties in normal dogs and CHF dogs.Methods Dogs(n=44) were randomized into four groups:Group 1(n=10)was the control.Group 2(n=10) was given amiodarone orally 300 mg·d-1 for4 to 5 weeks.Group 3(n=12)was the congestive heart failure(CHF)models induced by right ventricular rapid pacing(240 pulses·rain-1 for 4 to 5 weeks).Group 4 (n=12) was the CHF models given amiodarone orally 300 mg·d-1 for 4 to 5 weeks.The ventricular electrophysiological variables were evaluated by standard electric stimulation and monophasic action potential(MAP)recording.Results Amiodarone prolonged sinus cycle length(SCL),intra-ventricular conduction time(IVCT),MAP duration(MAPD90),ventricular effective period(VERP),ventricular activation time(VAT)and ventficular recovery time(VRT)without significant effects on the ratio of VERP to MAPD90 (VERP/MAPD90),ventricular fibrillation threshold(VFT),the dispersion of VRT(VRTD),and ventricular late repolarization duration(VLRD)in normal dogs.However,amiodarone did not further prolong the prolonged SCL,MAPD90,VERP,VAT and VRT,but further prolonged IVCT in CHF dogs.Amiodarone normalized the abnormal ventficular electrophysiological properties in CHF dogs as manifested by increasing the decreased VERP/MAPD90 and VFT,shortening the prolonged VLRD,and decreasing the increased VRTD.Amiodarone did not worsen the hemodynamic parameters in normal and CHF dogs.Conclusions Amiodarone had different effects on ventricular electrophysiological properties in normal and CHF dogs.The favorable effects of amiodarone in normalizing some abnormal cardiac electrophysiological properties in CHF models may have potential value on the prevention and treatment of ventricular arrhythmias and sudden cardiac death in CHF.

  18. Analytical Study of Pre-Congestion Notification (PCN Techniques

    Directory of Open Access Journals (Sweden)

    Marwah Almasri

    2012-08-01

    Full Text Available Maintaining the quality of service (QOS and controlling the network congestion are quite complicated tasks. They cause degrading the performance of the network, and disturbing the continuous communication process. To overcome these issues, one step towards this dilemma has been taken in form of Pre-congestion notification (PCN technique. PCN uses a packet marking technique within a PCN domain over IP networks. It is notified by egress node that works as guard at entry point of network. Egress node gives feedback to communicating servers whether rate on the link is exceeded than configured admissible threshold or within the limit. Based on this feedback, admission decisions are taken to determine whether to allow/block new coming flows or terminate already accepted. The actual question is about selection of right algorithm for PCN domain. In this paper, we investigate the analytical behavior of some known PCN algorithms. We make slide modifications in originality of PCN algorithms without disquieting working process in order to employ those within similar types of scenarios. Our goal is to simulate them either in highly congested or less congested realistic scenarios. On the basis of simulation done in ns2, we are able to recommend each PCN algorithm for specific conditions. Finally, we develop a benchmark that helps researchers and scientific communities to pick the right algorithm. Furthermore, the benchmark is designed to achieve specific objectives according to the users’ requirements without congesting the network.

  19. Losartan decreases vasopressin-mediated cAMP accumulation in the thick ascending limb of the loop of Henle in rats with congestive heart failure

    DEFF Research Database (Denmark)

    Torp, M; Brønd, L; Hadrup, N;

    2007-01-01

    INTRODUCTION: Vasopressin (AVP) stimulates sodium reabsorption and Na,K,2Cl-cotransporter (NKCC2) protein level in the thick ascending limb (TAL) of Henle's loop in rats. Rats with congestive heart failure (CHF) have increased protein level of NKCC2, which can be normalized by angiotensin II...

  20. Endocardiosis and congestive heart failure in a captive ostrich (Struthio camelus

    Directory of Open Access Journals (Sweden)

    M.A.G. Kubba

    2013-11-01

    Full Text Available A seven-year-old blue-necked male ostrich was found dead after a few days of illness. The animal was living in an open yard of 25 square meters along with three other females. They were given concentrate-rich ration with free access to green leaves and water. Autopsy revealed cardiac enlargement due to left ventricular hypertrophy and right ventricular dilatation. The left aterioventricular valves were irregularly thickened and contracted. The lungs were engorged with blood and the liver had nutmeg appearance. The small intestine showed segmental sub-serosal petechial hemorrhages. Histological examination revealed myxomatous degeneration of the left aterioventricular valves, pulmonary congestion and edema, congestion of periacinar hepatic zone and fatty degeneration of outer zones, renal glomerulosclerosis and arteriosclerosis. The affected parts of the small intestine showed villous atrophy with lacteal distention. The venules in the affected intestinal segment were severely dilated while the arterioles had narrow lumen and irregular wall thickening with hyaline deposition. The current article reports an endocardiosis in ostrich and discusses other vascular disorders.

  1. A Study of Truck Platooning Incentives Using a Congestion Game

    OpenAIRE

    Farokhi, Farhad; Karl H. Johansson

    2013-01-01

    We introduce an atomic congestion game with two types of agents, cars and trucks, to model the traffic flow on a road over various time intervals of the day. Cars maximize their utility by finding a trade-off between the time they choose to use the road, the average velocity of the flow at that time, and the dynamic congestion tax that they pay for using the road. In addition to these terms, the trucks have an incentive for using the road at the same time as their peers because they have plat...

  2. Managing Traffic Congestion-Case study of Hangzhou

    OpenAIRE

    Zhang, Wenjie

    2011-01-01

    Hangzhou is located in the east of China as one of most important cities in Yangtze River delta. With the rapid development of economy in the last three decades, Hangzhou, like many other Chinese cities, has met some challenges. Traffic congestion in Hangzhou is the one I want to talk about in this master thesis. Traffic congestion became to trouble people’s lives in the past decade, following with dramatic urbanization. People spent much more time on travel, and their quality of lives were t...

  3. The importance of organizational characteristics for improving outcomes in patients with chronic disease: a systematic review of congestive heart failure

    Directory of Open Access Journals (Sweden)

    Leykum Luci K

    2010-08-01

    Full Text Available Abstract Background Despite applications of models of care and organizational or system-level interventions to improve patient outcomes for chronic disease, consistent improvements have not been achieved. This may reflect a mismatch between the interventions and the nature of the settings in which they are attempted. The application of complex adaptive systems (CAS framework to understand clinical systems and inform efforts to improve them may lead to more successful interventions. We performed a systematic review of interventions to improve outcomes of patients with congestive heart failure (CHF to examine whether interventions consistent with CAS are more likely to be effective. We then examine differences between interventions that are most effective for improving outcomes for patients with CHF versus previously published data for type 2 diabetes to explore the potential impact of the nature of the disease on the types of interventions that are more likely to be effective. Methods We conducted a systematic review of the literature between 1998 and 2008 of organizational interventions to improve care of patients with CHF. Two independent reviewers independently assessed studies that met inclusion criteria to determine whether each reported intervention reflected one or more CAS characteristics. The effectiveness of interventions was rated as either 0 (no effect, 0.5 (mixed effect, or 1.0 (effective based on the type, number, and significance of reported outcomes. Fisher's exact test was used to examine the association between CAS characteristics and intervention effectiveness. Specific CAS characteristics associated with intervention effectiveness for CHF were contrasted with previously published data for type 2 diabetes. Results and discussion Forty-four studies describing 46 interventions met eligibility criteria. All interventions utilized at least one CAS characteristic, and 85% were either 'mixed effect' or 'effective' in terms of

  4. [11C]Acetate rest–stress protocol to assess myocardial perfusion and oxygen consumption reserve in a model of congestive heart failure in rats

    International Nuclear Information System (INIS)

    This study describes an [11C]acetate rest–stress method to obtain an indirect estimate of myocardial blood flow (MBF) and myocardial oxygen consumption (MVO2) in rats. Doxorubicin cardiotoxicity was used to test the usefulness of this approach for the assessment of congestive heart failure. Methods: [11C]Acetate rest–stress studies have been used in clinical research to assess the capacity of the coronary arteries to respond to stress. In this article, we used this approach to assess the cardiotoxicity of doxorubicin in a rat model. The method was first validated in a group of healthy rats and then used to follow the effect of doxorubicin chemotherapy on cardiac function. The effect of doxorubicin on myocardial perfusion and oxygen consumption reserve was measured at rest and under dobutamine stimulation. Results: Validation of the protocol showed a good correlation between the MBF and MVO2 (r2=.68). The doxorubicin-treated group showed a significant (P=.04) decrease in cardiovascular perfusion reserve at 1.3±0.2 compared with the control animals at 1.6±0.2. Similar results were obtained for the MVO2 reserve (treated 1.8±0.4 vs. controls 2.3±0.3; P=.02). Conclusions: We describe an [11C]acetate PET rest–stress protocol for the assessment of congestive heart failure in rats and its application to the follow-up of cardiotoxicity under doxorubicin chemotherapy. This is a rapid and reliable approach to the measurement of cardiac perfusion and oxygen consumption reserve that could be applied to the development of new strategies to reduce the cardiotoxicity of anthracycline.

  5. The effect of theophylline on sleep-disordered breathing in patients with stable chronic congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    胡克; 李清泉; 杨炯; 胡苏萍; 陈喜兰

    2003-01-01

    Objective To determine the prevalence of sleep-disordered breathing in patients with stable, optimally treated chronic congestive heart failure and the effect of short-term oral theophylline therapy on periodic breathing in these patients.Methods Patients with stable, optimally treated chronic congestive heart failure were monitored by polysomnography during nocturnal sleep. The effects of theophylline therapy on periodic breathing associated with stable heart failure were observed before and after treatment.Results Patients were divided into two groups. GroupⅠ(n=21) consisted of individuals with 15 episodes of apnea and hypopnea [as determined by the apnea-hypopnea index (AHI)] per hour or less; Group Ⅱ (n=15, 41.7%) individuals had an index of more than 15 episodes per hour. In group Ⅱ, the AHI varied from 16.8 to 78.8 (42.6±15.5) in which the obstructive AHI was 11.1±8.4 and the central AHI was 31.5±9.6. Group Ⅱ had significantly more arousals (36.8±21.3 compared with 19.4±11.2 in group Ⅰ) that were directly attributable to episodes of apnea and hypopnea, lower arterial oxyhemoglobin saturation (76.7%±4.6% compared with 86.5%±2.8%) and lower left ventricular ejection fraction (24.2%±8.8% compared with 31.5%±10.6%). Thirteen patients with compensated heart failure and periodic breathing received theophylline orally (at an average dose of 4.3 mg/kg) for five to seven days. After treatment, the mean plasma theophylline concentration was (11.3±2.5) μg/ml. Theophylline therapy resulted in significant decreases in the number of AHI (20.8±13.2 vs. 42.6±15.5; P<0.001) and the number of episodes of central apnea-hypopnea per hour (10.1±7.6 vs. 31.5±9.6; P<0.001). Furthermore, the percentage of total sleep time during which arterial oxyhemoglobin saturation (SaO2) was less than 90 percent (8.8%±8.6% vs. 23.4%±24.1%; P<0.05) and the arousals per hour (18.7±21.2 vs. 36.8±21.3; P<0.05) were also lower. There were no significant differences in the

  6. Determination of Sample Entropy and Fuzzy Measure Entropy Parameters for Distinguishing Congestive Heart Failure from Normal Sinus Rhythm Subjects

    Directory of Open Access Journals (Sweden)

    Lina Zhao

    2015-09-01

    Full Text Available Entropy provides a valuable tool for quantifying the regularity of physiological time series and provides important insights for understanding the underlying mechanisms of the cardiovascular system. Before any entropy calculation, certain common parameters need to be initialized: embedding dimension m, tolerance threshold r and time series length N. However, no specific guideline exists on how to determine the appropriate parameter values for distinguishing congestive heart failure (CHF from normal sinus rhythm (NSR subjects in clinical application. In the present study, a thorough analysis on the selection of appropriate values of m, r and N for sample entropy (SampEn and recently proposed fuzzy measure entropy (FuzzyMEn is presented for distinguishing two group subjects. 44 long-term NRS and 29 long-term CHF RR interval recordings from http://www.physionet.org were used as the non-pathological and pathological data respectively. Extreme (>2 s and abnormal heartbeat RR intervals were firstly removed from each RR recording and then the recording was segmented with a non-overlapping segment length N of 300 and 1000, respectively. SampEn and FuzzyMEn were performed for each RR segment under different parameter combinations: m of 1, 2, 3 and 4, and r of 0.10, 0.15, 0.20 and 0.25 respectively. The statistical significance between NSR and CHF groups under each combination of m, r and N was observed. The results demonstrated that the selection of m, r and N plays a critical role in determining the SampEn and FuzzyMEn outputs. Compared with SampEn, FuzzyMEn shows a better regularity when selecting the parameters m and r. In addition, FuzzyMEn shows a better relative consistency for distinguishing the two groups, that is, the results of FuzzyMEn in the NSR group were consistently lower than those in the CHF group while SampEn were not. The selections of m of 2 and 3 and r of 0.10 and 0.15 for SampEn and the selections of m of 1 and 2 whenever r (herein

  7. Computer assisted optimisation on non-pharmacological treatment of congestive heart failure and supraventricular arrhythmia

    OpenAIRE

    Reumann, Matthias

    2007-01-01

    Heart Failure is the most common cardiac disease worldwide; supraventricular arrhythmia the most common cardiac arrhythmia. The understanding of these diseases advances treatment options. Ablation therapy and atrial antitachycardial pacing are non-pharmacological options in the treatment of atrial fibrillation. Cardiac resynchronization therapy with biventricular pacing devices has been shown successful in patients with severe heart failure. However, an optimization or even individual therapy...

  8. Clinical usefulness of 123I-MIBG myocardial scintigraphy as a marker of the severity and prognosis of congestive heart failure

    International Nuclear Information System (INIS)

    To evaluate the clinical usefulness of 123I-MIBG myocardial scintigraphy in patients with congestive heart failure. Myocardial dynamic imaging was performed immediately after 123I-MIBG administration at 1 frame/sec for 500 sec in 52 patients with or without congestive heart failure. The %uptake/ROI, dynamic heart to mediastinum uptake ratio (H/M) and dynamic washout rate (WR) were calculated from their time activity curves to assess the relationship between the NYHA functional class and these values. In 52 other patients with heart failure, the initial and delayed MIBG anterior planar images were obtained, and H/M in delayed images and WR between initial and delayed images were measured. The patients were followed up for 31.8±16.8 months, and their survival rates were compared among three groups, H/M123I-MIBG myocardial scintigraphy is very useful to diagnose the severity and prognosis in patients with congestive heart failure. (K.H.)

  9. Prognostic importance of a short deceleration time in symptomatic congestive heart failure

    DEFF Research Database (Denmark)

    Akkan, Dilek; Kjaergaard, Jesper; Møller, Jacob Eifer;

    2008-01-01

    AIMS: A restrictive transmitral filling (RF) pattern predicts increased mortality in heart failure (HF) with reduced left ventricular (LV) systolic function. We performed a combined evaluation of LV function and RF for prognosis in patients with HF with and without systolic dysfunction. METHODS AND...

  10. Depressive symptoms and white blood cell count in coronary heart disease patients : Prospective findings from the Heart and Soul Study

    NARCIS (Netherlands)

    Duivis, Hester E.; Kupper, Nina; Penninx, Brenda W.; Na, Beeya; de Jonge, Peter; Whooley, Mary A.

    2013-01-01

    Background: Depression has been associated with elevated white blood cell (WBC) count - indicative of systemic inflammation - in cross-sectional studies, but no longitudinal study has evaluated whether depressive symptoms predict subsequent WBC count or vice versa. We sought to evaluate the bidirect

  11. Advances in the management of atrial fibrillation in congestive heart failure

    OpenAIRE

    Gopinathannair, Rakesh; Olshansky, Brian

    2009-01-01

    Atrial fibrillation, a common problem in patients with heart failure, is associated with increased mortality and morbidity. Pharmacological as well as invasive management and the endpoints of such management are complex. Recent randomized trials indicate that a rate-control strategy, along with anticoagulation treatment with warfarin, when appropriate, has a similar outcome in terms of mortality and morbidity as rhythm control, and could, therefore, be considered as the primary management str...

  12. Changes in absolute and relative importance in the prognostic value of left ventricular systolic function and congestive heart failure after acute myocardial infarction. TRACE Study Group. Trandolapril Cardiac Evaluation

    DEFF Research Database (Denmark)

    Køber, L; Torp-Pedersen, C; Jørgensen, S;

    1998-01-01

    echocardiography, was assessed in 6,676 consecutive patients with an enzyme-confirmed AMI. So that changes in the prognostic value of WMI or CHF could be studied, separate analyses were performed at selected time periods. Average monthly mortality (deaths per 100 patients per month) was determined from life......) but decreased within the first year to low, stable values (0.6% +/- 0.1% and 0.4% +/- 0.1%, respectively, average monthly mortality after year 3). In patients who received thrombolytic therapy, the relative risk associated with a WMI < or = 1.2 decreased from 3.0 (CI 2.0 to 4.4) to 1.3 (CI 0.9 to 1.......6) and from 3.2 (CI 2.0 to 5.1) to 1.7 (CI 1.2 to 2.4) in patients with CHF. The risk of dying decreases steeply with time after an AMI with or without LV dysfunction or CHF and stabilizes at low values after 1 year. This is in contrast to the relative importance of these risk factors, which is...

  13. Prognostic value of repeated {sup 123}I-metaiodobenzylguanidine imaging in patients with dilated cardiomyopathy with congestive heart failure before and after optimized treatments. Comparison with neurohumoral factors

    Energy Technology Data Exchange (ETDEWEB)

    Matsui, Toshiki; Tsutamoto, Takayoshi; Maeda, Keiko; Kusukawa, Junya; Kinoshita, Masahiko [Shiga Univ. of Medical Science, Otsu (Japan)

    2002-06-01

    The present study was undertaken to assess whether repeated measurement of cardiac {sup 123}I-metaiodobenzylguanidine (MIBG) imaging parameters before and after optimized treatments is useful for predicting the prognosis of patients with congestive heart failure (CHF) resulting from dilated cardiomyopathy (DCM). The subjects were 85 consecutive patients with DCM who had a left ventricular ejection fraction (LVEF) of less than 45%. The MIBG and the concentrations of neurohumoral factors were measured at baseline and after 6 months of optimized treatments. Cox proportional hazards analysis was performed to assess the various parameters before and after treatment. Twenty-three patients had a cardiac event (12 died; 11 hospitalized) during a mean follow-up period of 2 years. Although there was no difference between the baseline heart to mediastinum (H/M) ratio measured by MIBG between survivors and nonsurvivors, the H/M ratio was significantly decreased in nonsurvivors after 6 months. Multivariate analysis revealed that a high plasma concentration of brain natriuretic peptide level after 6 months (p=0.0049) and absolute changes in the H/M ratio (p=0.0046) were independent predictors of mortality. Comparison of the H/M ratio on MIBG imaging before and after optimized additional treatment provided useful information for predicting mortality and was independent of clinical and neurohumoral factors previously shown to be associated with poor prognosis in patients with DCM. (author)

  14. Prognostic value of repeated 123I-metaiodobenzylguanidine imaging in patients with dilated cardiomyopathy with congestive heart failure before and after optimized treatments. Comparison with neurohumoral factors

    International Nuclear Information System (INIS)

    The present study was undertaken to assess whether repeated measurement of cardiac 123I-metaiodobenzylguanidine (MIBG) imaging parameters before and after optimized treatments is useful for predicting the prognosis of patients with congestive heart failure (CHF) resulting from dilated cardiomyopathy (DCM). The subjects were 85 consecutive patients with DCM who had a left ventricular ejection fraction (LVEF) of less than 45%. The MIBG and the concentrations of neurohumoral factors were measured at baseline and after 6 months of optimized treatments. Cox proportional hazards analysis was performed to assess the various parameters before and after treatment. Twenty-three patients had a cardiac event (12 died; 11 hospitalized) during a mean follow-up period of 2 years. Although there was no difference between the baseline heart to mediastinum (H/M) ratio measured by MIBG between survivors and nonsurvivors, the H/M ratio was significantly decreased in nonsurvivors after 6 months. Multivariate analysis revealed that a high plasma concentration of brain natriuretic peptide level after 6 months (p=0.0049) and absolute changes in the H/M ratio (p=0.0046) were independent predictors of mortality. Comparison of the H/M ratio on MIBG imaging before and after optimized additional treatment provided useful information for predicting mortality and was independent of clinical and neurohumoral factors previously shown to be associated with poor prognosis in patients with DCM. (author)

  15. Quantitative 1H MR spectroscopy of the brain in patients with congestive heart failure before and after cardiac transplantation

    International Nuclear Information System (INIS)

    To evaluate the effects of cardiac transplantation on the brain in patients with congestive heart failure (CHF), using quantitative 1H MR spectroscopy (1H-MRS). Ten patients with CHF underwent MRI and quantitative 1H-MRS before and 1-2 and 4-9 months after cardiac transplantation. MR spectra were obtained from parietal white matter (PWM) and occipital gray matter (OGM) using PROBE (PROton Brain Exam). Changes in MR signal intensity were evaluated, and the cerebral metabolic concentrations in PWM and OGM were compared. For comparative purposes, 20 normal volunteers were included. No abnormal MR signal intensity was seen in the brain before or after cardiac transplantation. Changes in cerebral metabolic concentrations were observed on 1H-MRS; concentrations of creatine (Cr) in PWM, and of N-acetylacepartate (NAA), Cr and myo-Inositol(mI) in OGM were significantly lower before transplantation. After successful transplantation, Cr levels returned to their normal range in PWM and OGM, while a slightly increase choline (Cho) level was observed in PWM. Cerebral hypoperfusion in CHF can be evaluated using 1H-MRS. MRS may play a substantial role in monitoring the effect of cardiac transplantation

  16. CARDIAC RISK STRATIFICATION IN PATIENTS WITH CONGESTIVE HEART FAILURE: A CATECHOLAMINES-β- ADRENOCEPTOR-cAMP PATHWAY

    Institute of Scientific and Technical Information of China (English)

    Ying-xin Peng; Jiang Shan; Su-jun Zhang; Chun-li Rong; Jun-ping Li; Na Wang; Hao Xue; Shi-ling Zheng; Min Wu

    2005-01-01

    Objective To investigate the stratification risk of catecholamines-β-adrenoceptor (β-AR)-cAMP pathway for cardiogenic death events in patients with congestive heart failure (CHF).Methods A total of 83 identified CHF patients with a baseline and follow-up plasma levels of norepinephrine (NE)and epinephrine (E), lymphocytes β-AR density (Bmax), and intralymphocyte cAMP content in peripheral blood were followed up. Major cardiogenic death events were registered.Results The period between the initial entry and the last follow-up measurement were 51± 16 months, the total duration of clinical follow-up after the last measurement were 14±8 months. During follow-up, 39 patients died of cardiogenic (sudden death 17 patients, worsening heart failure 22 patients). Persistence of high NE, E, and cAMP from baseline to follow-up were confirmed as risk predicting factors of cardiovascular events. Persistence NE above 4.0 nmol/L, E above adverse prognostic predictors. The major cardiogenic death events rates per 100 patients-years were 1.33 and 4.82 in patients with NE below and above 4.0 nmol/L (HR: 2.91; 95% CI: 1.08-7.33; P = 0.015); were 1.42 and 4.36 in the patients with E levels below and above 3.5 nmol/L (HR: 2.64; 95% CI: 1.02-6.41; P = 0.019); were 1.81 and 4.67 in the 0.017), but difference was not significant between the β-AR density below and above median.Conclusions Persistent increase in circulating catecholamines and intralymphocyte cAMP content may increase the long-term mortality in CHF patients.

  17. Detection and significance of a discrete very low frequency rhythm in RR interval variability in chronic congestive heart failure.

    Science.gov (United States)

    Ponikowski, P; Chua, T P; Amadi, A A; Piepoli, M; Harrington, D; Volterrani, M; Colombo, R; Mazzuero, G; Giordano, A; Coats, A J

    1996-06-15

    Although in advanced chronic congestive heart failure (CHF) very low frequency (discrete VLF rhythm (0.019 +/- 0.008 Hz) in RR variability. The presence of VLF rhythm was not related to any difference in clinical parameters (etiology, New York Heart Association class, ejection fraction, oxygen uptake) but rather to a different pattern in RR interval and blood pressure variability: lower LF power (2.8 +/- 1.6 ms2 natural logarithm [ln]) compared either to patients without VLF (4.0 +/- 1.3 ms2 ln) or to controls (5.9 +/- 0.7 ms2 ln), higher percentage of power within VLF band (86.3 +/- 8.3% vs 77.5 +/- 7.9% and 61.5 +/- 14.1%) and a markedly impaired coherence between RR interval and systolic blood pressure variability within the LF band (0.26 +/- 0.10 vs 0.42 +/- 0.18 and 0.63 +/- 0.15, in patients with vs without VLF peak and controls, respectively). Patients with VLF had significantly increased hypoxic chemosensitivity, and hyperoxic conditions were able to decrease VLF power and abolish the VLF rhythm in 5 of 6 patients with CHF. Discrete VLF oscillations in RR variability are common in patients with advanced CHF and appear to be related to severely impaired autonomic regulation and suppression of baroreceptor function, with enhancement of hypoxic chemosensitivity. We hypothesize that this rhythm represents an enhanced chemoreflex harmonic oscillation in CHF patients, which may have application for arrhythmogenesis. PMID:8677873

  18. Effects of thyroxine on cardiac function and lymphocyte β-adrenoceptors in patients with chronic congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    卢新政; 黄峻; 张晓文; 李新华; 王赤京; 张佩生; 陈永生

    2003-01-01

    Objective To explore the effects of thyroid hormone (TH) on cardiac function and peripheral lymphocyte β-adrenoceptors (β-Ars) of patients with chronic congestive heart failure (CHF). Methods Twenty-eight patients with class Ⅲ or Ⅳ advanced CHF due to dilated cardiomyopathy (DCM) or ischemic cardiomyopathy (ICM) were randomly divided into groups A and B. L-thyroxine (L-T50) was administered to group B. Exercise tolerance, chest X-rays, and echocardiographic parameters were obtained before and after one month of treatment, Ficoll-hypaque solution was used to separate peripheral lymphocytes, and 125I-pindolol radioligand binding was used to measure β-AR levels in peripheral lymphocytes. Results L-T50 therapy improved cardiac output [CO, (2.98±0.31)L/min vs (3.24±0.28) L/min, P<0.01], left ventricular ejection fraction (LVEF, 26.21%±3.21% vs 37.93%±9.01%, P<0.01), and decreased isovolumetric relaxation time (IVRT, 0.12±0.04 vs 0.10±0.02, P<0.01). Serum TH levels and the maximal number of β-AR binding sites (βmax ) in peripheral lymphocytes were lower in patients with CHF than in normal healthy people, but L-T50 administration induced a β-AR up-regulation on peripheral lymphocyte surfaces. L-T50 was well tolerated without episodes of ischemia or arrhythmia. There was no significant change in heart rate or metabolic rate.Conclusion TH administration improves cardiac function and β-AR expression in peripheral lymphocytes of patients with CHF.

  19. Prognostic importance of a restrictive transmitral filling pattern in patients with symptomatic congestive heart failure and atrial fibrillation

    DEFF Research Database (Denmark)

    Raunsø, Jakob; Møller, Jacob Eifer; Kjaergaard, Jesper;

    2009-01-01

    BACKGROUND: Restrictive diastolic filling pattern is associated with increased mortality in patients with myocardial infarction and heart failure. Most studies have excluded patients with atrial fibrillation. The aim of the present study was to assess the prognostic value of a restrictive filling...... pattern in patients with atrial fibrillation. METHODS: Doppler echocardiography including pulsed wave Doppler assessment of transmitral flow was performed in 880 patients with a clinical diagnosis of heart failure on hospital admission. Filling was considered restrictive when the mitral deceleration time...

  20. CELL THERAPY OF HEART PATHOLOGIES

    OpenAIRE

    Lukash, L.

    2008-01-01

    The review article is devoted to cellular cardiomyoplasty as a novel technology of treatment of cardiac insufficiency. The experiments on animals and the first clinical trials have shown the possibility to improve the contractile function of diseased heart after transplantation of different types of donor cells: cardiomyocytes, bone marrow enriched by hematopoietic stem cells and mesenchymal stem cells. The problems of cellular cardiomyoplasty are discussed.

  1. Effects of perindopril on cardiac sympathetic nerve activity in patients with congestive heart failure: comparison with enalapril

    Energy Technology Data Exchange (ETDEWEB)

    Kasama, Shu; Toyama, Takuji; Suzuki, Tadashi; Kurabayashi, Masahiko [Gunma University School of Medicine, Department of Cardiovascular Medicine, Maebashi, Gunma (Japan); Kumakura, Hisao; Takayama, Yoshiaki; Ichikawa, Shuichi [Cardiovascular Hospital of Central Japan, Department of Internal Medicine, Gunma (Japan)

    2005-08-01

    The production of aldosterone in the heart is suppressed by the angiotensin-converting enzyme (ACE) inhibitor perindopril in patients with congestive heart failure (CHF). Moreover, perindopril has been reported to have more cardioprotective effects than enalapril. Forty patients with CHF [left ventricular ejection fraction (LVEF) <45%; mean 33{+-}7%] were randomly assigned to perindopril (2 mg/day; n=20) or enalapril (5 mg/day; n=20). All patients were also treated with diuretics. The delayed heart/mediastinum count (H/M) ratio, delayed total defect score (TDS) and washout rate (WR) were determined from {sup 123}I-meta-iodobenzylguanidine (MIBG) images, and plasma brain natriuretic peptide (BNP) concentrations were measured before and 6 months after treatment. The left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV) and LVEF were also determined by echocardiography. After treatment, in patients receiving perindopril, TDS decreased from 39{+-}10 to 34{+-}9 (P<0.01), H/M ratios increased from 1.62{+-}0.27 to 1.76{+-}0.29 (P<0.01), WR decreased from 50{+-}14% to 42{+-}14% (P<0.05) and plasma BNP concentrations decreased from 226{+-}155 to 141{+-}90 pg/ml (P<0.0005). In addition, the LVEDV decreased from 180{+-}30 to 161{+-}30 ml (P<0.05) and the LVESV decreased from 122{+-}35 to 105{+-}36 ml (P<0.05). Although the LVEF tended to increase, the change was not statistically significant (from 33{+-}8% to 36{+-}12%; P=NS). On the other hand, there were no significant changes in these parameters in patients receiving enalapril. Plasma BNP concentrations, {sup 123}I-MIBG scintigraphic and echocardiographic parameters improved after 6 months of perindopril treatment. These findings indicate that perindopril treatment can ameliorate the cardiac sympathetic nerve activity and the left ventricular performance in patients with CHF. (orig.)

  2. Repeated intracoronary infusion of peripheral blood stem cells with G-CSF in patients with refractory ischemic heart failure. A pilot study

    International Nuclear Information System (INIS)

    Recent investigations have suggested the clinical efficacy of granulocyte colony-stimulating factor (G-CSF) infusion alone or in combination with a single dose delivery of peripheral blood stem cells (PBSC) infusion in patients with myocardial infarction (MI) and congestive heart failure (HF). The current study tested the feasibility and effect of repeated intracoronary infusions PBSC and the mobilization of G-CSF in patients with refractory HF after MI. Patients with recent large MI and a lower left ventricular ejection fraction (LVEF) were enrolled into one of the following 3 groups: Group R (n=15) received repeated intracoronary infusion of PBSC and one-dose of G-CSF; Group S (n=15) received a single infusion of PBSC and a G-CSF dose; and Group C (n=15) received neither PBSC nor a G-CSF dose. Cardiac performance was evaluated by echocardiography and single photon-emission computed tomography (SPECT). All the patients underwent 12-month follow-up. LVEF in Group R (47.00±4.90%) was significantly higher than that in Group S (44.40±3.87%, P<0.01) and Group C (40.80±3.41%, P<0.01). Similarly, the improvement of myocardial perfusion assessed by SPECT in Group R was more than that in Group S (P=0.012) and Group C (P<0.01). Neither death nor new MI occurred. Repeated intracoronary infusions of PBSC plus mobilization of G-CSF might be an optional effective strategy for treating patients with refractory HF after recent large MI. (author)

  3. Stem cells in the heart: What’s the buzz all about? Part 2: Arrhythmic risks and clinical studies

    OpenAIRE

    Smith, Rachel Ruckdeschel; Barile, Lucio; Messina, Elisa; Marbán, Eduardo

    2008-01-01

    New approaches for cardiac repair have been enabled by the discovery that the heart contains its own reservoir of stem cells. In Part 1 of this review, we discussed various cardiac stem cell populations, reviewed our own work on cardiosphere-derived cells from human hearts, and outlined large animal preclinical models testing the regenerative potential of cardiac stem cells. Here we continue with a discussion on other adult stem cell sources with clinical potential. We summarize the critical ...

  4. Plasma semicarbazide-sensitive amine oxidase is elevated in patients with congestive heart failure

    NARCIS (Netherlands)

    Boomsma, F; vanVeldhuisen, DJ; deKam, PJ; ManintVeld, AJ; Mosterd, A; Lie, KI; Schalekamp, MADH

    1997-01-01

    Objective: Semicarbazide-sensitive amine oxidase (SSAO) is present in various mammalian tissues, especially in vascular smooth muscle cells, but also in plasma. The enzyme has been suggested to play a role in vascular endothelial damage through conversion of amines into cytotoxic aldehydes, ammonia

  5. Novel application of multi dynamic trend analysis as a sensitive tool for detecting the effects of aging and congestive heart failure on heart rate variability

    Science.gov (United States)

    Lin, Yu-Cheng; Lin, Yu-Hsuan; Lo, Men-Tzung; Peng, Chung-Kang; Huang, Norden E.; Yang, Cheryl C. H.; Kuo, Terry B. J.

    2016-02-01

    The complex fluctuations in heart rate variability (HRV) reflect cardiac autonomic modulation and are an indicator of congestive heart failure (CHF). This paper proposes a novel nonlinear approach to HRV investigation, the multi dynamic trend analysis (MDTA) method, based on the empirical mode decomposition algorithm of the Hilbert-Huang transform combined with a variable-sized sliding-window method. Electrocardiographic signal data obtained from the PhysioNet database were used. These data were from subjects with CHF (mean age = 59.4 ± 8.4), an age-matched elderly healthy control group (59.3 ± 10.6), and a healthy young group (30.3 ± 4.8); the HRVs of these subjects were processed using the MDTA method, time domain analysis, and frequency domain analysis. Among all HRV parameters, the MDTA absolute value slope (MDTS) and MDTA deviation (MDTD) exhibited the greatest area under the curve (AUC) of the receiver operating characteristics in distinguishing between the CHF group and the healthy controls (AUC = 1.000) and between the healthy elderly subject group and the young subject group (AUC = 0.834 ± 0.067 for MDTS; 0.837 ± 0.066 for MDTD). The CHF subjects presented with lower MDTA indices than those of the healthy elderly subject group. Furthermore, the healthy elderly subjects exhibited lower MDTA indices than those of the young controls. The MDTA method can adaptively and automatically identify the intrinsic fluctuation on variable temporal and spatial scales when investigating complex fluctuations in the cardiac autonomic regulation effects of aging and CHF.

  6. Effects of Long-term Ramipril on Ventricular Remodeling, Cardiac Function and Survival in Rat Congestive Heart Failure after Myocardial Infarction

    Institute of Scientific and Technical Information of China (English)

    陶则伟; 黄元伟

    2004-01-01

    Objectives The purpose of this study was to investigate the effects of long-term ramipril on ventricular remodeling, cardiac function and survival in rat congestive heart failure after myocardial infarction. Methods Myocardial infarction (MI) was caused by ligation of the left anterior descending coronary artery in rats. 7 days after the surgery, the surviving rats were randomly assigned to the following treatment protocols: 1) MI rats with no therapy, 2) MI rats treated with ramipril 3 mg/kg per day, 3) Sham-operated control rats, and 4) Sham-operated rats treated with ramipril 3 mg/kg per day. At 22 weeks, cardiac hemodynamic parameters such as MAP, LVSP, ±dP/dtmax and LVEDP were measured,and cardiac morphometric parameters such as HW,LVW and LVCA were measured, mRNA of cardiacmolecule genes, such as βMHC, BNP, collagen Ⅰ and Ⅲ, and TGF-β1, were quantified, and survival rates were calculated. Results Compared with sham-operated rats, MI rats without therapy showed significant increases in cardiac morphological parameters as well as in mRAN expressions of cardiac molecule genes (P<0.01); while their hemodynamic parameters were significantly impaired (P<0.01), and survival rate shortened (P<0.05). Compared with MI rats with no therapy, MI rats treated with ramipril showed significant attenuation of mRAN expressions of cardiac molecule genes (P<0.01); while their hemodynamic parameters were significantly impaired (P<0.01), and survival rate shortened (P<0.05). Compared with MI rats with no therapy, MI rats treated with ramipril showed significant attenuation of mRAN expressions of cardiac molecule genes (P<0.01); while their hemodynamic parameters were significantly improved (P<0.05 or P<0.01), and survival rates prolonged (P<0.05). Conclusions Treatment with long-term ramipril may improve LV remodeling, cardiac function and survival in rat congestive heart failure after MI.

  7. New Results in Magnitude and Sign Correlations in Heartbeat Fluctuations for Healthy Persons and Congestive Heart Failure (CHF) Patients

    Science.gov (United States)

    Diosdado, A. Muñoz; Cruz, H. Reyes; Hernández, D. Bueno; Coyt, G. Gálvez; González, J. Arellanes

    2008-08-01

    Heartbeat fluctuations exhibit temporal structure with fractal and nonlinear features that reflect changes in the neuroautonomic control. In this work we have used the detrended fluctuation analysis (DFA) to analyze heartbeat (RR) intervals of 54 healthy subjects and 40 patients with congestive heart failure during 24 hours; we separate time series for sleep and wake phases. We observe long-range correlations in time series of healthy persons and CHF patients. However, the correlations for CHF patients are weaker than the correlations for healthy persons; this fact has been reported by Ashkenazy et al. [1] but with a smaller group of subjects. In time series of CHF patients there is a crossover, it means that the correlations for high and low frequencies are different, but in time series of healthy persons there are not crossovers even if they are sleeping. These crossovers are more pronounced for CHF patients in the sleep phase. We decompose the heartbeat interval time series into magnitude and sign series, we know that these kinds of signals can exhibit different time organization for the magnitude and sign and the magnitude series relates to nonlinear properties of the original time series, while the sign series relates to the linear properties. Magnitude series are long-range correlated, while the sign series are anticorrelated. Newly, the correlations for healthy persons are different that the correlations for CHF patients both for magnitude and sign time series. In the paper of Ashkenazy et al. they proposed the empirical relation: αsign≈1/2(αoriginal+αmagnitude) for the short-range regime (high frequencies), however, we have found a different relation that in our calculations is valid for short and long-range regime: αsign≈1/4(αoriginal+αmagnitude).

  8. 培哚普利和依那普利治疗心力衰竭首剂低血压反应差异的临床研究%Differences in first dose response to perindopril or enalapril in congestive heart failure: a randomized controlled study

    Institute of Scientific and Technical Information of China (English)

    林曙光; 陈鲁原; 苏诚坚; 曾昭华; 李广镰; 曾冲; 王景峰; 谭桂明; 梅克治; 韦建瑞; 陆东风; 李国强

    2001-01-01

    Objective To test the hypothesis that not all angiotensin converting enzyme inhibitors produce first dose hypotension when they are initiated. Methods A multi-center, randomized, open, drugs controlled parallel study was conducted. Two hundred and eighty-one selected patients with chronic congestive heart failure (NYHA class II-IV ) were randomized to receive a first dose of perindopril 2 mg (n=144) or enalapril 2.5 mg (n=137). Blood pressure was measured at baseline, every half an hour during the first 10-hour period after drug treatment and recorded by ambulatory blood pressure monitor. Results The two groups of patients were similar in age, severity of heart failure, left ventricular ejection fraction value and mean arterial pressure. After administration of drugs, enalapril caused falls of mean arterial pressure at 1-4h, 5.5h and 8-10h period (P0.05). There were no significant changes in mean systolic and diastolic blood pressure before and after treatment in both groups. Conclusion Perindopril seems to be safe and not likely to result in first dose hypotension following its initiation.%目的检验关于“并非所有血管紧张素转换酶抑制剂在开始应用时均引起低血压反应”的假设。方法多中心的随机开放药物平行对照试验。281例经选择的充血性心力衰竭患者(NYHAⅡ~Ⅳ级)随机接受首剂培哚普利2 mg(n=144)或依那普利2.5 mg(n=137)。基线时,服药后10 h内每0.5 h测血压1次。血压由动态血压监测仪记录。结果平均动脉压的最大下降值分别为:培哚普利组(1.37±1.09) mm Hg(1 mm Hg=0.133 kPa),依那普利组(4.65±1.58) mm Hg,两组相比差异有极显著性(P<0.000 1)。整个观察期间,舒张压下降>10 mm Hg者分别为:依那普利组10例(7.3%),培哚普利组6例(4.2%),两组间比较,差异无显著性。未见症状性低血压反应。结论培哚普利在首次用于充血性心力衰竭的治疗时

  9. Cardiovascular and neurohumoral postural responses and baroreceptor abnormalities during a course of adjunctive vasodilator therapy with felodipine for congestive heart failure.

    Science.gov (United States)

    Kassis, E; Amtorp, O

    1987-06-01

    Studies in patients with congestive heart failure (CHF) have demonstrated an abnormal beta-adrenergic reflex vasodilation during orthostatic tilt. Baroreflex modulation of vascular resistance in patients with CHF was investigated during therapy with a vasoselective calcium antagonist, felodipine. Eight patients on conventional therapy for severe CHF were studied after a 3 week course of additional felodipine or placebo treatment under randomized, double-blind, and crossover conditions. Forearm subcutaneous vascular resistance (FSVR) was estimated with use of the local 133Xe washout. Aortic pulsatile stretch, expressed as the systolic distension in percent of diastolic diameter, was calculated from echocardiographic measurements of aortic root diameters. At 3 weeks, felodipine reduced the arterial pressure, systemic vascular resistance, and FSVR, preserved cardiac filling pressures and heart rate, and increased cardiac output, stroke volume, and aortic pulsatile stretch. Upright tilt (45 degrees) was used to study baroreflex-mediated cardiovascular responses. The unloading of cardiopulmonary baroreceptors during upright tilt was substantial and about equal during both treatment courses, but the pulse pressure was maintained during the placebo and decreased during the felodipine period. During tilt, the patients on placebo failed to increase heart rate and their FSVR, systemic vascular resistance, and arterial mean pressure were decreased, whereas during tilt after felodipine, heart rate and systemic vascular resistance increased to maintain arterial mean pressure and FSVR also tended to increase. Both the stroke volume and aortic pulsatile stretch increased during tilt in patients on placebo but they decreased in those on felodipine. The tilt caused increments in circulating norepinephrine and epinephrine levels during both treatment regimens. Regulation of FSVR during the sympathetic stimulation of orthostatic stress was further elucidated. Proximal neural blockade

  10. Common Traffic Congestion Features studied in USA, UK, and Germany employing Kerner's Three-Phase Traffic Theory

    OpenAIRE

    Rehborn, H.; Klenov, S. L.; Palmer, J

    2010-01-01

    Based on a study of real traffic data measured on American, UK and German freeways common features of traffic congestion relevant for many transportation engineering applications are revealed by the application of Kerner's three-phase traffic theory. General features of traffic congestion, i.e., features of traffic breakdown and of the further development of congested regions, are shown on freeways in the USA and UK beyond the previously known German examples. A general proof of the theory's ...

  11. Individual Tradable Permit Market And Traffic Congestion: An Experimental Study

    Directory of Open Access Journals (Sweden)

    Kean Siang Ch’ng

    2012-01-01

    Full Text Available The increasing vehicular traffic and the consequent over-consumption have emerged as the results of rapid motorization and urbanization throughout the world. Variety of measures have been attempted to deal with the vehicular problems. This paper was intended to investigate the potential of an individual tradable permit system in an experimental two-sided repeated double auction market to overcome over-consumption through road demand management. The auction began with the local authority distributing access rights to the vehicular owners. The owners could either use up the permit or to purchase permit from the open market. The latter allowed usage beyond the owner’s quota. The system showed that traders exhibited strong dependence on reservation price and there were significant transfers of permit from low-value users to high-value users: low-value owners sold access rights to high-value owners. Consequently, in the peak hours, the permit price increased owing to high demand, so the cost of using the road was high during congestion. This created incentive for low-value drivers to postpone their trips and resold permits in the peak hours to gain profit. The results showed the delayer pays principle, in which drivers who valued highly had to pay drivers who were willing to stay off the road during peak hours.

  12. Relationship Between Prohormone Brain Natriuretic Peptide (NT-proBNP Level and Severity of Pulmonary Dysfunction in Patients With Chronic Congestive Heart Failure

    Directory of Open Access Journals (Sweden)

    Nazemiyeh Masoud

    2015-03-01

    Full Text Available Introduction: Congestive heart failure (CHF is a common disease and its prevalence is increasingin industrialized countries. NT-proBNP measurement is an established diagnostic test fordiagnosis of CHF in patients who present to emergency room with acute dyspnea. The primaryobject of this study was to determine the relationship between levels of brain natriuretic peptideprecursor and severity of lung function impairment in patients with chronic CHF.Methods: This cross-sectional and analytical study that performed in Tuberculosis andLung Disease Research Center of Tabriz University of Medical Sciences on 95 patients withchronic heart failure, and relation between NT-proBNP levels and pulmonary functionparameters were examined.Results: Sixty-four patients were male and 31 were female. The average age of male and femaleswas 62.90 ± 11.54 and 61.61 ± 11.98 years, respectively. A significant inverse linear correlationwas found between NT-proBNP and FEV1 (P<0.001, r = -0.367, FVC (P<0.001, r = -0.444,TLC (P=0.022, r = -0.238, maximal midexpiratory flow (MMEF (P=0.047, r = -0.207 andleft ventricular ejection fraction (LVEF (P<0.001, r = -0.461. A significant positive linearcorrelation was found between NT-proBNP and FEV1/FVC (P =0.013, r = 0.257, RV/TLC (P =0.003, r=0.303 and 5 Hz Raw (r = 0.231, P = 0.024.Conclusion: This study showed that, both restrictive and obstructive ventilator impairments canoccur in chronic CHF and as NT-proBNP increases appropriate to hemodynamic deterioration,pulmonary dysfunction increases.

  13. Progenitor cells from the heart : in vitro study of CMPC and EPDC behavior

    OpenAIRE

    van Oorschot, A.A.M.

    2011-01-01

    Cardiovascular disorders are currently the leading cause of death in the Western world. Myocardial infarction (MI) is one of the main contributors to ischemic heart disease. After ischemia, cardiomyocytes die and are replaced by fibrous scar tissue while in the remaining cardiomyocytes hypertrophy is induced. This leads to a declined heart function and will result in death due to heart failure. Without taking heart transplantation into consideration, the current therapies to treat patients af...

  14. New auxiliary indicators for the differential diagnosis of functional cardiorespiratory limitation in patients with chronic obstructive pulmonary disease and congestive heart failure

    Directory of Open Access Journals (Sweden)

    Cesar Marcelo de Castro

    2003-01-01

    Full Text Available OBJECTIVE: To differentiate the nature of functional cardiorespiratory limitations during exercise in individuals with chronic obstructive pulmonary disease (COPD or congestive heart failure (CHF and to determine indicators that may help their classifications. METHODS: The study comprised 40 patients: 23 with COPD and 17 with CHF. All individuals underwent maximal cardiopulmonary exercise testing on a treadmill. RESULTS: The values of peak gas exchange ratio (R peak, peak carbon dioxide production (VCO2 peak, and peak oxygen ventilatory equivalent (V E O2 peak were higher in the patients with CHF than in those with COPD, and, therefore, those were the variables that characterized the differences between the groups. For group classification, the differentiating functions with the R peak, VCO2 peak (L/min, and V E O2 peak variables were used as follows: group COPD: - 44.886 + 78.832 x R peak + 5.442 x VCO2 peak + 0.336 x V E O2 peak; group CHF: - 69.251 + 89.740 x R peak + 8.461 x VCO2 peak + 0.574 x V E O2 peak. The differentiating function, whose result is greater, correctly classifies the patient's group as 90%. CONCLUSION: The R peak, VCO2 peak, and V E O2 peak values may be used to identify the cause of the functional cardiorespiratory limitations in patients with COPD and CHF.

  15. Comparison of the Frequency-dependent Effects of Amiodarone on Ventricular Electrophysiology in Congestive Heart Failure Canine Models and Normal Dogs

    Institute of Scientific and Technical Information of China (English)

    Zhou Shuxian; Zhang Yuling; Lei Juan; Wu Wei; Zhang Xuming

    2007-01-01

    Objectives To compare the frequency-dependent effects of amiodarone (Ami) on ventricular electrophysiology in right ventricular rapid pacing-induced congestive heart failure (CHF) canine models.Methods Thirty-two dogs were randomized into four groups: the control group, the Ami group in which the normal dogs were given Ami orally 300 mg a day for 4~5 weeks, the CHF group induced by right ventricular rapid pacing ( 240 pulses. min -1 for 4 ~ 5 weeks), and the group of CHF dogs fed with Ami orally 300 mg a day for 4 ~ 5 weeks. The techniques of electrical stimulation and monophasic action potential (MAP) recording were used in the electrophysiology studies. Results The effects of Ami on ventricular MAP duration(MAPD90) and effective refractory period (VERP)were not frequency-dependent in CHF dogs. There was also no frequency-dependent effect on the increase in the ratio of VERP to MAPD90 (VERP/MAPD90). The prolongation of ventricular conduction time was frequencydependent. Conclusions The frequency-dependent effects of Ami on ventricular electrophysiology in CHF dogs were similar to that in normal dogs.

  16. Stem cell therapy to treat heart ischaemia

    DEFF Research Database (Denmark)

    Qayyum, Abbas Ali; Mathiasen, Anders Bruun; Kastrup, Jens

    2014-01-01

    (CABG), morbidity and mortality is still high in patients with CAD. Along with PCI and CABG or in patients without options for revascularization, stem cell regenerative therapy in controlled trials is a possibility. Stem cells are believed to exert their actions by angiogenesis and regeneration of...... cardiomyocytes. Recently published clinical trials and meta-analysis of stem cell studies have shown encouraging results with increased left ventricle ejection fraction and reduced symptoms in patients with CAD and heart failure. There is some evidence of mesenchymal stem cell being more effective compared to...... other cell types and cell therapy may be more effective in patients with known diabetes mellitus. However, further investigations are warranted....

  17. Histopathological studies of the heart in three lines of broiler chickens.

    Science.gov (United States)

    Gesek, M; Otrocka-DomagaŁa, I; SokóŁ, R; PaŹdzior-Czapula, K; Lambert, B D; WiŚniewska, A M; Żechowicz, M; Mikiewicz, M; Korzeniowska, P

    2016-04-01

    The aim of this study was to analyse the morphological lesion pattern of the heart of broiler chickens (Cobb 500, Hubbard F15 and Ross 308) during fattening with no clinical signs of disease and to determine the most susceptible period for the occurrence of morphological lesions. The most frequently diagnosed lesions in each genetic line were degeneration of the fibres with vacuolation, congestion of cardiac muscle, oedema and vacuolisation of the Purkinje cells. The highest numbers of morphological lesions were observed on d 38, 31 and 10 of life. The lesions were most numerous in the septum, followed by the left and right ventricles. Ischaemic cardiomyocytes were also most numerous on d 38 of life and in the left ventricle. Overload of cardiac muscle, prolonged hypoxia and increasing body weight on d 38 are the likely reasons for the largest number of lesions and ischaemic fibres, which may lead to heart failure. PMID:26955858

  18. Primary culture of avian embryonic heart forming region cells to study the regulation of vertebrate early heart morphogenesis by vitamin A

    OpenAIRE

    Cakstina, Ieva; Riekstina, Una; Boroduskis, Martins; Nakurte, Ilva; Ancans, Janis; Zile, Maija H; Muiznieks, Indrikis

    2014-01-01

    Background Important knowledge about the role of vitamin A in vertebrate heart development has been obtained using the vitamin A-deficient avian in ovo model which enables the in vivo examination of very early stages of vertebrate heart morphogenesis. These studies have revealed the critical role of the vitamin A-active form, retinoic acid (RA) in the regulation of several developmental genes, including the important growth regulatory factor, transforming growth factor-beta2 (TGFβ2), involved...

  19. The change of cerebral blood flow after heart transplantation in congestive heart failure: a voxel-based and automatic VOl analysis of Tc-99m ECD SPECT

    International Nuclear Information System (INIS)

    To investigate the change of global and regional cerebral blood flow after heart transplantation (HT) in congestive heart failure (CHF) patients. Twenty-one patients with CHF who underwent HT (45±12 yrs, M/F=19/2) and 10 healthy volunteers (39±13 yrs, M/F = 7/3) were prospectively included. All patients underwent echocardiography and radionuclide angiography including brain and aorta with brain SPECT which was performed after iv bolus injection of Tc-99m ECD (740MBq) before (175±253 days) and after (129±82 days) HT. Patients were divided into two groups according to the interval between HT and postoperative SPECT [early follow-up (f/u): 6 mo, n=7]. Global CBF (gCBF) of bilateral hemispheres were calculated by Patlak graphical analysis. Absolute rCBF map was obtained from brain SPECT by Lassen's correction algorithm. Age-corrected voxel-based analysis using SPM2 and automatic VOl analysis were performed to assess the rCBF change. Cardiac ejection fraction of all patients improved after HT (20.8%→64.0%). gCBF was reduced compared to normal before HT (35.7±3.9 vs. 49.1±3.0 ml/100g/min; p<0.001) and improved postoperatively (46.6±5.4, p<0.001). The preoperative gCBFs of early and late f/u group were not different (34.6±3.2 vs. 38.0±4.4, p=0.149) but postoperative gCBF (43.9±3.7) of late f/u group was higher than those (52.0±4.0) of early f/u group (p<0.001). On voxel-based analysis, preoperative rCBF was reduced in entire brain but most severely in bilateral superior and inferior frontal cortex, supplementary motor area, precuneus and anterior cingulum, compared to normals (uncorrected p<0.001). After HT, rCBF of these areas improved more significantly in late f/u group than in early f/u group but still lower than normals. Global CBF was significantly reduced in CHF patients and improved after HT. rCBFs of the frontal cortex, precuneus and cingulum were most severely reduced and slowly improved after HT compared to other brain regions

  20. The change of cerebral blood flow after heart transplantation in congestive heart failure: a voxel-based and automatic VOl analysis of Tc-99m ECD SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Hong, I. K.; Kim, J. J.; Lee, C. H.; Lim, K. C.; Moon, D. H.; Rhu, J. S.; Kim, J. S. [Asan Medical Center, Seoul (Korea, Republic of)

    2007-07-01

    To investigate the change of global and regional cerebral blood flow after heart transplantation (HT) in congestive heart failure (CHF) patients. Twenty-one patients with CHF who underwent HT (45{+-}12 yrs, M/F=19/2) and 10 healthy volunteers (39{+-}13 yrs, M/F = 7/3) were prospectively included. All patients underwent echocardiography and radionuclide angiography including brain and aorta with brain SPECT which was performed after iv bolus injection of Tc-99m ECD (740MBq) before (175{+-}253 days) and after (129{+-}82 days) HT. Patients were divided into two groups according to the interval between HT and postoperative SPECT [early follow-up (f/u): <6 mo, n=14; late f/u: >6 mo, n=7]. Global CBF (gCBF) of bilateral hemispheres were calculated by Patlak graphical analysis. Absolute rCBF map was obtained from brain SPECT by Lassen's correction algorithm. Age-corrected voxel-based analysis using SPM2 and automatic VOl analysis were performed to assess the rCBF change. Cardiac ejection fraction of all patients improved after HT (20.8%{yields}64.0%). gCBF was reduced compared to normal before HT (35.7{+-}3.9 vs. 49.1{+-}3.0 ml/100g/min; p<0.001) and improved postoperatively (46.6{+-}5.4, p<0.001). The preoperative gCBFs of early and late f/u group were not different (34.6{+-}3.2 vs. 38.0{+-}4.4, p=0.149) but postoperative gCBF (43.9{+-}3.7) of late f/u group was higher than those (52.0{+-}4.0) of early f/u group (p<0.001). On voxel-based analysis, preoperative rCBF was reduced in entire brain but most severely in bilateral superior and inferior frontal cortex, supplementary motor area, precuneus and anterior cingulum, compared to normals (uncorrected p<0.001). After HT, rCBF of these areas improved more significantly in late f/u group than in early f/u group but still lower than normals. Global CBF was significantly reduced in CHF patients and improved after HT. rCBFs of the frontal cortex, precuneus and cingulum were most severely reduced and slowly improved after

  1. The analysis of CT and 3D-VRCT images in highly elderly patients with congestive heart failure/pulmonary edema

    International Nuclear Information System (INIS)

    In 20 elderly patients with congestive heart failure, the pulmonary/mediastinal findings of MPR images with 3D volume rendering (VR) CT were reviewed. Diffuse ground-glass areas and/or consolidation were observed along the bronchovascular bundle and dorsal dependent areas. Vascular enlargement of pulmonary vessels and interlobular septal thickenings were also observed The increased attenuation with a gravitaional anteroposterior (ventrodorsal) gradient was more apparent on sagittal reconstructed image than conventional axial images. 3DVR CT can demonstrate the inter-and intralobular septal lines predominating not only in the anterior portions of the middle and lingular lobe, but also the apical and lung base areas. (author)

  2. Effect of ketanserin on hemodynamics, plasma-catecholamine concentrations, and serotonin uptake by platelets in volunteers and patients with congestive heart failure

    OpenAIRE

    Grobecker, H; Gessler, I.; Delius, W.; Dominiak, P; Kees, Frieder K.

    1985-01-01

    Ketanserin, which preferentially blocks 5-HT2-serotonergic receptors, was injected intravenously (i.v.) to patients with congestive heart failure in a bolus dose of 10 mg, followed by an i.v. infusion of 3 mg/h over a period of 4 h. The drug caused a decrease in total peripheral resistance and, conversely, an increase in stroke volume. Right atrial and pulmonary artery pressures were decreased. Plasma noradrenaline rose twofold over the basal levels shortly after injection, but showed a disti...

  3. How many probe vehicles are enough for identifying traffic congestion?—a study from a streaming data perspective

    Science.gov (United States)

    Wang, Handong; Yue, Yang; Li, Qingquan

    2013-03-01

    Many studies have been carried out using vehicle trajectory to analyze traffic conditions, for instance, identifying traffic congestion. However, there is a lack of a systematic study on the appropriate number of probe vehicles and their sampling interval in order to identify traffic congestion accurately. Moreover, most of related studies ignore the streaming feature of trajectory data. This paper first represents a novel method of identifying traffic congestion considering the stream feature of vehicle trajectories. Instead of processing the whole data stream, a series of snapshots are extracted. Congested road segments can be identified by analyzing the clusters' evolution among a series of adjacent snapshots. We then calculated a series of parameters and their corresponding congestion identification accuracy. The results have implications for related probe vehicle deployment and traffic analysis; for example, when 5% of probe vehicles are available, 85% identification accuracy can be reached if the sampling time interval is 10 s.

  4. Stem cell markers in the heart of the human newborn

    OpenAIRE

    Armando Faa; Elvira Podda; Vassilios Fanos

    2016-01-01

    The identification of cardiac progenitor cells in mammals raises the possibility that the human heart contains a population of stem cells capable of generating cardiomyocytes and coronary vessels. Several recent studies now show that the different cell types that characterize the adult human heart arise from a common ancestor. Human cardiac stem cells differentiate into cardiomyocytes, and, in lesser extent, into smooth muscle and endothelial cells. The characterization of human cardiac stem ...

  5. Pathophysiology of nasal congestion

    Directory of Open Access Journals (Sweden)

    Robert M Naclerio

    2010-02-01

    Full Text Available Robert M Naclerio1, Claus Bachert2, James N Baraniuk31University of Chicago, Department of Surgery, Section of Otolaryngology – Head and Neck Surgery, Chicago, Illinois, USA; 2University of Ghent, Ghent, Belgium; 3Georgetown University, Washington, DC, USAAbstract: Nasal congestion is a common symptom in rhinitis (both allergic and nonallergic, rhinosinusitis and nasal polyposis. Congestion can also be caused by physical obstruction of nasal passages and/or modulation of sensory perception. Mucosal inflammation underlies many of the specific and interrelated factors that contribute to nasal congestion, as well as other symptoms of both allergic rhinitis and rhinosinusitis. A wide range of biologically active agents (eg, histamine, tumor necrosis factor-α, interleukins, cell adhesion molecules and cell types contribute to inflammation, which can manifest as venous engorgement, increased nasal secretions and tissue swelling/edema, ultimately leading to impaired airflow and the sensation of nasal congestion. Inflammation-induced changes in the properties of sensory afferents (eg, expression of peptides and receptors that innervate the nose can also contribute to altered sensory perception, which may result in a subjective feeling of congestion. Increased understanding of the mechanisms underlying inflammation can facilitate improved treatment selection and the development of new therapies for congestion.Keywords: allergic rhinitis, congestion, obstruction, pathophysiology, rhinosinusitis

  6. Progenitor cells from the heart : in vitro study of CMPC and EPDC behavior

    NARCIS (Netherlands)

    van Oorschot, A.A.M.

    2011-01-01

    Cardiovascular disorders are currently the leading cause of death in the Western world. Myocardial infarction (MI) is one of the main contributors to ischemic heart disease. After ischemia, cardiomyocytes die and are replaced by fibrous scar tissue while in the remaining cardiomyocytes hypertrophy i

  7. Tumour necrosis factor alpha in severe congestive cardiac failure.

    OpenAIRE

    Dutka, D P; Elborn, J. S.; Delamere, F.; Shale, D. J.; Morris, G K

    1993-01-01

    OBJECTIVE--To examine the concentration of circulating tumour necrosis factor alpha (TNF alpha) in patients with severe congestive heart failure (New York Heart Association class IV) during one year and to correlate changes in this cytokine with changes in plasma noradrenaline, plasma renin activity, and weight. DESIGN--A prospective study of the role of TNF alpha in severe chronic heart failure. Blood samples were collected at intervals of three months. SETTING--Medical research centre of a ...

  8. Congestive Hepatomegaly

    Science.gov (United States)

    ... 2 Diabetes, Heart Disease a Dangerous Combo Are 'Workaholics' Prone to OCD, Anxiety? ALL NEWS > Resources First ... liver, resulting from heart failure. Severe heart failure causes blood to back up from the heart into ...

  9. Percentage of peak-to-peak pulsatility of portal blood flow can predict right-sided congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    Jui-Ting Hu; Sien-Sing Yang; Yun-Chih Lai; Cheng-Yen Shih; Cheng-Wen Chang

    2003-01-01

    AIM: To study the change of portal blood flow for the prediction of the status of right-sided heart failure by using non-invasive way.METHODS: We studied 20 patients with rheumatic and atherosclerotic heart diseases. All the patients had constant systemic blood pressure and body weight 1 week prior to the study. Cardiac index (CI), left ventricular end-diastolic pressure (LVEDP), mean aortic pressure (AOP), pulmonary wedge pressure (PWP), mean pulmonary arterial pressure (PAP), mean right atrial pressure (RAP), right ventricular end-diastolic pressure (RVEDP) were recorded during cardiac catheterization. Ten patients with RAP<10 mmHg were classified as Group 1. The remaining 10 patients with RAP ≥ 10 mmHg were classified as Group 2. Portal blood velocity profiles were studied using an ultrasonic Doppler within 12h after cardiac catheterization.RESULTS: CI, AOP, and LVEDP had no difference between two groups. Patients in Group 1 had normal PWP (14.6±7.3mmHg), PAP (25.0±8.2 mmHg), RAP (4.7±2.4 mmHg), and RVEDP (6.4±2.7 mmHg). Patients in Group 2 had increased PWP (29.9±9.3 mmHg), PAP (46.3±13.2 mmHg), RAP (17.5±5.7 mmHg), and RVEDP (18.3±5.6 mmHg) (P<0.001).Mean values of maximum portal blood velocity (Vmax), mean portal blood velocity (Vmean), cross-sectional area (Area)and portal blood flow volume (PBF) had no difference between 2 groups. All the patients in Group 1 had a continuous antegrade portal flow with a mean percentage of peak-topeak pulsatility (PP) 27.0±8.9 % (range: 17-40 %). All the patients in Group 2 had pulsatile portal flow with a mean PP 86.6±45.6 (range: 43-194 %). One patient had a transient stagnant and three patients had a transient hepatofugal portal flow, which occurred mainly during the ventricular systole. Vmax, Vmean and PBF had a positive correlation with CO (P<0.001) but not with AOP, LVEDP, PWP, PAP,RAP, and RVEDP.PP showed a good correlation (P<0.001)with PWP, PAP, RAP, and RVEDP but not with CI, AOP, and LVEDP. All

  10. Assessment of vasodilator therapy in patients with severe congestive heart failure: limitations of measurements of left ventricular ejection fraction and volumes

    International Nuclear Information System (INIS)

    Although noninvasive techniques are often used to assess the effect of vasodilator therapy in patients with congestive heart failure, it is unknown whether changes in noninvasively determined left ventricular ejection fraction, volume, or dimension reliably reflect alterations in intracardiac pressure and flow. Accordingly, we compared the acute effect of sodium nitroprusside on left ventricular volume and ejection fraction (determined scintigraphically) with its effect on intracardiac pressure and forward cardiac index (determined by thermodilution) in 12 patients with severe, chronic congestive heart failure and a markedly dilated left ventricle. Nitroprusside (infused at 1.3 +/- 1.1 [mean +/- standard deviation] microgram/kg/min) caused a decrease in mean systemic arterial, mean pulmonary arterial, and mean pulmonary capillary wedge pressure as well as a concomitant increase in forward cardiac index. Simultaneously, left ventricular end-diastolic and end-systolic volume indexes decreased, but the scintigraphically determined cardiac index did not change significantly. Left ventricular ejection fraction averaged 0.19 +/- 0.05 before nitroprusside administration and increased by less than 0.05 units in response to nitroprusside in 11 of 12 patients. The only significant correlation between scintigraphically and invasively determined variables was that between the percent change in end-diastolic volume index and the percent change in pulmonary capillary wedge pressure (r . 0.68, p . 0.01). Although nitroprusside produced changes in scintigraphically determined left ventricular ejection fraction, end-systolic volume index, and cardiac index, these alterations bore no predictable relation to changes in intracardiac pressure, forward cardiac index, or vascular resistance. Furthermore, nitroprusside produced a considerably greater percent change in the invasively measured variables than in the scintigraphically determined ones

  11. Assessment of vasodilator therapy in patients with severe congestive heart failure: limitations of measurements of left ventricular ejection fraction and volumes

    Energy Technology Data Exchange (ETDEWEB)

    Firth, B.G.; Dehmer, G.J.; Markham, R.V. Jr.; Willerson, J.T.; Hillis, L.D.

    1982-11-01

    Although noninvasive techniques are often used to assess the effect of vasodilator therapy in patients with congestive heart failure, it is unknown whether changes in noninvasively determined left ventricular ejection fraction, volume, or dimension reliably reflect alterations in intracardiac pressure and flow. Accordingly, we compared the acute effect of sodium nitroprusside on left ventricular volume and ejection fraction (determined scintigraphically) with its effect on intracardiac pressure and forward cardiac index (determined by thermodilution) in 12 patients with severe, chronic congestive heart failure and a markedly dilated left ventricle. Nitroprusside (infused at 1.3 +/- 1.1 (mean +/- standard deviation) microgram/kg/min) caused a decrease in mean systemic arterial, mean pulmonary arterial, and mean pulmonary capillary wedge pressure as well as a concomitant increase in forward cardiac index. Simultaneously, left ventricular end-diastolic and end-systolic volume indexes decreased, but the scintigraphically determined cardiac index did not change significantly. Left ventricular ejection fraction averaged 0.19 +/- 0.05 before nitroprusside administration and increased by less than 0.05 units in response to nitroprusside in 11 of 12 patients. The only significant correlation between scintigraphically and invasively determined variables was that between the percent change in end-diastolic volume index and the percent change in pulmonary capillary wedge pressure (r . 0.68, p . 0.01). Although nitroprusside produced changes in scintigraphically determined left ventricular ejection fraction, end-systolic volume index, and cardiac index, these alterations bore no predictable relation to changes in intracardiac pressure, forward cardiac index, or vascular resistance. Furthermore, nitroprusside produced a considerably greater percent change in the invasively measured variables than in the scintigraphically determined ones.

  12. Intrathoracic manifestations of sickle cell disease

    International Nuclear Information System (INIS)

    A retrospective analysis of 50 patients with sickle cell disease was performed. The majority of patients was admitted because of sickle cell crisis, pneumonia or congestive heart failure. Global casdiomegaly, pulmonary vascular engorgement, pneumonia and infiltrative lung parenchymal abnormalities were encountered. Our study shows a very high prevalence of intrathoracic abnormalities in patients afflicted with sickle cell disease. (orig.)

  13. 妊娠合并肺动脉高压伴心力衰竭患者的围生结局%Perinatal outcomes in pregnant women with pulmonary hypertension and concurrent congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    谢爱兰; 杨安素; 颜林志; 王剑平; 王玉环; 徐肖文

    2011-01-01

    目的 探讨妊娠合并肺动脉高压伴心衰患者的围生结局.方法 收集2000年1月至2010年12月温州医学院附属第二医院产科、心内科收治的妊娠合并肺动脉高压患者54例,其中伴心衰患者34例,分析其终止妊娠的时机、方式及围生结局,并比较肺动脉高压伴心衰患者和无心衰患者的妊娠结局.结果 (1)54例妊娠合并肺动脉高压患者中,心衰发生率为62.96%(34/54),轻度、中度和重度肺动脉高压心衰发生率分别为27.78%(5/18),73.33%(11/15),85.71%(18/21),三组比较差异具有统计学意义(P<0.05);(2)妊娠合并肺动脉高压伴心衰患者中并发症发生率为47.06%(16/34),孕产妇病死率为17.64%(6/34),医源性胎儿丢失率为29.41%(10/34),早产发生率52.94%(18/34),新生儿窒息35.29%(12/34),围生儿死亡23.53%(8/34).(3)妊娠合并肺动脉高压伴心衰患者以剖宫产分娩为主91.18%(31/34).(4)妊娠合并肺动脉高压伴心衰患者医源性引产、早产,孕产妇并发症,孕产妇死亡,新生儿窒息和胎儿、新生儿死亡发生率明显高于无心衰组,差异有统计学意义(P<0.05).结论 随着肺动脉压力的升高,孕妇心衰发生率随之增加;心衰是影响妊娠合并肺动脉高压患者围生预后的最主要因素;剖宫产终止妊娠是比较安全的分娩方式.%Objective To discuss the effect of the occurrence of congestive heart failure on the outcome of pregnant women with pulmonary hypertension. Methods Fifty-four pregnant patients complicated with pulmonary hypertension were admitted from January 2000 through December 2010. Among them, 34 had comorbidity of congestive heart failure. The timing and mode of pregnancy termination, and perinatal outcomes were studied, and comparison was made between those with and without heart failure. Results ① Of all 54 pregnant women with pulmonary hypertension, 34 had congestive heart failure. The incidences of congestive heart failure in patients with mild

  14. Influence of Androgen Deprivation Therapy on All-Cause Mortality in Men With High-Risk Prostate Cancer and a History of Congestive Heart Failure or Myocardial Infarction

    International Nuclear Information System (INIS)

    Purpose: It is unknown whether the excess risk of all-cause mortality (ACM) observed when androgen deprivation therapy (ADT) is added to radiation for men with prostate cancer and a history of congestive heart failure (CHF) or myocardial infarction (MI) also applies to those with high-risk disease. Methods and Materials: Of 14,594 men with cT1c–T3aN0M0 prostate cancer treated with brachytherapy-based radiation from 1991 through 2006, 1,378 (9.4%) with a history of CHF or MI comprised the study cohort. Of these, 22.6% received supplemental external beam radiation, and 42.9% received a median of 4 months of neoadjuvant ADT. Median age was 71.8 years. Median follow-up was 4.3 years. Cox multivariable analysis tested for an association between ADT use and ACM within risk groups, after adjusting for treatment factors, prognostic factors, and propensity score for ADT. Results: ADT was associated with significantly increased ACM (adjusted hazard ratio [AHR] = 1.76; 95% confidence interval [CI], 1.32–2.34; p = 0.0001), with 5-year estimates of 22.71% with ADT and 11.62% without ADT. The impact of ADT on ACM by risk group was as follows: high-risk AHR = 2.57; 95% CI, 1.17–5.67; p = 0.019; intermediate-risk AHR = 1.75; 95% CI, 1.13–2.73; p = 0.012; low-risk AHR = 1.52; 95% CI, 0.96–2.43; p = 0.075). Conclusions: Among patients with a history of CHF or MI treated with brachytherapy-based radiation, ADT was associated with increased all-cause mortality, even for patients with high-risk disease. Although ADT has been shown in Phase III studies to improve overall survival in high-risk disease, the small subgroup of high-risk patients with a history of CHF or MI, who represented about 9% of the patients, may be harmed by ADT.

  15. Impact of β-blocker selectivity on long-term outcomes in congestive heart failure patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Kubota Y

    2015-03-01

    Full Text Available Yoshiaki Kubota, Kuniya Asai, Erito Furuse, Shunichi Nakamura, Koji Murai, Yayoi Tetsuou Tsukada, Wataru Shimizu Department of Medicine (Division of Cardiology, Nippon Medical School, Bunkyo-ku, Tokyo, Japan Background: Chronic obstructive pulmonary disease (COPD is present in approximately one-third of all congestive heart failure (CHF patients, and is a key cause of underprescription and underdosing of β-blockers, largely owing to concerns about precipitating respiratory deterioration. For these reasons, the aim of this study was to evaluate the impact of β-blockers on the long-term outcomes in CHF patients with COPD. In addition, we compared the effects of two different β-blockers, carvedilol and bisoprolol. Methods: The study was a retrospective, non-randomized, single center trial. Acute decompensated HF patients with COPD were classified according to the oral drug used at discharge into β-blocker (n=86; carvedilol [n=52] or bisoprolol [n=34] and non-β-blocker groups (n=46. The primary endpoint was all-cause mortality between the β-blocker and non-β-blocker groups during a mean clinical follow-up of 33.9 months. The secondary endpoints were the differences in all-cause mortality and the hospitalization rates for CHF and/or COPD exacerbation between patients receiving carvedilol and bisoprolol. Results: The mortality rate was higher in patients without β-blockers compared with those taking β-blockers (log-rank P=0.039, and univariate analyses revealed that the use of β-blockers was the only factor significantly correlated with the mortality rate (hazard ratio: 0.41; 95% confidence interval: 0.17–0.99; P=0.047. Moreover, the rate of CHF and/or COPD exacerbation was higher in patients treated with carvedilol compared with bisoprolol (log-rank P=0.033. In the multivariate analysis, only a past history of COPD exacerbation significantly increased the risk of re-hospitalization due to CHF and/or COPD exacerbation (adjusted hazard

  16. Influence of Androgen Deprivation Therapy on All-Cause Mortality in Men With High-Risk Prostate Cancer and a History of Congestive Heart Failure or Myocardial Infarction

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, Paul L., E-mail: pnguyen@LROC.harvard.edu [Department of Radiation Oncology, Dana Farber Cancer Institute and Brigham and Women' s Hospital, Harvard Medical School, Boston, MA (United States); Chen, Ming-Hui [Department of Statistics, University of Connecticut, Storrs, CT (United States); Beckman, Joshua A. [Department of Cardiology, Brigham and Women' s Hospital, Harvard Medical School, Boston, MA (United States); Beard, Clair J.; Martin, Neil E. [Department of Radiation Oncology, Dana Farber Cancer Institute and Brigham and Women' s Hospital, Harvard Medical School, Boston, MA (United States); Choueiri, Toni K. [Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, MA (United States); Hu, Jim C. [Division of Urologic Surgery, Brigham and Women' s/Faulkner Hospital, Harvard Medical School, Boston, MA (United States); Hoffman, Karen E. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Dosoretz, Daniel E. [21st Century Oncology, Fort Myers, FL (United States); Moran, Brian J. [Chicago Prostate Center, Westmont, IL (United States); Salenius, Sharon A. [21st Century Oncology, Fort Myers, FL (United States); Braccioforte, Michelle H. [Chicago Prostate Center, Westmont, IL (United States); Kantoff, Philip W. [Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, MA (United States); D' Amico, Anthony V. [Department of Radiation Oncology, Dana Farber Cancer Institute and Brigham and Women' s Hospital, Harvard Medical School, Boston, MA (United States); Ennis, Ronald D. [Department of Radiation Oncology, St. Luke' s-Roosevelt and Beth Israel Hospitals, Continuum Cancer Centers of New York, Albert Einstein College of Medicine, New York, NY (Israel)

    2012-03-15

    Purpose: It is unknown whether the excess risk of all-cause mortality (ACM) observed when androgen deprivation therapy (ADT) is added to radiation for men with prostate cancer and a history of congestive heart failure (CHF) or myocardial infarction (MI) also applies to those with high-risk disease. Methods and Materials: Of 14,594 men with cT1c-T3aN0M0 prostate cancer treated with brachytherapy-based radiation from 1991 through 2006, 1,378 (9.4%) with a history of CHF or MI comprised the study cohort. Of these, 22.6% received supplemental external beam radiation, and 42.9% received a median of 4 months of neoadjuvant ADT. Median age was 71.8 years. Median follow-up was 4.3 years. Cox multivariable analysis tested for an association between ADT use and ACM within risk groups, after adjusting for treatment factors, prognostic factors, and propensity score for ADT. Results: ADT was associated with significantly increased ACM (adjusted hazard ratio [AHR] = 1.76; 95% confidence interval [CI], 1.32-2.34; p = 0.0001), with 5-year estimates of 22.71% with ADT and 11.62% without ADT. The impact of ADT on ACM by risk group was as follows: high-risk AHR = 2.57; 95% CI, 1.17-5.67; p = 0.019; intermediate-risk AHR = 1.75; 95% CI, 1.13-2.73; p = 0.012; low-risk AHR = 1.52; 95% CI, 0.96-2.43; p = 0.075). Conclusions: Among patients with a history of CHF or MI treated with brachytherapy-based radiation, ADT was associated with increased all-cause mortality, even for patients with high-risk disease. Although ADT has been shown in Phase III studies to improve overall survival in high-risk disease, the small subgroup of high-risk patients with a history of CHF or MI, who represented about 9% of the patients, may be harmed by ADT.

  17. Isolation of Cardiovascular Precursor Cells from the Human Fetal Heart

    OpenAIRE

    Gonzales, Christine; Ullrich, Nina D.; Gerber, Stefan; Berthonneche, Corinne; Niggli, Ernst; Pedrazzini, Thierry

    2011-01-01

    Weakening of cardiac function in patients with heart failure results from a loss of cardiomyocytes in the damaged heart. Cell replacement therapies as a way to induce myocardial regeneration in humans could represent attractive alternatives to classical drug-based approaches. However, a suitable source of precursor cells, which could produce a functional myocardium after transplantation, remains to be identified. In the present study, we isolated cardiovascular precursor cells from ventricles...

  18. Muscling up damaged hearts through cell therapy

    Institute of Scientific and Technical Information of China (English)

    Chi Van Dang

    2006-01-01

    @@ Molecular and cellular processes gleaned from the most fundamental of biomedical studies are now harnessed for their potential healing properties. In the US and throughout the world, millions of patients suffer from myocardial infarction and many succumb to the morbidity and mortality of the ensuing cardiac failure, a protracted condition in need of healing. While pharmacological agents have been the mainstay intervention that ameliorates cardiac failure through increased contractility or reduction of cardiac workload, these agents do not inherently heal the wounds inflicted by poor perfusion of the affected cardiac tissue.Cell therapy, however, holds the promise of repleting the damage heart with new contractile cells that can be engineered to secrete concoctions that promote healing by recruiting new blood vessel development or angiogenesis.Such cell therapeutic promise has already been fulfilled for many decades for hematological diseases through transplantation of bone marrow stem cells, which are now more broadly implicated for their healing potential of other tissues.

  19. Sympathetic reflex control of skeletal muscle blood flow in patients with congestive heart failure: evidence for beta-adrenergic circulatory control

    Energy Technology Data Exchange (ETDEWEB)

    Kassis, E.; Jacobsen, T.N.; Mogensen, F.; Amtorp, O.

    1986-11-01

    Mechanisms controlling forearm muscle vascular resistance (FMVR) during postural changes were investigated in seven patients with severe congestive heart failure (CHF) and in seven control subjects with unimpaired left ventricular function. Relative brachioradial muscle blood flow was determined by the local /sup 133/Xe-washout technique. Unloading of baroreceptors with use of 45 degree upright tilt was comparably obtained in the patients with CHF and control subjects. Control subjects had substantially increased FMVR and heart rate to maintain arterial pressure whereas patients with CHF had decreased FMVR by 51 +/- 11% and had no increase in heart rate despite a fall in arterial pressure during upright tilt. The autoregulatory and local vasoconstrictor reflex responsiveness during postural changes in forearm vascular pressures were intact in both groups. In the patients with CHF, the left axillary nerve plexus was blocked by local anesthesia. No alterations in forearm vascular pressures were observed. This blockade preserved the local regulation of FMVR but reversed the vasodilator response to upright tilt as FMVR increased by 30 +/- 7% (p less than .02). Blockade of central neural impulses to this limb combined with brachial arterial infusions of phentolamine completely abolished the humoral vasoconstriction in the tilted position. Infusions of propranolol to the contralateral brachial artery that did not affect baseline values of heart rate, arterial pressure, or the local reflex regulation of FMVR reversed the abnormal vasodilator response to upright tilt as FMVR increased by 42 +/- 12% (p less than .02). Despite augmented baseline values, forearm venous but not arterial plasma levels of epinephrine increased in the tilted position, as did arteri rather than venous plasma concentrations of norepinephrine in these patients.

  20. Sympathetic reflex control of skeletal muscle blood flow in patients with congestive heart failure: evidence for beta-adrenergic circulatory control

    International Nuclear Information System (INIS)

    Mechanisms controlling forearm muscle vascular resistance (FMVR) during postural changes were investigated in seven patients with severe congestive heart failure (CHF) and in seven control subjects with unimpaired left ventricular function. Relative brachioradial muscle blood flow was determined by the local 133Xe-washout technique. Unloading of baroreceptors with use of 45 degree upright tilt was comparably obtained in the patients with CHF and control subjects. Control subjects had substantially increased FMVR and heart rate to maintain arterial pressure whereas patients with CHF had decreased FMVR by 51 +/- 11% and had no increase in heart rate despite a fall in arterial pressure during upright tilt. The autoregulatory and local vasoconstrictor reflex responsiveness during postural changes in forearm vascular pressures were intact in both groups. In the patients with CHF, the left axillary nerve plexus was blocked by local anesthesia. No alterations in forearm vascular pressures were observed. This blockade preserved the local regulation of FMVR but reversed the vasodilator response to upright tilt as FMVR increased by 30 +/- 7% (p less than .02). Blockade of central neural impulses to this limb combined with brachial arterial infusions of phentolamine completely abolished the humoral vasoconstriction in the tilted position. Infusions of propranolol to the contralateral brachial artery that did not affect baseline values of heart rate, arterial pressure, or the local reflex regulation of FMVR reversed the abnormal vasodilator response to upright tilt as FMVR increased by 42 +/- 12% (p less than .02). Despite augmented baseline values, forearm venous but not arterial plasma levels of epinephrine increased in the tilted position, as did arteri rather than venous plasma concentrations of norepinephrine in these patients

  1. Framework for Traffic Congestion Management

    Directory of Open Access Journals (Sweden)

    Mahmud Hassan TALUKDAR

    2013-06-01

    Full Text Available Traffic Congestion is one of many serious global problems in all great cities resulted from rapid urbanization which always exert negative externalities upon society. The solution of traffic congestion is highly geocentric and due to its heterogeneous nature, curbing congestion is one of the hard tasks for transport planners. It is not possible to suggest unique traffic congestion management framework which could be absolutely applied for every great cities. Conversely, it is quite feasible to develop a framework which could be used with or without minor adjustment to deal with congestion problem. So, the main aim of this paper is to prepare a traffic congestion mitigation framework which will be useful for urban planners, transport planners, civil engineers, transport policy makers, congestion management researchers who are directly or indirectly involved or willing to involve in the task of traffic congestion management. Literature review is the main source of information of this study. In this paper, firstly, traffic congestion is defined on the theoretical point of view and then the causes of traffic congestion are briefly described. After describing the causes, common management measures, using world- wide, are described and framework for supply side and demand side congestion management measures are prepared.

  2. SERUM CONCENTRATIONS OF HYALURONIC ACID, PROCOLLAGEN TYPE Ⅲ NH2-TERMINAL PEPTIDE, AND LAMININ IN PATIENTS WITH CHRONIC CONGESTIVE HEART FAILURE

    Institute of Scientific and Technical Information of China (English)

    Gang Li; Qing-bo Yan; Liang-ming Wei

    2006-01-01

    Objective To explore the role of serum fibrotic indices including hyaluronic acid (HA), procollagen type ⅢNH2-terminal peptide (PCⅢP), and laminin (LN) in assessing the severity of myocardial fibrosis in chronic congestive heart failure (CHF).Methods Serum levels of HA, PCⅢP, and LN in 39 patients with CHF [ 14 with New York Heart Association (NYHA) functional class Ⅱ, 21 with class Ⅲ, 4 with class Ⅳ] and in 46 patients with NYHA functional class Ⅰ were assessed by radioimmunoassay.Results The serum concentrations of HA, PCⅢP, and LN were 359.75 ± 84. 59 μg/L, 77.88±24. 67μg/L,86.73±23.90 μg/L in CHF group, and 211.60±54. 80μg/L, 64.82±23.99 μg/L, 82.26±23.98μg/L in NYHA functional class Ⅰ group, respectively. The HA level was significantly higher in CHF patients as compared with NYHA functional class Ⅰ group (P<0.05 ). However, no difference was found in the levels of PCⅢP and LN between CHF group and NYHA functional class Ⅰ group. The serum HA concentration was negatively correlated with left ventricular ejection fraction (r=-0.71, P<0.05 ).Conclusion Serum HA level may act as an indicator for myocardial fibrosis.

  3. Significance of QRS duration and left bundle branch block in development and course of congestive heart failure

    Directory of Open Access Journals (Sweden)

    Bockeria L. A.

    2012-03-01

    Full Text Available Patients with severe chronic heart failure (CHF often have such intraventricular conduction disturbances as left bundle branch block which show morphological and QRS-duration changes on ECG and result in evident intra- and interventricular dyssinchrony. Delayed left ventricular activation via interventricular septum results in evident asynchrony at the beginning of left and right ventricular contration. Diagnostic significance of ECG data increases in presence of CHF clinical signs, especially echocardiographic signs of myocardial dysfunction. EVEREST study analyzed the influence of QRS duration on number of hospital admissions and mortality in patients with CHF. The study included 2962 patients, 1614 of them had normal QRS duration – less than 120 ms, 1321 patients had increased QRS duration – more than 120 ms. 678 deaths occurred during followup period, 307 (18.7% of them were from group with normal QRS duration and 371 (28.1% – from group with increased QRS interval. Mortality rate due to cardiovascular causes was more significant in patients with increased QRS. In 3 months of follow-up the mortality rate was 21.1% in patients with increased QRS and 14.6% in patients with normal QRS. In 9.9 months of follow-up the rates were 41.6% and 32.4%, respectively. Different international studies showed that isolated right ventricular pacing resulted in prolongation of QRS complex and contributed to CHF progression. 2010 patients were randomized in MOST-study which aimed to compare dual chamber pacing and right ventricular pacing. Reduction of CHF symptoms was noted in the course of study in patients who underwent dual chamber pacing, while M.O. Sweeney et al. analyzed the results of treatment of 1339 patients with initially normal QRS duration. However the authors revealed a higher rate in group of right ventricular pacing which proved the higher rates of hospital admission for CHF and more frequent rates for atrial fibrillation occurrence

  4. Empirical Study of Accepted Gap and Lane Change Duration within Arterial Traffic under Recurrent and Non-Recurrent Congestion

    Directory of Open Access Journals (Sweden)

    Saravanan Gurupackiam

    2012-12-01

    Full Text Available This paper investigated variations in accepted gaps and lane change duration on arterial under recurrent and non-recurrent congestion. Descriptive statistics and best-fit distributions were obtained for the two parameters for both traffic conditions. Hypothesis testing using Mann-Whitney U-Test showed that the means of accepted gaps and lane change durations were statistically different between the two types of traffic’ conditions. The study found that during non-recurrent congestion, drivers on an average accepted smaller gaps but took longer lane change durations. Based on the fact that the data were collected for the same flow-rate (70-90 vehicles/minute in both traffic conditions and based on the literature, the reason for the above findings could be that, drivers get more frustrated during non-recurring congestion that they accept smaller gaps. Drivers visiting the study location for game day (non-recurrent exhibit different driver behavioral characteristics when compared to regular commuters (recurrent which could have also contributed to the statistical differences in the lane changing characteristics of two types of congestion. These findings have direct implications on the lane changing parameters used in microscopic traffic simulation and also help transportation planners and managers to understand driver behavior during recurrent and non-recurrent congestion and better manage the facilities.

  5. Predictors of sudden death and death from pump failure in congestive heart failure are different. Analysis of 24 h Holter monitoring, clinical variables, blood chemistry, exercise test and radionuclide angiography

    DEFF Research Database (Denmark)

    Madsen, B K; Rasmussen, Verner; Hansen, J F

    1997-01-01

    One hundred and ninety consecutive patients discharged with congestive heart failure were examined with clinical evaluation, blood chemistry, 24 h Holter monitoring, exercise test and radionuclide angiography. Median left ventricular ejection fraction was 0.30, 46% were in New York Heart Associat......One hundred and ninety consecutive patients discharged with congestive heart failure were examined with clinical evaluation, blood chemistry, 24 h Holter monitoring, exercise test and radionuclide angiography. Median left ventricular ejection fraction was 0.30, 46% were in New York Heart...... Association class II and 44% in III. Total mortality after 1 year was 21%, after 2 years 32%. Of 60 deaths, 33% were sudden and 49% due to pump failure. Multivariate analyses identified totally different risk factors for sudden death: ventricular tachycardia, s-sodium < or = 137 mmol/l, s-magnesium < or = 0.......80 mmol/l, s-creatinine > 121 mumol/l, and maximal change in heart rate during exercise < or = 35 min-1, and for death from progressive pump failure: New York Heart Association class III + IV, delta heart rate over 24 h < or = 50 min-1, low ejection fraction, high resting p-noradrenaline, s-urea > 7...

  6. THE STUDY OF PREVALENCE AND CLINICAL PROFILE OF VALVULAR HEART DISEASES IN A TEACHING HOSPITAL

    Directory of Open Access Journals (Sweden)

    Radha Krishnan

    2015-04-01

    Full Text Available Valvular heart disease is still a common causes of mortality and morbidity in India and rheumatic heart disease is still far more frequent. AIMS AND OBJECTIVES: To study the prevalence and clinical profile of rheumatic and non - rheumatic valvular heart dise ase in patients attending to Government General Hospital, Kakinada. MATERIALS AND METHODS: 100 Adult patients with valvular abnormalities attending to the Medicine and Cardiology Units of Government General Hospital, Kakinada from Nov 2011 - May 2013 were studied. C linical history including various symptoms, past history of rheumatic fever, followed by systemic examination was done. A detailed cardiovascular examination with relevant investigations and evaluation was done. OBSERVATIONS AND RESULTS: The most common cause of acquired valvular heart disease is Rheumatic Heart Disease. Mitral valve involvement is the most common valve involvement with Mitral regurgitation as the most common valvular lesion. Mitral stenosis is the most common valvular lesion amon g rheumatic valvular heart disease. The most common complaint is breathlessness and the most common complication is Congestive heart failure. Multi valvular lesion is the most common valve involvement in patients presenting with congestive heart failure an d infective endocarditis. Patients having atrial fibrillation are noted to have mitral stenosis more commonly. Mitral stenosis is the valve abnormality commonly noted in patients presenting with haemoptysis, respiratory tract infection and chorea. Left sid ed hemiplegia is common in patients with acquired valvular heart disease. CONCLUSIONS: Though the incidencen of rheumatic valvular disease is decreased in modern era, still continuing in our country. The analysis of the present study gives us insight into the various types of presentation of acquired valvular heart disease and to increase awareness besides early detection of valvular diseases clinically. It also helps in planning of

  7. Stem cells for the heart

    Institute of Scientific and Technical Information of China (English)

    Suzanne Kadereit

    2004-01-01

    @@ Cardiovascular disease is one of the major health concerns of modern societies. In the United States in the year 2001 alone, an estimated 64 million people had had one or more forms of cardiovascular disease, claiming almost one million liyes, 38.5 percent of all deaths (American Heart Association).

  8. Receptor binding studies of the living heart

    International Nuclear Information System (INIS)

    Receptors form a class of intrinsic membrane proteins (or glycoproteins) defined by the high affinity and specificity with which they bind ligands. Many receptors are associated directly or indirectly with membrane ion channels that open or close after a conformational change of the receptor induced by the binding of the neurotransmitter. Changes in number and/or affinity of cardiac neurotransmitter receptors have been associated with myocardial ischemia and infarction, congestive heart failure, and cardiomyopathy as well as diabetes or thyroid-induced heart muscle disease. These alterations of cardiac receptors have been demonstrated in vitro on membrane homogenates from samples collected mainly during surgery or postmortem. The disadvantage of these in vitro binding techniques is that receptors lose their natural environment and their relationships with the other components of the tissue

  9. Traffic Congestion and Congestion Pricing

    OpenAIRE

    Lindsey, C. Robin; Verhoef, Erik T.

    2000-01-01

    For several decades growth of traffic volumes has outstrippedinvestments inroad infrastructure. The result has been a relentless increase intrafficcongestion. This paper reviews the economic principles behindcongestionpricing in static and dynamic settings, which derive from thebenefits ofcharging travellers for the externalities they create. Specialattention ispaid to various complications that make simple textbook congestionpricingmodels of limited relevance, and dictate that congestion pri...

  10. Congestion and Residential Moving Behaviour

    OpenAIRE

    Larsen, Morten Marott; Pilegaard, Ninette; van Ommeren, Jos

    2004-01-01

    In this paper we study how congestion and residential movingbehaviour are interrelated using a two-region job search model. Workerschoose optimally between interregional commuting and residential movingto live closer to the place of work. This choice affects the external costs ofcommuting due to congestion. The welfare maximizing road tax is derived.We demonstrate that road pricing may not only reduce congestion but alsoincrease total residential moving costs in the economy. One of the mainco...

  11. Evaluation of passive cardiomyoplasty using left- and right-ventricular volume measurements by EBCT and MRI in patients with chronic congestive heart failure

    International Nuclear Information System (INIS)

    Purpose: To evaluate the efficacy of passive cardiomyoplasty with the determination of biventricular volumes, global systolic function as well as left-ventricular muscle mass. Materials and Methods: In 19 patients with congestive heart failure of idiopathic or ischemic origin, a polyester mesh-graft was implanted around both ventricles for stabilization and functional support. Before and three months after surgery, 15 patients underwent EBCT and 4 patients with impaired renal function underwent MRI, for the evaluation of the volume and ejection fraction of both ventricles. Results: EBCT demonstrated a decrease from 385 to 310 ml in LV-EDV, from 312 to 242 ml in LV-ESV, from 209 to 160 ml in RV-EDV and from 149 to 87 ml in RV-ESV, and an increase from 20 to 26% in LV-EF and from 37 to 50% in RV-EF as well as a reduction of LV-MM from 300 to 274 g (p < 0.05 each). Similar results were obtained by MRI. Conclusion: Following passive cardiomyoplasty, EBCT and MRI revealed an improvement of the global systolic function as well as a reduction of biventricular volumes and left-ventricular muscle mass. (orig.)

  12. Cheyne-Stokes respiration in patients with congestive heart failure: causes and consequences A respiração de Cheyne-Stokes em pacientes com insuficiência cardíaca congestiva: causas e conseqüências

    OpenAIRE

    Geraldo Lorenzi-Filho; Genta, Pedro R.; Adelaide C. Figueiredo; Daniel Inoue

    2005-01-01

    Cheyne-Stokes respiration is a form of periodic breathing in which central apneas and hypopneas alternate with periods of hyperventilation, producing a waxing and waning pattern of tidal volume. This review focuses on the causes and consequences of Cheyne-Stokes respiration in patients with congestive heart failure, in whom the prevalence is strikingly high and ranges from 30% to 50%. Several factors have been implicated in the genesis of Cheyne-Stokes respiration, including low cardiac outpu...

  13. The role of statins in preventing the progression of congestive heart failure in patients with metabolic syndrome.

    Science.gov (United States)

    Fazio, Giovanni; Amoroso, Gisella Rita; Barbaro, Giuseppe; Novo, Giuseppina; Novo, Salvatore

    2008-01-01

    Heart Failure (CHF) is a very important public health problem in the world and certainly one of the most common debilitating diseases and cause of mortality. Current knowledge underlines that incidence rates are also influenced by the coexisting pathologic conditions that accelerate the development of disease or increase its severity. Important scientific evidence is emerging to demonstrate a strong correlation between HF and the metabolic syndrome (MetS). Hypolipemia-inducing medication offers the opportunity to discuss the possible existence of pharmacological substances that in addition to their specific targets have several demonstrated pleiotropic effects that could be beneficial in HF. Although several trials investigated statins treatment effects on HF in general, some evidence exists about the role that these drugs can have in the progression of the disease in the specific category of HF patients affected by MetS. In this review the possible positive effects of the statins treatment in this specific subset of patients are discussed. PMID:18991677

  14. The cost of urban congestion in Canada

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-03-22

    A systematic analysis of urban congestion in Canada was presented. The analysis developed congestion indicators for the 9 largest urban areas in Canada. An engineering approach was used to define and to develop the congestion indicators and to estimate the social costs of congestion associated with extra time wasted due to congestion and the cost associated with greenhouse gas (GHG) emissions. The approach focused on direct and physical characteristics of congestion which linked vehicle flow and traffic speed to road capacity. An economic approach recognized that there is an economically efficient level of congestion caused by impeding users, and that some congestion is already internalized for some users. The study estimated that the total annual cost of congestion in 2002 ranged from $2.3 billion to $3.7 billion for the major urban areas in Canada. More than 90 per cent of the cost represented the value of the time lost to automobile travellers in congestion. Seven per cent of the cost represented the value of fuels consumed, and 3 per cent represented the amount of GHGs emitted under congestion conditions. The study estimated an increase of 1.2 to 1.4 megatonnes of GHG due to congestion every year. It was concluded that estimates provided in the report did not include data of costs associated with non-recurrent congestion caused by bad weather, accidents and other congestion-related costs such as noise and stress. 14 refs., 8 tabs.

  15. Brain and heart disease studies

    International Nuclear Information System (INIS)

    Highlights of important studies completed during the past year using the Donner 280-crystal positron ring tomograph are summarized in this article. Using rubidium-82, images of a brain tumor and an arteriovenous malformation are described. An image demonstrating methionine uptake in a patient with schizophrenia and an image reflecting sugar metabolism in the brain of a man with Alzheimer's disease are also included. Uptake of rubidium-82 in subjects before and after exercise is being investigated. The synthesis of new radiopharmaceuticals and the development of a new synthesis for C-taurine for use in the study of metabolism in the human heart are also being studied

  16. Heart failure - medicines

    Science.gov (United States)

    CHF - medicines; Congestive heart failure - medicines; Cardiomyopathy - medicines; HF - medicines ... You will need to take most of your heart failure medicines every day. Some medicines are taken ...

  17. Plasmacytoid Dendritic Cells: From Heart to Vessels

    OpenAIRE

    Rosalinda Sorrentino; Silvana Morello; Aldo Pinto

    2010-01-01

    Cardiovascular diseases, formerly only attributed to the alterations of the stromal component, are now recognized as immune-based pathologies. Plasmacytoid Dendritic Cells (pDCs) are important immune orchestrators in heart and vessels. They highly produce IFN type I that promote the polarization of T cells towards a Th1 phenotype; however, pDCs can also participate to suppressive networks via the recruitment of T regulatory cells that downmodulate proinflammatory responses. pDCs populate the ...

  18. Cell death signalling mechanisms in heart failure

    OpenAIRE

    Mughal, Wajihah; Kirshenbaum, Lorrie A.

    2011-01-01

    In 2003, cardiovascular disease was the most costly disease in Canada, and it is still on the rise. The loss of properly functioning cardiomyocytes leads to cardiac impairment, which is a consequence of heart failure. Therefore, understanding the pathways of cell death (necrosis and apoptosis) has potential implications for the development of therapeutic strategies. In addition, the role of B-cell lymphoma-2 family members is discussed and the importance of mitochondria in directing cell deat...

  19. Heart Failure After Heart Attack Tied to Cancer Risk in Study

    Science.gov (United States)

    ... gov/news/fullstory_159804.html Heart Failure After Heart Attack Tied to Cancer Risk in Study Preliminary finding ... News) -- People who develop heart failure after a heart attack may also face a higher risk of cancer, ...

  20. Altruism in Congestion Games

    CERN Document Server

    Hoefer, Martin

    2008-01-01

    This paper studies the effects of introducing altruistic agents into atomic congestion games. Altruistic behavior is modeled by a trade-off between selfish and social objectives. In particular, we assume agents optimize a linear combination of personal delay of a strategy and the resulting increase in social cost. Our model can be embedded in the framework of congestion games with player-specific latency functions. Stable states are the Nash equilibria of these games, and we examine their existence and the convergence of sequential best-response dynamics. Previous work shows that for symmetric singleton games with convex delays Nash equilibria are guaranteed to exist. For concave delay functions we observe that there are games without Nash equilibria and provide a polynomial time algorithm to decide existence for symmetric singleton games with arbitrary delay functions. Our algorithm can be extended to compute best and worst Nash equilibria if they exist. For more general congestion games existence becomes NP...

  1. Alcohol consumption and risk of atrial fibrillation in men and women: the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Mukamal, KJ; Tolstrup, JS; Friberg, J;

    2005-01-01

    hazard ratio of 1.45 (95% CI 1.02 to 2.04); few women consumed this amount of alcohol. Approximately 5% of cases of atrial fibrillation among men were attributable to heavy alcohol use. Further adjustment for blood pressure and incident coronary heart disease and congestive heart failure did not...... incident atrial fibrillation among 16,415 women and men enrolled in the Copenhagen City Heart Study. We ascertained use of beer, wine, and spirits individually at up to 3 study visits with a structured questionnaire. We identified cases of atrial fibrillation by routine study ECGs and a validated...... attenuate the association (hazard ratio 1.63; 95% CI 1.15 to 2.31). CONCLUSIONS: Heavy alcohol consumption is associated with a higher risk of atrial fibrillation, at least among men. This relationship does not appear to be related to the adverse effects of heavy drinking on coronary heart disease or blood...

  2. Study of the change of IL-1β in patients with congestive heart failure and effect of lidocaine on the production of the IL-1 β in vitro%充血性心力衰竭患者IL-1β的变化及利多卡因对其影响的研究

    Institute of Scientific and Technical Information of China (English)

    姚恒臣; 冯桂芹; 张颖新; 孔祥泉; 王英丽; 高航

    2001-01-01

    Objectives To examine the change of serum interleukins (IL)-1β in patients with congestve heart failure(CHF) and the effect of lidocaine on the prodution of IL-1β in vitro.Methods Food fasting blood of both healthy volunteers(n=20),and CHF patients(n=20) were obtained in the morning.Serum IL-1β was measured by an Enzyme-linked immunosorbent assay (ELISA).Peripheral blood mononuclear cell (PBMC) were obtained from both the control and the patients group.PBMC were cultured with 0,0.1,1 and 10 mmol/L of lidocine in the presence of lipopolysaccharide.After 24 hours'incubation,IL-1 β was measured in the culture supernatants by an ELISA.Results Serum IL-1β was significantly higher than that of the control group(P<0.001),and the higher the heart failure degree,the higher the level of IL- 1β (P<0.001).No effect was found of lidocaine on the production of IL-1β in the two groups.Conclusion IL-1β may play an importan trole in the pathogenesis of CHF.%目的 探讨充血性心力衰竭(CHF)患者血清IL-1β的变化,以及利多卡因对培养的正常人及CHF患者单个核细胞分泌IL-1β的影响,以明确IL-1β在CHF发生和发展过程中的作用机制,以及利多卡因作用于CHF的免疫学机制。方法 取20例正常人和20例Ⅱ~Ⅲ度CHF患者清晨空腹静脉血:①测其血清IL-1β;②离心取单个核细胞(PBMC),加入利多卡因、LPS等,使利多卡因的终浓度分别为0、0.1、1和10mmol/L进行培养,经24小时孵化后,取培养液上清,用ELISA法测培养液上清中IL-1β。结果 CHF患者血清IL-1β明显高于对照组(P<0.001),并随心衰程度的加重而增加(P<0.001)。利多卡因对正常组IL-1β的分泌无明显影响。结论 IL-1β参与CHF的发生和发展。

  3. CD20 antigen expression by lymphoma cells in lung allograft recipients is associated with higher remission rate and superior survival: A study on heart and lung transplant recipients

    Directory of Open Access Journals (Sweden)

    Aghil Gholipour-Shoiili

    2014-01-01

    Full Text Available Post-transplant lymphoproliferative disorders (PTLD are one of the fatal complications of transplantation, and there is scarcity of data on the relevance of antigen expression by tumor cells in PTLD. In the current study, we aimed to investigate the potential effects of CD20 antigen expression by PTLD lesions developing in heart/lung transplant recipients. A comprehensive search was performed for reports indicating CD20 antigen tests in PTLD lesions developing in heart and/or lung transplant recipients. For data accumulation, we developed a standard questionnaire and data of patients presented in different published reports were entered into it. Finally, data from 26 previously published reports from different centers around the world were included in the analysis. CD20-positive PTLD lesions are significantly more likely to be of the B cell type (P = 0.006. PTLD in patients with a CD20-positive test represented relevantly shorter time from transplantation to PTLD, although it did not reach a significance level (P = 0.08. At the last follow-up, 53% patients were dead. Survival analysis showed no prognosis difference regarding CD20 test. When data were reanalyzed separately for heart and lung transplant recipients, lung recipients developing PTLD with a CD20-positive test were significantly more likely to represent remission episodes (P = 0.03, and also represented a significantly better outcome than CD20-negative PTLD patients (P = 0.04. CD20-positive PTLD lesions in heart/lung recipients are more likely of the B cell type and develop PTLD lesions earlier than their CD20-negative counterparts. Lung recipients developing CD20-positive PTLD lesions represented higher remission rates and better outcome. Further studies with prospective follow-up of patients are needed for confirming our findings.

  4. Study on correlation between circulating endothelial progenitor cells and brain natriuretic peptide in patients with myocardial infarction complicated heart failure after stem cell mobilization

    Directory of Open Access Journals (Sweden)

    Zi-lin ZHAO

    2014-06-01

    Full Text Available Objective: It is to observe the correlation between circulating endothelial progenitor cells (endothelial progenitor cells, EPCs and brain natriuretic peptide (BNP in patients with myocardial infarction and heart failure after stem cell mobilizer granulocyte colony stimulating factor (granulocyte colony stimulating factor, G-CSF.Methods: Patients were divided into the control group(37 and the observation group (38. The observation group took injection of G-CSF, 10μg/kg, for 7d. The Two groups were observed the amount of circulating EPCs , the levels of BNP, TNF- α and other indicators, and make clinical analysis. Results: Compared with control group, the amount of EPCs were significantly increased, the level of BNP, TNF- α were decreased, the difference between the observation group and control group is statistical significant (P < 0.05; the amount of  EPCs had negative correlation with BNP. Conclusion: The application of stem cell mobilization of circulating EPCs can improve the clinical curative effect of myocardial infarction patients and heart failure, cyclic EPCs and BNP detection can effectively evaluate the heart function and prognosis.

  5. Stem Cell Therapy Shows Promise Against Heart Failure

    Science.gov (United States)

    ... nlm.nih.gov/medlineplus/news/fullstory_158122.html Stem Cell Therapy Shows Promise Against Heart Failure A second ... 4, 2016 MONDAY, April 4, 2016 (HealthDay News) -- Stem cell therapy shows promise for people battling heart failure, ...

  6. Controlling Congestion on Complex Networks

    CERN Document Server

    Buzna, Lubos

    2016-01-01

    From the Internet to road networks and the power grid, modern life depends on controlling flows on critical infrastructure networks that often operate in a congested state. Yet, we have a limited understanding of the relative performance of the control mechanisms available to manage congestion and of the interplay between network topology, path layout and congestion control algorithms. Here, we consider two flow algorithms (max-flow and uniform-flow), and two more realistic congestion control schemes (max-min fairness and proportional fairness). We analyse how the algorithms and network topology affect throughput, fairness and the location of bottleneck edges. Our results show that on large random networks a network operator can implement the trade-off (proportional fairness) instead of the fair allocation (max-min fairness) with little sacrifice in throughput. We illustrate how the previously studied uniform-flow approach leaves networks severely underutilised in comparison with congestion control algorithms...

  7. Environmentally Reformed Travel Habits During the 2006 Congestion Charge Trial in Stockholm—A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Håkan Andréasson

    2011-08-01

    Full Text Available Policy measures that reduce or replace road traffic can improve environmental conditions in most large cities. In Stockholm a congestion charge was introduced during a test period in 2006. This was a full-scale trial that proved to meet its targets by reducing traffic crossing the inner city segment during rush hours by 20%. Emissions of carbon dioxide and particles were also substantially reduced. This study, based on in-depth interviews with 40 inhabitants, analyses how and why new travel habits emerged. The results show that particular, sometimes unexpected, features of everyday life (habits, resources, opportunities, values, etc. were crucial for adjustment of travel behaviour in relation to the policy instrument. One example was that those accustomed to mixing different modes of transport on a daily basis more easily adapted their travel in the targeted way. On a more general level, the results revealed that the policy measure could actually tip the scales for the individual towards trying out a new behaviour.

  8. Environmentally reformed travel habits during the 2006 congestion charge trial in Stockholm--a qualitative study.

    Science.gov (United States)

    Henriksson, Greger; Hagman, Olle; Andréasson, Håkan

    2011-08-01

    Policy measures that reduce or replace road traffic can improve environmental conditions in most large cities. In Stockholm a congestion charge was introduced during a test period in 2006. This was a full-scale trial that proved to meet its targets by reducing traffic crossing the inner city segment during rush hours by 20%. Emissions of carbon dioxide and particles were also substantially reduced. This study, based on in-depth interviews with 40 inhabitants, analyses how and why new travel habits emerged. The results show that particular, sometimes unexpected, features of everyday life (habits, resources, opportunities, values, etc.) were crucial for adjustment of travel behaviour in relation to the policy instrument. One example was that those accustomed to mixing different modes of transport on a daily basis more easily adapted their travel in the targeted way. On a more general level, the results revealed that the policy measure could actually tip the scales for the individual towards trying out a new behaviour. PMID:21909301

  9. Stem cells:An eventual treatment option for heart diseases

    Institute of Scientific and Technical Information of China (English)

    Joseph; C; Bilgimol; Subbareddy; Ragupathi; Lakshmanan; Vengadassalapathy; Nathan; S; Senthil; Kali-muthu; Selvakumar; M; Ganesan; Sadananda; Rao; Manjunath

    2015-01-01

    Stem cells are of global excitement for various diseases including heart diseases. It is worth to understand the mechanism or role of stem cells in the treatment of heart failure. Bone marrow derived stem cells are commonly practiced with an aim to improve the function of the heart. The majority of studies have been conducted with acute myocardial infarction and a few has been investigated with the use of stem cells for treating chronic or dilated cardiomyopathy. Heterogeneity in the treated group using stem cells has greatly emerged. Ever increasing demand for any alternative made is of at most priority for cardiomyopathy. Stem cells are of top priority with the current impact that has generated among physicians. However,meticulous selection of proper source is required since redundancy is clearly evident with the present survey. This review focuses on the methods adopted using stem cells for heart diseases and outcomes that are generated so far with an idea to determine the best therapeutic possibility in order to fulfill the present demand.

  10. Congestion in Europe: Measurements, spatial patterns, policies

    OpenAIRE

    Bovy, P.H.L.; Salomon, I.

    1998-01-01

    The paper addresses the road traffic congestion issue from a Western-European perspective. A view is given on factors causing trends in its temporal and spatial distribution. A discussion is presented on the difficulties encountered in measuring the levels and extent of congestion. Based on the few comparative studies on European congestion patterns, figures are presented on route traffic congestion in European countries and regions enabling an explanation of simularities and differences. Aft...

  11. Insomnia Self-Management in Heart Failure

    Science.gov (United States)

    2016-05-11

    Cardiac Failure; Heart Failure; Congestive Heart Failure; Heart Failure, Congestive; Sleep Initiation and Maintenance Disorders; Chronic Insomnia; Disorders of Initiating and Maintaining Sleep; Fatigue; Pain; Depressive Symptoms; Sleep Disorders; Anxiety

  12. Effects of captopril and a combination of hydralazine and isosorbide dinitrate on myocardial sympathetic tone in patients with severe congestive heart failure.

    OpenAIRE

    Daly, P; Rouleau, J L; Cousineau, D.; Burgess, J H; Chatterjee, K.

    1986-01-01

    Changes in circulating catecholamines and transmyocardial catecholamine balance associated with improved left ventricular function were studied in patients with chronic heart failure after treatment with captopril (10 patients) and hydralazine in combination with isosorbide dinitrate (eight patients). Cardiac performance improved in response to both captopril and hydralazine-nitrate treatment. The systemic haemodynamic effects were also qualitatively similar, but the hydralazine-nitrate combi...

  13. 全身炎症反应综合征在婴幼儿肺炎 合并心衰中的表现%Clinical significance of systemic inflammatory response syndrome following pneumonia complicated by actue congestive heart failure in infants

    Institute of Scientific and Technical Information of China (English)

    许蔓春; 朱会英

    2001-01-01

    目的 应用新概念——全身炎症反应综合征(SIRS)评估婴幼儿肺炎合并心衰的病程及预后。方法 总结32例婴幼儿肺炎合并心衰者,根据Hayden修订的SIRS诊断标准进行临床分析。结果 婴幼儿肺炎合并心衰32例,符合SIRS诊断标准者共27例,与SIRS≤2 d相比,SIRS≥3 d者其心衰持续时间较长,预后也差。患儿入院危重评分<90分,或伴有其他合并症,是SIRS≥3 d的高危因素。患儿月龄、性别和SIRS项目与SIRS持续时间无明显相关。SIRS持续时间与心衰持续时间呈明显相关。结论 SIRS持续时间是婴幼儿肺炎合并心衰病情评估的有用指标,SIRS的持续存在,将影响患儿心衰症状的改善。应予以重视和早期干预。%Objective To employ the new concept of systemic inflammatory response syndrome (SIRS) to evaluate the course and outcome of illness in pneumonia complicated by acute congestive heart failure in infants.Methods According to the criteria of SIRS by Hayden, thirty-two infants with pneumonia complicated by acute congestive heart failure were studied. Results Twenty seven cases (27/32) were diagnosed as SIRS. The duration of heart failure was significantly longer in patients with SIRS for≥3 days than that of SRIS sustained for ≤2 days. The former had a outcome. The risk of factors of SIRS for ≥3 days included other complications and severity of the illness. The duration of SIRS was not related to the age, sex and the number of SIRS criteria, but was correlated with heart failure.Conclusion The duration of SIRS may be used to evaluate the infants with pneumonia complicated by acute congestive heart failure. Persistent SIRS may hamper the amelioration of heart failure and early intervention should be taken in such cases.

  14. Stem cell markers in the heart of the human newborn

    Directory of Open Access Journals (Sweden)

    Armando Faa

    2016-07-01

    Full Text Available The identification of cardiac progenitor cells in mammals raises the possibility that the human heart contains a population of stem cells capable of generating cardiomyocytes and coronary vessels. Several recent studies now show that the different cell types that characterize the adult human heart arise from a common ancestor. Human cardiac stem cells differentiate into cardiomyocytes, and, in lesser extent, into smooth muscle and endothelial cells. The characterization of human cardiac stem cells (CSCs has important clinical implications. In recent years, CD117 (c-kit has been reported to mark a subtype of stem/progenitor cells in the human heart, with stem cell-like properties, including the ability to self-renewal and clonogenicity multipotentiality. Proceedings of the 2nd International Course on Perinatal Pathology (part of the 11th International Workshop on Neonatology · October 26th-31st, 2015 · Cagliari (Italy · October 31st, 2015 · Stem cells: present and future Guest Editors: Gavino Faa, Vassilios Fanos, Antonio Giordano

  15. Intracoronary stem cell infusion in heart transplant candidates

    International Nuclear Information System (INIS)

    The stem cell transplantation is emerging as a potential therapeutic modality for patients with heart failure. It has been demonstrated that intracoronary stem cell transplantation had beneficial effects on left ventricular perfusion and contractile functions. We hypothesized that patients with end-stage ischemic cardiomyopathy, who are candidates for heart transplantation, could also benefit from autologous intracoronary stem cell transplantation. We performed a prospective, open-labeled study in 10 patients with end-stage ischemic cardiomyopathy, who were on the waiting list for heart transplantation. Each patient received bone marrow-derived mononuclear cell infusion via balloon catheter in the target vessel, which had been revascularized by percutaneous intervention and was patent before the procedure. Clinical and laboratory evaluations, a treadmill exercise test, echocardiography, and single photon emission tomography (SPECT) were performed to the patients at baseline and 6 months after stem cell infusion. At 6-month follow-up of the eight patients who were able to complete the study, we revealed a significant increase in ejection fraction (from 30.0±6.6% to 36.2±7.3%; p=0.001) in echocardiographic evaluation. SPECT evaluation also displayed a reduction in infarct area (50.4±16.1% to 44.1±12.5%; p=0.003). Both myocardial oxygen consumption (p=0.001) and metabolic equivalents (p=0.001) were significantly increased at 6-month follow-up. These results demonstrate that intracoronary stem cell transplantation ameliorates heart failure symptoms and improves left ventricular function and perfusion. Therefore intracoronary stem cell transplantation may be used as an alternative treatment option for heart transplant candidates. (author)

  16. [Changes of heart function after different cell type stem cell transplantation in chronic heart failure].

    Science.gov (United States)

    Fan, Zhongcai; Chen, Mao; Deng, Juelin; Liu, Xiaojing; Zhang, Li; Rao, Li; Yang, Qing; Huang, Dejia

    2006-12-01

    To investigate the feasibility of introcoronary cell infusion into nonischemic heart failure (HF) heart and whether different types of stem cell transplantation would affect heart function to a similar degree. Japanese white ears rabbits were used as HF models by intravenous injection adriamycin. Autologous bone marrow mononuclear cells(BMCs), bone marrow stromal cells (MSCs), skeletal myoblasts (SMs) or culture medium were infused into coronary arteries respectively by occluding the root of ascending aorta. The mortality during and 4 weeks after the procedure the mortality was 7.1% and 16.7% respectively. After 4 weeks, the ejection fraction (EF) in BMCs group had significant improvement (P 0.05). In sham group,the left ventricular endostolic diameter (LVED) had significant enlargement (P 0.05). Immunofluorescence revealed de novo expression of cardiac troponin I in BMCs and MSCs groups, cardiac troponin I was not detected in SMs group. In conclusions, intracoronary cell transplantation could provide effective cell delivery into dilated cardiomyopathy hearts and could be a useful strategy for treating CHF, BMCs cell transplantation may be the first choice in all the above cell types. PMID:17228727

  17. Evaluation Study for Delay and Link Utilization with the New-Additive Increase Multiplicative Decrease Congestion Avoidance and Control Algorithm

    CERN Document Server

    Jasem, Hayder Natiq; Othman, Mohamed; Subramaniam, Shamala

    2010-01-01

    As the Internet becomes increasingly heterogeneous, the issue of congestion avoidance and control becomes ever more important. And the queue length, end-to-end delays and link utilization is some of the important things in term of congestion avoidance and control mechanisms. In this work we continue to study the performances of the New-AIMD (Additive Increase Multiplicative Decrease) mechanism as one of the core protocols for TCP congestion avoidance and control algorithm, we want to evaluate the effect of using the AIMD algorithm after developing it to find a new approach, as we called it the New-AIMD algorithm to measure the Queue length, delay and bottleneck link utilization, and use the NCTUns simulator to get the results after make the modification for the mechanism. And we will use the Droptail mechanism as the active queue management mechanism (AQM) in the bottleneck router. After implementation of our new approach with different number of flows, we expect the delay will less when we measure the delay ...

  18. Human Mesenchymal Stem Cells Reendothelialize Porcine Heart Valve Scaffolds: Novel Perspectives in Heart Valve Tissue Engineering

    Science.gov (United States)

    Lanuti, Paola; Serafini, Francesco; Pierdomenico, Laura; Simeone, Pasquale; Bologna, Giuseppina; Ercolino, Eva; Di Silvestre, Sara; Guarnieri, Simone; Canosa, Carlo; Impicciatore, Gianna Gabriella; Chiarini, Stella; Magnacca, Francesco; Mariggiò, Maria Addolorata; Pandolfi, Assunta; Marchisio, Marco; Di Giammarco, Gabriele; Miscia, Sebastiano

    2015-01-01

    Abstract Heart valve diseases are usually treated by surgical intervention addressed for the replacement of the damaged valve with a biosynthetic or mechanical prosthesis. Although this approach guarantees a good quality of life for patients, it is not free from drawbacks (structural deterioration, nonstructural dysfunction, and reintervention). To overcome these limitations, the heart valve tissue engineering (HVTE) is developing new strategies to synthesize novel types of valve substitutes, by identifying efficient sources of both ideal scaffolds and cells. In particular, a natural matrix, able to interact with cellular components, appears to be a suitable solution. On the other hand, the well-known Wharton's jelly mesenchymal stem cells (WJ-MSCs) plasticity, regenerative abilities, and their immunomodulatory capacities make them highly promising for HVTE applications. In the present study, we investigated the possibility to use porcine valve matrix to regenerate in vitro the valve endothelium by WJ-MSCs differentiated along the endothelial lineage, paralleled with human umbilical vein endothelial cells (HUVECs), used as positive control. Here, we were able to successfully decellularize porcine heart valves, which were then recellularized with both differentiated-WJ-MSCs and HUVECs. Data demonstrated that both cell types were able to reconstitute a cellular monolayer. Cells were able to positively interact with the natural matrix and demonstrated the surface expression of typical endothelial markers. Altogether, these data suggest that the interaction between a biological scaffold and WJ-MSCs allows the regeneration of a morphologically well-structured endothelium, opening new perspectives in the field of HVTE. PMID:26309804

  19. Comparison of High Speed Congestion Control Protocols

    Directory of Open Access Journals (Sweden)

    Jawhar Ben Abed

    2012-10-01

    Full Text Available Congestion control limits the quantity of information input at a rate less important than that of thetransmission one to ensure good performance as well as protect against overload and blocking of thenetwork. Researchers have done a great deal of work on improving congestion control protocols,especially on high speed networks.In this paper, we will be studying the congestion control alongside low and high speed congestion controlprotocols. We will be also simulating, evaluating, and comparing eight of high speed congestion controlprotocols : Bic TCP, Cubic TCP, Hamilton TCP, HighSpeed TCP, Illinois TCP, Scalable TCP,Compound TCP and YeAH TCP, with multiple flows.

  20. Modelling airport congestion charges

    OpenAIRE

    Janić, Milan

    2012-01-01

    This article deals with modelling congestion charges at an airport. In this context, congestion charging represents internalizing the cost of marginal delays that a flight imposes on other flights due to congestion. The modelling includes estimating congestion and flight delays, the cost of these delays and the efficiency of particular flights following the introduction ofa congestion charge. The models are applied to an airport / New York LaGuardia / to illustrate their ability to handle mor...

  1. Multipotent (adult) and pluripotent stem cells for heart regeneration: what are the pros and cons?

    Science.gov (United States)

    Liao, Song-Yan; Tse, Hung-Fat

    2013-01-01

    Heart failure after myocardial infarction is the leading cause of mortality and morbidity worldwide. Existing medical and interventional therapies can only reduce the loss of cardiomyocytes during myocardial infarction but are unable to replenish the permanent loss of cardiomyocytes after the insult, which contributes to progressive pathological left ventricular remodeling and progressive heart failure. As a result, cell-based therapies using multipotent (adult) stem cells and pluripotent stem cells (embryonic stem cells or induced pluripotent stem cells) have been explored as potential therapeutic approaches to restore cardiac function in heart failure. Nevertheless, the optimal cell type with the best therapeutic efficacy and safety for heart regeneration is still unknown. In this review, the potential pros and cons of different types of multipotent (adult) stem cells and pluripotent stem cells that have been investigated in preclinical and clinical studies are reviewed, and the future perspective of stem cell-based therapy for heart regeneration is discussed. PMID:24476362

  2. Congestion Free Routing in Adhoc Networks

    Directory of Open Access Journals (Sweden)

    V. Sankaranarayanan

    2012-01-01

    Full Text Available Problem statement: A Mobile Ad-Hoc Network (MANET is a temporary network; the mobile devices in an ad-hoc network are communicating through wireless links without any pre-existing infrastructure. The one major problem of this network is network congestion, it may take place at any intermediate nodes when data packets are traveling from source to destination. The major problems of congestion or high data loss, increasing End to End and retransmission packets which affects the overall network performance. The main goal of congestion control is to effectively utilize the existing network resources and maintain the network load below the capacity. Approach: This study presents the Congestion Free Routing in Adhoc networks (CFR, based on dynamically estimated mechanism to monitor network congestion by calculating the average queue length at the node level. While using the average queue length, the nodes’ congestion status divided into the three zones (safe zone, likely to be congested zone and congested zone. CFR utilizes the non-congested neighbors and initiates route discovery mechanism to discover a congestion free route between source and destination. This path becomes a core path between source and destination. To maintain the congestion free status, the nodes which are helping data packet transmission periodically calculate their congestion status at the node level. When a core node is noticed that it fell in to likely to congested zone and alerts to its neighbors. The predecessor core path node is aware of this situation and initiates an alternate path discovery mechanism to a destination. Finally it discovers a new congestion free route to the destination. Results: The assessment between CFR and AODV was conducted by using the Ns-2 simulator. The simulation results confirmed that the CFR improved packet delivery ratio, reduction of End to End delay and control packets. Conclusion: Our proposed technique solved the congestion problems in a

  3. Stem cells and heart: an open future or a mirage?

    Directory of Open Access Journals (Sweden)

    Pier Paolo Bassareo

    2016-01-01

    Full Text Available Stem cells (SC look like to be the possible solution to a number of human pathologies, including those involving the heart. In fact, some studies based on animal models suggest that SC can be used to repair the damaged cardiac tissue, such as in case of myocardial infarction. In fact it has been demonstrated that it would be possible to produce a quantity of SC sufficient to repair an animal heart having physiology and dimensions as the human heart.The aim of this short review is to examine the different subtypes of SC potentially involved in the heart repair (autologous and heterologous processes as well as the serious concerns that have still to be overcome before considering SC a sure therapy for the heart diseases: rejections, oncogenesis due to SC high proliferative activity, difficult in ruling their differentiation, massive SC death when introducing them in an ischemic environment, ethical problems when SC are derived from embryos. Proceedings of the 2nd International Course on Perinatal Pathology (part of the 11th International Workshop on Neonatology · October 26th-31st, 2015 · Cagliari (Italy · October 31st, 2015 · Stem cells: present and future Guest Editors: Gavino Faa, Vassilios Fanos, Antonio Giordano

  4. Plasmacytoid Dendritic Cells: From Heart to Vessels

    Directory of Open Access Journals (Sweden)

    Rosalinda Sorrentino

    2010-01-01

    Full Text Available Cardiovascular diseases, formerly only attributed to the alterations of the stromal component, are now recognized as immune-based pathologies. Plasmacytoid Dendritic Cells (pDCs are important immune orchestrators in heart and vessels. They highly produce IFN type I that promote the polarization of T cells towards a Th1 phenotype; however, pDCs can also participate to suppressive networks via the recruitment of T regulatory cells that downmodulate proinflammatory responses. pDCs populate the vessel wall layers during pathological conditions, such as atherosclerosis. It is thus clear that a better identification of pDCs activity in cardiovascular diseases can not only elucidate pathological mechanisms but also lead to new therapeutic approaches.

  5. Transport Congestion Events Detection (TCED): Towards Decorrelating Congestion Detection from TCP

    OpenAIRE

    Anelli, Pascal; Lochin, Emmanuel; Harivelo, Fanilo; Lopez-Pacheco, Dino Martin

    2010-01-01

    International audience TCP(Transmission Control Protocol ) uses a loss-based algorithm to estimate whether the network is congested or not. The main difficulty for this algorithm is to distinguish spurious from real network congestion events. Other research studies have proposed to enhance the reliability of this congestion estimation by modifying the internal TCP algorithm. In this paper, we propose an original congestion event algorithm implemented independently of the TCP source code. B...

  6. Cardiac stem cells in patients with heart disease

    OpenAIRE

    Zhao, Xiaohui; Huang, Lan

    2013-01-01

    The heart has been regarded as a terminally differentiated organ for decades. There are numerous indicators for the potency of myocardial regeneration, which opens up new avenues for the treatment of heart disease. Cardiac stem cells (CSCs) have been discovered in the human heart and they play a vital role in myocardial regeneration. This review discusses the distribution, properties and proliferation of CSCs in the myocardium of patients with heart disease. Additionally, the potency of myoca...

  7. Estimation of pulmonary water distribution and pulmonary congestion by computed tomography

    International Nuclear Information System (INIS)

    Computed tomography (CT) of the lung in normal subjects and patients with congestive heart failure was performed in the supine position with deep inspiration to obtain pulmonary CT values and images. The mean CT value in normal subjects was higher in the posterior than anterior lung field, presumably because blood vessels were more dilated in the former than the latter due to the effects of gravity. The mean pulmonary CT value in patients with congestive heart failure was significantly increased possibly due to an increase in blood flow per unit lung volume arising from either pulmonary congestion or pulmonary interstitial and alveolar edema. The mean pulmonary CT value increased parallel to the severity of pulmonary congestion, interstitial or alveolar edema and was well correlated with the pulmonary arterial wedge pressure, indicating that such a correlation was a valuable tool in assessing therapeutic effects. The results of the present study indicatethat pulmonary CT is useful for the noninvasive estimation of intrapulmonary water content and its distribution, thereby providing an effective diagnostic clue to various conditions in congestive heart failure. (author)

  8. Human bone marrow-derived mesenchymal stem cells transplanted into damaged rabbit heart to improve heart function*

    OpenAIRE

    Wang, Jian-an; Fan, You-qi; Li, Chang-Ling; He, Hong; Sun, Yong; Lv, Bing-jian

    2005-01-01

    Objective: The present study was designed to test whether transplantation of human bone marrow-derived mesenchymal stem cells (hMSCs) in New Zealand rabbits with myocardial infarction can improve heart function; and whether engrafted donor cells can survive and transdifferentiated into cardiomyocytes. Methods: Twenty milliliters bone marrow was obtained from healthy men by bone biopsy. A gradient centrifugation method was used to separate bone marrow cells (BMCs) and red blood cells. BMCs wer...

  9. Immunosuppressive T-cell antibody induction for heart transplant recipients

    DEFF Research Database (Denmark)

    Penninga, Luit; Møller, Christian H; Gustafsson, Finn;

    2013-01-01

    Heart transplantation has become a valuable and well-accepted treatment option for end-stage heart failure. Rejection of the transplanted heart by the recipient's body is a risk to the success of the procedure, and life-long immunosuppression is necessary to avoid this. Clear evidence is required...... to identify the best, safest and most effective immunosuppressive treatment strategy for heart transplant recipients. To date, there is no consensus on the use of immunosuppressive antibodies against T-cells for induction after heart transplantation....

  10. Optimum congestion pricing in a complex network

    OpenAIRE

    Babri, Sahar; McArthur, David Philip; Thorsen, Inge; Ubøe, Jan

    2013-01-01

    Road tolls are a well established way of dealing with problems of con- gestion. Over recent years, the literature has expanded to take account of how congestion charges might interact with imperfections in other mar- kets. In this paper, we consider the case where congestion occurs within a complex road network, with congestion on multiple links. To derive a truly optimal toll, account must be taken of the entire network. As a case study, we take a stylised version of the ro...

  11. Self-perceived symptoms and care needs of patients with severe to very severe chronic obstructive pulmonary disease, congestive heart failure or chronic renal failure and its consequences for their closest relatives: the research protocol

    Directory of Open Access Journals (Sweden)

    Schols Jos MGA

    2008-05-01

    Full Text Available Abstract Background Recent research shows that the prevalence of patients with very severe chronic obstructive pulmonary disease (COPD, congestive heart failure (CHF and chronic renal failure (CRF continues to rise over the next years. Scientific studies concerning self-perceived symptoms and care needs in patients with severe to very severe COPD, CHF and CRF are scarce. Consequently, it will be difficult to develop an optimal patient-centred palliative care program for patients with end-stage COPD, CHF or CRF. The present study has been designed to assess the symptoms, care needs, end-of-life care treatment preferences and communication needs of patients with severe to very severe COPD, CHF or CRF. Additionally, family distress and care giving burden of relatives of these patients will be assessed. Methods/design A cross-sectional comparative and prospective longitudinal study in patients with end-stage COPD, CHF or CRF has been designed. Patients will be recruited by their treating physician specialist. Patients and their closest relatives will be visited at baseline and every 4 months after baseline for a period of 12 months. The following outcomes will be assessed during home visits: self-perceived symptoms and care needs; daily physical functioning; general health status; end-of-life care treatment preferences; end-of-life care communication and care-giver burden of family caregivers. Additionally, end-of-life care communication and prognosis of survival will be assessed with the physician primarily responsible for the management of the chronic organ failure. Finally, if patients decease during the study period, the baseline preferences with regard to life-sustaining treatments will be compared with the real end-of-life care. Discussion To date, the symptoms, care needs, caregiver burden, end-of-life care treatment preferences and communication needs of patients with very severe COPD, CHF or CRF remain unknown. The present study will

  12. Assessment of network traffic congestion through Traffic Congestability Value (TCV: a new index

    Directory of Open Access Journals (Sweden)

    Patel Nilanchal

    2015-12-01

    Full Text Available Traffic congestion is a major and growing problem in urban areas across the globe. It reduces the effective spatial interaction between different locations. To mitigate traffic congestion, not only the actual status of different routes needs to be known but also it is imperative to determine network congestion in different spatial zones associated with distinct land use classes. In the present paper, a new formula is proposed to quantify traffic congestion in the different spatial zones of a study area characterized by distinct land use classes. The proposed formula is termed the Traffic Congestability Value (TCV. The formula considers three major influencing factors: congestion index value, pedestrian movement and road surface conditions; since these parameters are significantly related to land use in a region. The different traffic congestion parameters, i.e. travel time, average speed and the proportion of time stopped, were collected in real time. Lower values of TCV correspond to a higher degree of congestion in the respective spatial zones and vice-versa and the results were validated in the field. TCV differs from the previous approaches to quantifying traffic congestion since it focuses on the causes of network congestion while in previous works the focus was generally on link flow congestion.

  13. General practitioners' reasoning when considering the diagnosis heart failure: a think-aloud study

    Directory of Open Access Journals (Sweden)

    Bring Johan

    2005-01-01

    Full Text Available Abstract Background Diagnosing chronic heart failure is difficult, especially in mild cases or early in the course of the disease, and guidelines are not easily implemented in everyday practice. The aim of this study was to investigate general practitioners' diagnostic reasoning about patients with suspected chronic heart failure in comparison with recommendations in European guidelines. Methods Think-aloud technique was used. Fifteen general practitioners reasoned about six case vignettes, representing authentic patients with suspected chronic heart failure. Information about each case was added successively in five steps. The general practitioners said their thoughts aloud while reasoning about the probability of the patient having chronic heart failure, and tried to decide about the diagnosis. Arguments for and against chronic heart failure were analysed and compared to recommendations in guidelines. Results Information about ejection fraction was the most frequent diagnostic argument, followed by information about cardiac enlargement or pulmonary congestion on chest X-ray. However, in a third of the judgement situations, no information about echocardiography was utilized in the general practitioners' diagnostic reasoning. Only three of the 15 doctors used information about a normal electrocardiography as an argument against chronic heart failure. Information about other cardio-vascular diseases was frequently used as a diagnostic argument. Conclusions The clinical information was not utilized to the extent recommended in guidelines. Some implications of our study are that 1 general practitioners need more information about how to utilize echocardiography when diagnosing chronic heart failure, 2 guidelines ought to give more importance to information about other cardio-vascular diseases in the diagnostic reasoning, and 3 guidelines ought to treat the topic of diastolic heart failure in a clearer way.

  14. Endometriosis Linked to Heart Disease in Study

    Science.gov (United States)

    ... epidemiologic research in reproductive medicine at Brigham and Women's Hospital in Boston. Missmer said the study found an association between endometriosis and the risk of heart disease, but can't prove a cause-and-effect relationship. She believes this is the first study to ...

  15. Voiding dysfunction in patients with nasal congestion treated with pseudoephedrine: a prospective study

    Science.gov (United States)

    Shao, I-Hung; Wu, Chia-Chen; Tseng, Hsiao-Jung; Lee, Ta-Jen; Lin, Yu-Hsiang; Tam, Yuan-Yun

    2016-01-01

    Background Pseudoephedrine is a sympathomimetic drug widely used as a nasal decongestant. However, it can cause adverse effects, such as voiding dysfunction. The risk of voiding dysfunction remains uncertain in patients without subjective voiding problems. Methodology We prospectively enrolled patients with nasal congestion who required treatment with pseudoephedrine from May to August 2015. All patients denied concomitant subjective voiding problem. The International Prostate Symptom Score (IPSS) questionnaire was used to evaluate voiding function before and 1 week after the pseudoephedrine treatment. The results of the IPSS questionnaire were analyzed as the total (IPSS-T), voiding (IPSS-V), storage (IPSS-S), and quality of life due to urinary symptom scores. Results We enrolled 131 males with a mean age of 42.0±14.3 years. The IPSS-T, IPSS-V, and IPSS-S scores slightly increased after the medication (IPSS-T increased from 6.49 to 6.77, IPSS-V from 3.33 to 3.53, and IPSS-S from 3.17 to 3.24). The quality of life due to urinary symptom score nonsignificantly decreased from 2.02 to 1.87. We observed that older age and a higher premedication IPSS-V score yielded significant differences (P50 years, even without subjective voiding symptoms. PMID:27486310

  16. Liguzinediol improved the heart function and inhibited myocardial cell apoptosis in rats with heart failure

    OpenAIRE

    Li, Yu; Song, Ping; ZHU Qing; Yin, Qiu-yi; Ji, Jia-wen; Li, Wei; Bian, Hui-min

    2014-01-01

    Aim: Liguzinediol is a novel derivative of ligustrazine isolated from the traditional Chinese medicine Chuanxiong (Ligusticum wallichii Franch), and produces significant positive inotropic effect in isolated rat hearts. In this study we investigated the effects of liguzinediol on a rat model of heart failure. Methods: To induce heart failure, male SD rats were injected with doxorubicin (DOX, 2 mg/kg, ip) once a week for 4 weeks. Then the rats were administered with liguzinediol (5, 10, 20 mg·...

  17. A case study on multi-lane roundabouts under congestion: Comparing software capacity and delay estimates with field data

    Directory of Open Access Journals (Sweden)

    Xuanwu Chen

    2016-04-01

    Full Text Available Existing studies on modern roundabouts performance are mostly based on data from singe lane roundabouts that are not heavily congested. For planners and designers interested in building multilane roundabouts for intersections with potential growth in future traffic, there has been a lack of existing studies with field data that provide reference values in terms of capacity and delay measurements. With the intent of providing such reference values, a case study was conducted by using the East Dowling Road Roundabouts in Anchorage, Alaska, which are currently operating with extensive queues during the evening peak hours. This research used multiple video camcorders to capture vehicle turning movements at the roundabouts as well as the progression of vehicle queues at the roundabout entrance approaches. With these video records, the number of vehicles in the queues can be accurately counted in any single minute during the peak hours. This study shows that unbalanced entrance flow patterns (i.e., one entrance has significant higher flow than others can intensify the queue and delay for the overall roundabouts. Then various software packages including RODEL, SIDRA and VISSIM were used to estimate several performance measurements, such as capacity, queue length, and delay, compared with the collected field data. With the comparison, it is found that all the three software packages overestimate multi-lane roundabout capacity before calibration. With default parameters, SIDRA and VISSIM tend to underestimate delays and queue lengths for the multi-lane roundabouts under congestion, while RODEL results in higher delay and queue length estimations at most of the entrance approaches.

  18. Traffic Congestion and Accidents

    OpenAIRE

    Schrage, Andrea

    2006-01-01

    Obstructions caused by accidents can trigger or exacerbate traffic congestion. This paper derives the efficient traffic pattern for a rush hour with congestion and accidents and the corresponding road toll. Compared to the model without accidents, where the toll equals external costs imposed on drivers using the road at the same time, a new insight arises: An optimal toll also internalizes the expected increase in future congestion costs. Since accidents affect more drivers if traffic volumes...

  19. Measuring road congestion

    OpenAIRE

    Panayotis CHRISTIDIS; IBANEZ RIVAS Juan Nicolas

    2012-01-01

    The methodology presented here allows to measure and monitor road congestion across Europe using data from TomTom in-vehicle navigation systems. The approach is based on the analysis of a large number of real vehicle speeds that have been measured on each road link and the application of algorithms that allow the estimation of congestion indicators for specific types of roads during selected time periods. The results include the detailed mapping of recurrent congestion both geographically and...

  20. A Hospital-Based Study on Causes Peculiar to Heart Failure

    Directory of Open Access Journals (Sweden)

    Muhammad Hafizullah

    2009-03-01

    Full Text Available Background: We sought to determine the frequency of the risk factors for congestive cardiac failure (CCF in a tertiary care hospital in Peshawar, Pakistan. Methods: This retrospective, observational study was conducted in the department of cardiology, Postgraduate Medical Institute, Lady Reading Hospital Peshawar, from March 2005 to September 2007. Relevant information regarding the risk factors of CCF was recorded on questionnaires, devised in accordance with the objectives of the study. Results: This study recruited 1019 patients with an established diagnosis of CCF on the basis of clinical findings and pertinent investigations. The study population comprised 583 (57.12% men and 436 (42.78% women. The patients’ age ranged from 6 years to 82 years with a mean age of 48.5 years and a mode of age of 45 years. The distribution of the causative factors of CCF was as follows: ischemic heart disease in 38.56%; hypertension in 26.30%; dilated cardiomyopathies in 10.10%; obstructive and restrictive cardiomyopathies in 5.39%; valvular heart diseases in 9.32%; congenital heart diseases like ventricular septal defects and atrial septal defects in 4.41% and 0.58%, respectively; constrictive pericarditis in 1.07%; pericardial effusion in 0.68%; chronic obstructive pulmonary disease and pulmonary hypertension in 1.47%; thyrotoxicosis in 0.68%; complete heart block in 0.29%; and Paget’s disease in 0.09% of the cases.Conclusion: Ischemic heart disease, hypertension, cardiomyopathy, valvular heart disease, and congenital heart disease were the major contributors to CCF in our patients.

  1. Cells and Angiogenic Cytokines in Therapeutic Angiogenesis for Ischemic Heart Disease

    DEFF Research Database (Denmark)

    Luo, Yu; Zhang, Dai-Fu; Liang, Bo

    2005-01-01

    In the past 20 to 30 years,great developments had been achieved in the applying of cells and angiogenic cytokines for ischemic heart disease.The thesis reviews latest studies of mechanism and clinic application of this novel therapy.......In the past 20 to 30 years,great developments had been achieved in the applying of cells and angiogenic cytokines for ischemic heart disease.The thesis reviews latest studies of mechanism and clinic application of this novel therapy....

  2. Surgery of congestive heart failure - the role of computed tomography in the pre- and postsurgical diagnostic evaluation; Chirurgie der Herzinsuffizienz - Stellenwert der Computertomographie in der prae- und postoperativen Diagnostik

    Energy Technology Data Exchange (ETDEWEB)

    Lembcke, A.; Kivelitz, D.E.; Rogalla, P.; Dewey, M.; Klessen, C.; Hamm, B.; Enzweiler, C.N.H. [Inst. fuer Radiologie, Charite - Universitaetsmedizin Berlin, Charite Campus Mitte, Berlin (Germany); Dohmen, P.M.; Konertz, W.F. [Klinik fuer Kardiovaskulaere Chirurgie, Charite - Universitaetsmedizin Berlin, Charite Campus Mitte, Berlin (Germany); Wiese, T.H. [Inst. fuer Radiologie, Augusta-Kranken-Anstalt, Bochum (Germany)

    2005-07-01

    The treatment of advanced, drug resistant congestive heart failure gains in importance in the field of cardiac surgery. Cardiac imaging for preoperative assessment and follow-up focuses on the determination of ventricular volumes and function as well as on the detection of postoperative complications. Computed tomography (CT) is highly accurate irrespective of the individual patient's anatomic situation, has a low examiner dependence and short examination time, does not require an arterial vascular access and can be performed in patients with metal implants. CT is the modality of choice in the follow-up of heart transplants to detect extracardiac and cardiac complications including coronary calcifications as an early sign of transplant vasculopathy. In addition, CT visualizes the elements of mechanical assist devices and can identify their possible local cardiac and mediastinal complications CT can detect fibrolipomatous involution of the mobilized muscle flap in dynamic cardiomyoplasty and can depict fibrous reactions along the epicardial mesh implant in passive cardiac containment. Further indications include assessment of typical local postoperative complications, such as intrathoracic infection and mediastinal bleeding, intracardiac thrombus formation or pericardial effusion. CT is routinely used for evaluating bypass patency but is limited in assessing associated valve defects since it does not visualize flow. (orig.)

  3. 胺碘酮治疗充血性心力衰竭合并心房颤动临床研究%The Clinical Research of Amiodarone Treatment Congestive Heart Failure Merger Atrial Fibrillation

    Institute of Scientific and Technical Information of China (English)

    胡华元; 刘建修; 廖远雄

    2011-01-01

    Objective:The objective of this essay was to observe the clinial research of Amiodarone treatment congestive heart failure merger atrial fibrillation.Methods:180 patients randomly into two groups of comparison group and observation group with 90 members for each respectively.The observation group treated with fundamental Resistance to heart failure treatment like furosemidum,digoxin and oxygen uptake,and at the same time, added up amiodarone with 600mg/d in the first week,400mg/d in the second week and 200mg/d lasted for three months.The comparison group took advantage of cardiac tonic,diuresis and extender vascular medicine regularly.Results:To compare the clinical results of two groups' Amiodarone treatment congestive heart failure merger atrial fibrillation.the total effective rate of the observation group was 92.22%,while that of the comparison group was 81.11%.Their compparative differences entailed the useful meaning of statistics(P <0.05).To compare the improvement situation of their patients'electrocardiogram,the total effective rate of the observation group was 86.67%,while that of the comparison group was 74.44%.Their comparative differences entailed the useful meaning of statistics(P<0.05).Conclusions:Thus we could draw the conclusion that amiodarone possesses the advantages of high curative effect and small side effects in treating the Amiodarone treatment congestive heart failure merger atrial fibrillation.%目的:观察胺碘酮治疗充血性心力衰竭(CHF)合并心房颤动(AF)的临床疗效.方法:随机将入组180例患者随机分为对照组和观察组各90例.观察组予以速尿、地高辛、吸氧等基础抗心衰治疗,同时加用胺碘酮,第1周600mg/d,第2周400mg/d,以后改用200mg/d持续3个月;对照组常规使用强心、利尿、扩血管药.结果:2组CHF合并AF患者临床疗效比较,观察组总有效率为92.22%,对照组总有效率为81.11%,2组比较差异有统计学意义(P<0.05);2组CHF合并AF

  4. Comparison of Standard and Heart-pacer Type 3rd Electrodes in Design Variable Cells

    Science.gov (United States)

    Morrow, G. W.

    1984-01-01

    Nine packs of sealed aerospace nickel cadmium cells were put on life test in February 1979. Each 5 cell pack contained one cell with a standard sensor signal electrode and one cell with a new heart pacer sensor signal electrode. Testing was discontinued in May 1983 and the signal electrode performance data was studied. It was found that the heart pacer electrode generally provided a greater voltage swing over a cycle; that both types of electrodes lost significant sensitivity during life, and that both types of electrodes show great signal variation from cell to cell.

  5. 性别因素对心力衰竭住院患者病因和预后的影响%Associations of gender and etiology with outcomes in hospitalized patients with congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    尹巧香; 赵玉生; 侯晓平

    2012-01-01

    Objective To explore the gender-related differences in etiology and outcomes of congestive heart failure(CHF)in hospitalized patients. Methods A retrospective study was performed in 6949 patients (4344 males, 2605 females) with a validated primary discharge diagnosis of CHF hospitalized from January 1,1993,through December 31,2007. The patients were divided into two groups according to the gender, to explore the gender-related differences in etiology and 30-days in-hospital mortality. Results Irrespective of etiology in hospitalized patients with CHF,men were more coronary artery disease (49.6% ,P=0.000) .hypertension (39.3% ,P = 0.000)and cardiomy-opathy(8.0%,P =0.001). Women were more valvular disease(37. 5% ,P =0. 000) ,cor pulmonale( 10. 6% ,P = 0.008) and hyperthyrosis (1.0% ,P = 0.002). Hospital mortality of heart failure was higher among women than among men between the age ranges 18-29 years,in-hospital mortality was almost threefold (4.8% vs 1.7% ,P =0.000) ,and by age ranges ≥80 years (16.1 % vs 11.4% ,P =0.000). With the rising of age, both men and women were all high in-hospital mortality. Conclusion In-hospital mortality differ by both gender and etiology among hospitalized patients with CHF. Understanding these differences can help better management of CHF patients and improved overall prognosis.%目的 调查不同性别对心力衰竭住院患者病因和预后的影响.方法 1993年1月至2007年12月初次住院有效诊断充血性心力衰竭患者6949例(男4344例,女2605例),按照性别不同分成2组,比较各组间的病因及30 d在院病死率.结果 心力衰竭住院患者中,男性病因以冠心病(49.6%)、高血压(39.3%)和心肌病(8.0%)为主.而女性以瓣膜性心脏病(37.5%),肺心病(10.6%)和甲亢(1.0%)为主.在18 ~29岁人群组,女性的死亡率几乎为男性的3倍(4.8%vs 1.7%);在≥80岁以上人群组,女性死亡率显著高于男性( 16.1% vs 11.4%).随着年龄增长,男性和女

  6. Convex Congestion Network Problems

    OpenAIRE

    2004-01-01

    This paper analyzes convex congestion network problems.It is shown that for network problems with convex congestion costs, an algorithm based on a shortest path algorithm, can be used to find an optimal network for any coalition. Furthermore an easy way of determining if a given network is optimal is provided.

  7. Congestion and residential moving behaviour

    DEFF Research Database (Denmark)

    Larsen, Morten Marott; Pilegaard, Ninette; Van Ommeren, Jos

    2008-01-01

    we study how congestion and residential moving behaviour are interrelated, using a two-region job search model. Workers choose between interregional commuting and residential moving, in order to live closer to their place of work. This choice affects the external costs of commuting, due to...

  8. Time, Speeds, Flows and Densities in Static Models of Road Traffic Congestion and Congestion Pricing

    OpenAIRE

    Verhoef, Erik

    1997-01-01

    This paper studies some of the properties and fundamentals of static models of road traffic congestion that have triggered much debate in the literature. The first part of the paper focuses in particular on the difficulties arising with the backward-bending cost curve in the context of 'continuous congestion'. Therelevance of the backward-bending segment of the cost curve for the static analysis of congestion is questioned by demonstrating that 'equilibria' on this segment produce upwards shi...

  9. Heart failure

    Institute of Scientific and Technical Information of China (English)

    1997-01-01

    970284 Effects of enalapril on heart rate variabilityin patients with congestive heart failure. ZHANGYouhua(章友华), et a1. Dept Cardiol, Cardiovasc Instit& Fuwai Hosp, CAMS & PUMC, Beijing, 100037. ChinCir J 1996; 11(2): 729-732.

  10. Efficacy of trimetazidine combined with perindopril on treating congestive heart failure%曲美他嗪联合培哚普利治疗充血性心力衰竭效果观察

    Institute of Scientific and Technical Information of China (English)

    周发展; 卢连元; 张焕轶

    2010-01-01

    Objective To study the efficacy of trimetazidine combined with perindopril in treating congestive heart failure (CHF). Methods One hundred and eighteen patients with CHF were randomly divided into experimental group and control group. All patients were given conventional medical treatment. Patients in the control group was treated with additionally with perindopril. The initial dose was 2 mg/d, and gradually increased to target dose of 4 mg/d. The experimental group was additionally treated with trimetazidine 20 mg orally 3 times a day for 12 weeks based on the regimen in the control group. The changes of left ventricular ejection fraction ( LVEF) , left ventricular end of diastolic volume ( LVEDV) , left ventricular end of systolic volume ( LVESV), stroke volume (SV),cardiac output (CO)and cardiac function (NYHA) were observed. Results In the experiment group, after treatment,LVEF,LVEDV,LVESV,CO and SV were(46. 89 ±8. 00)% ,(129. 20 ±25. 00)ml, (70.90 ±32. 00)ml, (4. 32 ±0. 65 ) L/min and (55. 06 ± 13. 27) ml, respectively, which were significantly improved compared to those before treatment (29.60 ± 11. 00)% ,(164. 40 ± 31. 00) ml, (95. 60 ± 33. 00) ml, (2.91 ±0.56) L/min and (37. 69 ± 13. 62) ml .respectively) ( P < 0.01 or P < 0. 05). After treatment, the LVEF, LVEDV, LVESV, CO and SV were (46.89 ± 8. 00)% , (34. 70 ± 9. 00)% ,( 129. 20 ± 25. 00) ml, ( 148. 20 ±29. 00) ml and (70.90 ± 32. 00)ml in the experiment group, respectively, which were significantly higher than those in the control group (81. 10 ±31.00)ml, (4. 32 ±0.65) L/min, (3. 14 ±0.60) L/min, (55. 06 ±13.27 )ml and (49. 56 ± 14. 29) ml, respectively) (P <0. 01 or P <0. 05). The overall effective rate in the experiment group was 93. 2% .which was significantly higher than that in the control group (66. 1% ) ( P < 0.01). No obvious adverse effect was observed. Conclusions The effect of trimetazidine combined with perindopril in treating congestive heart failure is satisfactory. It

  11. Cheyne-Stokes respiration in patients with congestive heart failure: causes and consequences A respiração de Cheyne-Stokes em pacientes com insuficiência cardíaca congestiva: causas e conseqüências

    Directory of Open Access Journals (Sweden)

    Geraldo Lorenzi-Filho

    2005-08-01

    Full Text Available Cheyne-Stokes respiration is a form of periodic breathing in which central apneas and hypopneas alternate with periods of hyperventilation, producing a waxing and waning pattern of tidal volume. This review focuses on the causes and consequences of Cheyne-Stokes respiration in patients with congestive heart failure, in whom the prevalence is strikingly high and ranges from 30% to 50%. Several factors have been implicated in the genesis of Cheyne-Stokes respiration, including low cardiac output and recurrent hypoxia. The key pathophysiological mechanism triggering Cheyne-Stokes respiration is hyperventilation and low arterial CO2 (PaCO2 that when below the apneic threshold triggers a central apnea. Hyperventilation is associated with pulmonary congestion, and Cheyne-Stokes respiration is more prone to occur during sleep, when the respiratory system is mainly dependent on chemical control. It is associated with recurrent dips in oxygen saturation and arousals from sleep, with oscillations in blood pressure and heart rate, sympathetic activation and increased risk of ventricular tachycardia. Cheyne-Stokes respiration is an independent marker of poor prognosis and may participate in a vicious cycle, further stressing the failing heart.A respiração de Cheyne-Stokes é uma forma de respiração periódica na qual apnéias e hipopnéias se alternam com períodos de hiperpnéias que apresentam um padrão crescendo e decrescendo de volume corrente. Esta revisão enfoca as causa e conseqüências da respiração de Cheyne- Stokes em pacientes com insuficiência cardíaca congestiva na qual a prevalência é extremamente alta e varia entre 30 a 50%. Vários fatores foram implicados na gênese da respiração de Cheyne-Stokes, incluindo baixo debito cardíaco e hipoxia recorrente. Hiperventilacão e baixos níveis de CO2 arterial (PaCO2, que quando abaixo do limiar de apnéia desencadeiam apnéia central são os mecanismos fisiopatológicos chave na g

  12. Evaluation Framework For Commercial Vehicle Responses To Congestion Pricing

    OpenAIRE

    Wachs, Martin; Kawamura, Kazuya

    1997-01-01

    This report presents a short-run framework for analyzing the impacts of congestion pricing on commercial vehicles. The framework is based on microeconomics principles and past theoretical studies of congestion pricing. The relationship between value of time and the welfare gain/loss induced by using congestion pricing is identified. The social cost function and empirical demand and supply functions are also discussed.

  13. Donor-derived exosomes induce specific regulatory T cells to suppress immune inflammation in the allograft heart

    OpenAIRE

    Jiangping Song; Jie Huang; Xiao Chen; Xiao Teng; Zhizhao Song; Yong Xing; Mangyuan Wang; Kai Chen; Zheng Wang; Pingchang Yang; Shengshou Hu

    2016-01-01

    To inhibit the immune inflammation in the allografts can be beneficial to organ transplantation. This study aims to induce the donor antigen specific regulatory T cells (Treg cell) inhibit the immune inflammation in the allograft heart. In this study, peripheral exosomes were purified from the mouse serum. A heart transplantation mouse model was developed. The immune inflammation of the allograft heart was assessed by histology and flow cytometry. The results showed that the donor antigen-spe...

  14. Translational research of adult stem cell therapy

    Institute of Scientific and Technical Information of China (English)

    Gen; Suzuki

    2015-01-01

    Congestive heart failure(CHF) secondary to chronic coronary artery disease is a major cause of morbidity and mortality world-wide. Its prevalence is increasing despite advances in medical and device therapies. Cell based therapies generating new cardiomyocytes and vessels have emerged as a promising treatment to reverse functional deterioration and prevent the progression to CHF. Functional efficacy of progenitor cells isolated from the bone marrow and the heart have been evaluated in preclinical large animal models. Furthermore, several clinical trials using autologous and allogeneic stem cells and progenitor cells have demonstrated their safety in humans yet their clinical relevance is inconclusive. This review will discuss the clinical therapeutic applications of three specific adult stem cells that have shown particularly promising regenerative effects in preclinical studies, bone marrow derived mesenchymal stem cell, heart derived cardiosphere-derived cell and cardiac stem cell. We will also discuss future therapeutic approaches.

  15. Telocytes and putative stem cells in ageing human heart

    Science.gov (United States)

    Popescu, Laurentiu M; Curici, Antoanela; Wang, Enshi; Zhang, Hao; Hu, Shengshou; Gherghiceanu, Mihaela

    2015-01-01

    Tradition considers that mammalian heart consists of about 70% non-myocytes (interstitial cells) and 30% cardiomyocytes (CMs). Anyway, the presence of telocytes (TCs) has been overlooked, since they were described in 2010 (visit http://www.telocytes.com). Also, the number of cardiac stem cells (CSCs) has not accurately estimated in humans during ageing. We used electron microscopy to identify and estimate the number of cells in human atrial myocardium (appendages). Three age-related groups were studied: newborns (17 days–1 year), children (6–17 years) and adults (34–60 years). Morphometry was performed on low-magnification electron microscope images using computer-assisted technology. We found that interstitial area gradually increases with age from 31.3 ± 4.9% in newborns to 41 ± 5.2% in adults. Also, the number of blood capillaries (per mm2) increased with several hundreds in children and adults versus newborns. CMs are the most numerous cells, representing 76% in newborns, 88% in children and 86% in adults. Images of CMs mitoses were seen in the 17-day newborns. Interestingly, no lipofuscin granules were found in CMs of human newborns and children. The percentage of cells that occupy interstitium were (depending on age): endothelial cells 52–62%; vascular smooth muscle cells and pericytes 22–28%, Schwann cells with nerve endings 6–7%, fibroblasts 3–10%, macrophages 1–8%, TCs about 1% and stem cells less than 1%. We cannot confirm the popular belief that cardiac fibroblasts are the most prevalent cell type in the heart and account for about 20% of myocardial volume. Numerically, TCs represent a small fraction of human cardiac interstitial cells, but because of their extensive telopodes, they achieve a 3D network that, for instance, supports CSCs. The myocardial (very) low capability to regenerate may be explained by the number of CSCs, which decreases fivefold by age (from 0.5% to 0.1% in newborns versus adults). PMID:25545142

  16. Antidepressant No Help to Heart Failure Patients: Study

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_159604.html Antidepressant No Help to Heart Failure Patients: Study Depression ... 2016 TUESDAY, June 28, 2016 (HealthDay News) -- The antidepressant Lexapro may not help heart failure patients suffering ...

  17. Study Finds No Heart Risk from SSRI Antidepressants

    Science.gov (United States)

    ... Study Finds No Heart Risk From SSRI Antidepressants Prozac actually appeared to protect against heart attack, researchers ... analysis suggests. Commonly prescribed SSRIs include Celexa, Lexapro, Prozac, Paxil and Zoloft. The findings are reassuring, said ...

  18. Snoring and Nasal Congestion

    Science.gov (United States)

    ... the noisy breathing caused by vibrations of the upper airway during sleep. In contrast to snoring (noisy but ... can even require a tracheostomy to bypass the upper airway obstruction. If you suffer from nasal congestion, snoring, ...

  19. Progenitor Cell Therapy to Treat Acute Myocardial Infarction: The Promise of High-Dose Autologous CD34+ Bone Marrow Mononuclear Cells

    OpenAIRE

    Poole, Joseph C.; Quyyumi, Arshed A.

    2013-01-01

    ST elevation myocardial infarction (STEMI) is associated with an increased risk for congestive heart failure and long-term mortality despite the widespread use of thrombolysis and catheter-based revascularization. The need for improved post-STEMI therapies has led to a surge of novel therapeutics, especially regenerative approaches using autologous mononuclear cells. Indeed, the past decade has been marked by a number of human trials studying the safety and efficacy of progenitor cell deliver...

  20. Xenopus: An Emerging Model for Studying Congenital Heart Disease

    OpenAIRE

    Kaltenbrun, Erin; Tandon, Panna; Amin, Nirav M.; Waldron, Lauren; Showell, Chris; Conlon, Frank L

    2011-01-01

    Congenital heart defects affect nearly 1% of all newborns and are a significant cause of infant death. Clinical studies have identified a number of congenital heart syndromes associated with mutations in genes that are involved in the complex process of cardiogenesis. The African clawed frog, Xenopus, has been instrumental in studies of vertebrate heart development and provides a valuable tool to investigate the molecular mechanisms underlying human congenital heart diseases. In this review, ...

  1. Mesenchymal stem cell therapy for heart disease.

    Science.gov (United States)

    Gnecchi, Massimiliano; Danieli, Patrizia; Cervio, Elisabetta

    2012-08-19

    Mesenchymal stem cells (MSC) are adult stem cells with capacity for self-renewal and multi-lineage differentiation. Initially described in the bone marrow, MSC are also present in other organs and tissues. From a therapeutic perspective, because of their easy preparation and immunologic privilege, MSC are emerging as an extremely promising therapeutic agent for tissue regeneration and repair. Studies in animal models of myocardial infarction have demonstrated the ability of transplanted MSC to engraft and differentiate into cardiomyocytes and vascular cells. Most importantly, engrafted MSC secrete a wide array of soluble factors that mediate beneficial paracrine effects and may greatly contribute to cardiac repair. Together, these properties can be harnessed to both prevent and reverse remodeling in the ischemically injured ventricle. In proof-of-concept and phase I clinical trials, MSC therapy improved left ventricular function, induced reverse remodeling, and decreased scar size. In this review we will focus on the current understanding of MSC biology and MSC mechanism of action in cardiac repair. PMID:22521741

  2. Congestion levies; Congestieheffingen

    Energy Technology Data Exchange (ETDEWEB)

    Verhoef, E.T. [Vakgroep Ruimtelijke Economie, Vrije Universiteit en Tinbergen Instituut, Amsterdam (Netherlands)

    1998-02-20

    Traffic jams or congestion can be controlled by means of Pigouvian levies. Congestion costs comprise both time losses as scheduling costs. Because a part of those costs are external costs, the free market output is not Pareto-efficient, and therefore levies are required to recover the efficiency. With some restrictions, road-pricing for the western part of the Netherlands is considered to be a feasible option

  3. Congestion in the bathtub

    OpenAIRE

    Fosgerau, Mogens

    2015-01-01

    This paper presents a model of urban traffic congestion that allows for hypercongestion. Hypercongestion has fundamental importance for the costs of congestion and the effect of policies such as road pricing, transit provision and traffic management, treated in the paper. In the simplest version of the model, the unregulated Nash equilibrium is also the social optimum among a wide range of potential outcomes and any reasonable road pricing scheme will be welfare decreasing. Large welfare gain...

  4. Assessment of re-distribution and efficacy of stem cell transplantation in different heart status after acute myocardial infarction by MRI: an experimental study

    International Nuclear Information System (INIS)

    Objective: To evaluate the efficacy of MRI for assessment of re-distribution of bone marrow mesenchymal stem cells injected intramyocardially in main organs (heart, liver, spleen and kidney) under different heart status (beating or arresting) in a porcine model. Methods: Bone marrow-derived mesenchymal stem cells were obtained from the male swine and labeled with iron oxide during culture. Acute myocardial infarction was created in female swine, one week later, the survivors were randomly divided into 4 groups. Cardiopulmonary bypass was set up to arrest the heart, and then labeled cells (1 × 108) were intramyocardially injected into the border of the infracted myocardium in group 1 (n=6). The same volume of cells was grafted into the beating heart in group 2 (n=6). In group 3 and 4, saline was injected into either the arresting or beating myocardium. Three days later, re-distribution of stem cells and cardiac function were assessed by T2* WI and cine MRI, respectively. All animals were sacrificed for histology and real-time quantitative polymerase chain reaction (RT-PCR) of sex-determining region on Y-chromosome (SRY) investigation. The ANOVA and t test was used for statistics. Results: The left ventricular end- diastolic volume (LVEDV) before transplantation for group 1-4 were: (56.8±5.3), (54.8±6.8), (57.4±4.3) and (56.8±2.8) ml, and after transplantation for group 1-4 were: (65.2±5.2), (63.2± 3.7), (60.2±4.7) and (62.2±4.4) ml. The left ventricular end-systolic volume (LVESV) before transplantation for group 1-4 were : (33.5±7.6), (32.3±5.3), (33.5±3.6) and (32.7±4.6) ml, and after transplantation for group 1-4 were: (37.3±5.6), (36.3±6.9), (34.3±5.4) and (36.3± 8.1) ml. The left ventricular EF values (LVEF) before transplantation for group 1-4 were: (42.3± 7.2)%, (41.7±6.8)%, (41.8±8.6)% and (42.7±7.7)%, and after transplantation for group 1- 4 were: (44.5±8.7)%, (43.1±7.4)%, (42.8±5.6)% and (43.3±8.4)%. The myocardial infarction area

  5. Epidemiology and burden of nasal congestion

    Directory of Open Access Journals (Sweden)

    Michael Stewart

    2010-02-01

    Full Text Available Michael Stewart1, BJ Ferguson2, Len Fromer31Department of Otorhinolaryngology, Weill Cornell Medical College, New York-Presbyterian Hospital/Weill Cornell Medical Center, USA; 2Department of Otolaryngology, University of Pittsburgh School of Medicine, USA; 3University of California, Los Angeles; David Geffen School of Medicine Los Angeles, California, USAAbstract: Nasal congestion, which may be described as fullness, obstruction, reduced airflow, or being “stuffed up,” is a commonly encountered symptom in clinical practice. Systematic study of congestion has largely considered it as a component of a disease state. Conditions associated with congestion include nasal polyposis, obstructive sleep apnea, and anatomic variation; however, most information on the burden of congestion comes from studies of allergic rhinitis and rhinosinusitis, diseases of which congestion is the major symptom. Congestion can be caused by other rhinologic conditions, such as non-allergic rhinitis, viral or bacterial rhinitis, and vasomotor rhinitis. Allergic rhinitis affects as much as one quarter of the population worldwide and imposes a significant economic burden. Additionally, allergic rhinitis significantly impairs quality of life; congestion causes allergic rhinitis sufferers decreased daytime productivity at work or school and reduces night-time sleep time and quality. Annually, rhinosinusitis affects tens of millions of Americans and leads to approximately $6 billion in overall health care expenditures; it has been found to be one of the most costly physical conditions for US employers. Given the high prevalence and significant social and economic burden of nasal congestion, this symptom should be a key consideration in treating patients with rhinologic disease, and there continues to be a significant unmet medical need for effective treatment options for this condition.Keywords: allergic rhinitis, congestion, epidemiology, obstruction, rhinosinusitis

  6. Stem Cell Therapy for Heart Failure

    OpenAIRE

    Michler, Robert E.

    2013-01-01

    The last decade has witnessed the publication of a large number of clinical trials primarily using bone marrow-derived stem cells as the injected cell. These “first-generation” clinical trials have advanced our understanding and shown us that (1) cell therapy is safe, (2) cell therapy has been modestly effective, and (3) in humans, bone marrow-derived stem cells do not transdifferentiate into cardiomyocytes or new blood vessels (or at least in sufficient numbers to have any effect).

  7. Congestion pricing: A mechanism design approach

    OpenAIRE

    Heller, C.-Philipp; Johnen, Johannes; Schmitz, Sebastian

    2015-01-01

    We study road congestion as a mechanism design problem. In our basic model we analyze the allocation of a set of drivers among two roads, one of which may be congested. An additional driver on the congestible road imposes an externality on the other drivers by increasing their travel time. Each driver is privately informed about her value of time and asked to report that value to the mechanism designer, who assigns drivers to roads. With a finite number of drivers, there is aggregate uncertai...

  8. Stem Cells and Progenitor Cells for Tissue-Engineered Solutions to Congenital Heart Defects

    OpenAIRE

    Yang Gao; Jacot, Jeffrey G.

    2015-01-01

    Synthetic patches and fixed grafts currently used in the repair of congenital heart defects are nonliving, noncontractile, and not electrically responsive, leading to increased risk of complication, reoperation, and sudden cardiac death. Studies suggest that tissue-engineered patches made from living, functional cells could grow with the patient, facilitate healing, and help recover cardiac function. In this paper, we review the research into possible sources of cardiomyocytes and other cardi...

  9. On endocytosis of foreign ferritin and occurrence of phagolysosomes in fish heart endothelial cells.

    Science.gov (United States)

    Leknes, Ingvar Leiv

    2016-04-01

    In the present study the ultrastructure and function of the endothelial cells enveloping the muscle trabeculae in heart in two teleosts, platyfish and firemouth cichlid, are described and discussed. These cells displayed a structure making them able to take up large amounts of foreign ferritin particles from the blood stream. The ferritin particles were assembled into huge phagolysosomes. Large amounts of Prussian blue were precipitated throughout these lysosomes when treated with acid ferrohexacyanide solution. The occurrence of Prussian blue precipitations in the control heart endothelial cells after Schmorl's solution, suggests that these cells normally contain undigestible material, a finding which strengthens the view that this tissue is involved in blood clearance in the present species. In conclusion, these heart endothelial cells seem able to perform a very efficient blood clearance of scavenger and foreign macromolecules and particles in the present species. PMID:26852295

  10. Telocytes and putative stem cells in ageing human heart

    OpenAIRE

    Laurentiu M. Popescu; Curici, Antoanela; Wang, Enshi; Zhang, Hao; Hu, Shengshou; Gherghiceanu, Mihaela

    2014-01-01

    Tradition considers that mammalian heart consists of about 70% non-myocytes (interstitial cells) and 30% cardiomyocytes (CMs). Anyway, the presence of telocytes (TCs) has been overlooked, since they were described in 2010 (visit http://www.telocytes.com). Also, the number of cardiac stem cells (CSCs) has not accurately estimated in humans during ageing. We used electron microscopy to identify and estimate the number of cells in human atrial myocardium (appendages). Three age-related groups we...

  11. A genome-wide association study of saturated, mono- and polyunsaturated red blood cell fatty acids in the Framingham Heart Offspring Study.

    Science.gov (United States)

    Tintle, N L; Pottala, J V; Lacey, S; Ramachandran, V; Westra, J; Rogers, A; Clark, J; Olthoff, B; Larson, M; Harris, W; Shearer, G C

    2015-03-01

    Most genome-wide association studies have explored relationships between genetic variants and plasma phospholipid fatty acid proportions, but few have examined apparent genetic influences on the membrane fatty acid profile of red blood cells (RBC). Using RBC fatty acid data from the Framingham Offspring Study, we analyzed over 2.5 million single nucleotide polymorphisms (SNPs) for association with 14 RBC fatty acids identifying 191 different SNPs associated with at least 1 fatty acid. Significant associations (pFADS (chromosome 11) and ELOVL (chromosome 6) regions. Multiple SNPs explained 8-14% of the variation in 3 high abundance (>11%) fatty acids, but only 1-3% in 4 low abundance (genes influence tissue fatty acid content and pathways modulated by fatty acids. PMID:25500335

  12. A randomised double blind placebo controlled clinical trial of a standardised extract of fresh Crataegus berries (Crataegisan) in the treatment of patients with congestive heart failure NYHA II.

    Science.gov (United States)

    Degenring, F H; Suter, A; Weber, M; Saller, R

    2003-01-01

    A placebo controlled, randomised, parallel group, multicentre trial conducted in accordance with the guidelines of Good Clinical Practice (GCP) shows the efficacy and safety of a standardised extract of fresh berries of Crataegus oxyacantha L. and monogyna Jacq. (Crataegisan) in patients with cardiac failure NYHA class II. A total of 143 patients (72 men, 71 women, mean age of 64.8 (8.0 years) were recruited and treated with 3 times 30 drops of the extract (n = 69) or placebo (n = 74) for 8 weeks. The primary variable for the evaluation of efficacy was the change in exercise tolerance determined with bicycle exercise testing, secondary variables included the blood pressure-heart rate product (BHP). Subjective cardiac symptoms at rest and at higher levels of exertion were assessed by the patient on a categorical rating scale. An overall assessment of efficacy at the final visit was provided by the patient and the investigator. In the ITT population there was a significant increase in exercise tolerance in both groups between visit 1 and visit 3. The difference between the treatment groups was 8.3 watts in favour of the standardised extract of fresh Crataegus berries (p = 0.045). The result is confirmed in the PP population (p = 0.047). Changes in BHP at 50 watts and at comparable maximum load were in favour of Crataegus extract but the results are not statistically significant. The subjective assessment of cardiac symptoms at rest and at higher levels of exertion did not change significantly and the patient and investigator overall assessment of efficacy were similar for the two groups. The medication was well tolerated and had a high level of patient acceptability. The significant improvement, due to the fact that dyspnoea and fatigue do not occur until a significantly higher wattage has been reached in the bicycle exercise testing allows the conclusion that the recruited NYHA II patients may expect an improvement in their heart failure condition under long term

  13. Prueba de esfuerzo cardiopulmonar (PEC en el síndrome de falla cardíaca. Una propuesta basada en la evidencia Cardiopulmonary exercise testing in congestive heart failure. a proposal based on evidence

    Directory of Open Access Journals (Sweden)

    Juan Manuel Sénior Sánchez

    2008-06-01

    ; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;}

    The purpose of this document is to present recommendations for the clinical utilization of the cardiopulmonary exercise testing in patients with congestive heart failure with special emphasis on the evidence-based medicine, by means of a systematic search of the literature. The cardiopulmonary exercise testing is a useful tool in the evaluation and follow-up of patients with heart failure, but it is infrequently used in the daily practice of specialists in internal medicine and clinical cardiology. It allows differential diagnoses in patients with dyspnea of unexplained cause; to evaluate the tolerance to exercise, the functional capacity and prognosis; to select patients for heart transplantation; to provide parameters for the prescription of exercise, and to monitor the response to training in rehabilitation programs.

  14. Primary synovial cell sarcoma of the heart: A rare case

    Directory of Open Access Journals (Sweden)

    Anil Sharma

    2015-01-01

    Full Text Available A synovial sarcoma (also known as malignant synovioma is a rare form of cancer that usually occurs near the joints of the arm, neck, or leg. It is one of the soft tissue sarcomas. Primary cardiac neoplasms are rare. Most common site for synovial sarcoma is lower limb. Synovial sarcoma of the heart is extremely rare. Occurrence of synovial sarcoma at extra synovial site is very uncommon. It is two times common in right side heart than left side so left side synovial sarcoma is rarest of rare, only very limited cases are reported. Here, we report a case of primary synovial cell sarcoma of the left side of the heart in a 26-year-old female. She presented with dyspnea and weakness only. She was operated for left-sided mass covering mitral valve; further histo-pathology revealed the mass as synovial cell sarcoma. In Indian scenario, this type of rare case needs documentation.

  15. Programming and reprogramming a human heart cell

    Science.gov (United States)

    Sahara, Makoto; Santoro, Federica; Chien, Kenneth R

    2015-01-01

    The latest discoveries and advanced knowledge in the fields of stem cell biology and developmental cardiology hold great promise for cardiac regenerative medicine, enabling researchers to design novel therapeutic tools and approaches to regenerate cardiac muscle for diseased hearts. However, progress in this arena has been hampered by a lack of reproducible and convincing evidence, which at best has yielded modest outcomes and is still far from clinical practice. To address current controversies and move cardiac regenerative therapeutics forward, it is crucial to gain a deeper understanding of the key cellular and molecular programs involved in human cardiogenesis and cardiac regeneration. In this review, we consider the fundamental principles that govern the “programming” and “reprogramming” of a human heart cell and discuss updated therapeutic strategies to regenerate a damaged heart. PMID:25712211

  16. Study on the effect of the survival time and the T cells in the discordant heart xenotransplantation produced by intrathymic inoculation with xenogeneic antigen using the model of pig to monkey

    International Nuclear Information System (INIS)

    Objective: This study was designed to investigate the effect of survival time and T cells on the delayed xenograft rejection caused by intrathymic injection of xenogeneic antigen in the discordant cardiac xenotransplantation, and to investigate the possibility of inducing the tolerance for cardiac xenografts. Methods: In this experiment, pig and monkey were, respectively, selected as donor and recipient. Donor and recipient were divided randomly into four groups. In the blank group (group A) recipients didn't accept any treatments but heart xenotransplantation; In the whole body irradiation (WBI) group (group B) 3 Gy (60Co) was received on d30 before transplantation. In the intrathymic injection group (group C) monkeys were pretreated by the intrathymic injection of pig spleen cells (5 x 107) on d21 before transplantation, the other treatments were the same as that in group A. In the irradiation and intrathymic injection group (group D) monkeys were pretreated by WBI and the intrathymic injection of pig spleen cells at the time just as that in group B and group C. In every group, monkeys were performed heterotopic heart xenotransplantation in abdomen in order to observe the survival time of cardiac xenografts. Results: (1) Survival time of donor heart in group D (91.1 ± 22.8 h) was significantly longer than group B(42.56 ± 1.4 h) and group A (35.6 ± 2.2 h) (P0.05). (3) The results of MLR showed that there is significant reduction in group D than in group A and B (P+ and CD8+ T cells in peripheral blood, but pretreatment with IT and WBI can induce T cells immune 4 suppression or immune tolerance, that is similar to allotransplantation in the rodent. (2) Pretreatment with IT and WBI can induce T cells immune suppression or immune tolerance. (authors)

  17. Desk Congest Desktop Congesting Software for Desktop Clutter Congestion

    Directory of Open Access Journals (Sweden)

    Solomon A. Adepoju

    2015-06-01

    Full Text Available Abstract The computer desktop environment is a working environment which can be likened unto a users desk in homes and offices. Often times the computer desktop get cluttered with files either as shortcuts used for quick links files stored temporarily to be accessed later or just being dumped there for no vivid reasons. However previous researches have shown that cluttered desktop affects users productivity and getting these files organized is a laborious task for most users. To be able to conveniently alleviate the effect clutters have on users performances and productivity there is need for third party software that will help get the desktop environment organized in a logical and efficient manner. It is to this end that desktop decongesting software is being designed and implemented to help curb clutter problems which existing tools have only partially addressed. The system is designed using Visual Basic .Net and it proves to be effective in tackling desktop congestion problem.

  18. Contemporary treatment of amyloid heart disease.

    Science.gov (United States)

    Palecek, Tomas; Fikrle, Michal; Nemecek, Eduard; Bauerova, Lenka; Kuchynka, Petr; Louch, William E; Spicka, Ivan; Rysava, Romana

    2015-01-01

    The amyloidoses represent a group of diseases characterized by extracellular deposition of abnormal protein, amyloid, which is formed by insoluble extracellular fibrils in β-pleated sheets. Although cardiac involvement may occur in all types of amyloidoses, clinically relevant amyloid cardiomyopathy is a typical feature of AL amyloidosis and transthyretin-related amyloidoses. Congestive heart failure represents the commonest manifestation of amyloid heart disease. Noninvasive imaging techniques, especially echocardiography and cardiac magnetic resonance, play a major role in the diagnosis of amyloid cardiomyopathy; however, histological confirmation and exact typing of amyloid deposits is necessary whether in extracardiac location or directly in the myocardium. Early diagnosis of amyloid heart disease is of utmost importance as the presence and especially the severity of cardiac involvement generally drives the prognosis of affected subjects and plays a major role in determining the intensity of specific treatment, namely in AL amyloidosis. The management of patients with amyloid heart disease is complex. Loop diuretics together with aldosterone antagonists represent the basis for influencing signs of congestion. In AL amyloidosis, high-dose chemotherapy followed by autologous stem cell transplantation is generally considered to be a front-line treatment option, if the disease is diagnosed at its early stage. The combination of mephalan with dexamethasone has been the standard therapy for severely affected individuals; however, the combinations with several novel agents including immunomodulatory drugs and bortezomibe have been tested in clinical trials with promising results. New therapeutic substances with the potential to slow or even stop the progression of transthyretin-related amyloidosis are also extensively studied. PMID:25483951

  19. Understanding congested travel in urban areas

    OpenAIRE

    Çolak, Serdar; Lima, Antonio; González, Marta C.

    2016-01-01

    Rapid urbanization and increasing demand for transportation burdens urban road infrastructures. The interplay of number of vehicles and available road capacity on their routes determines the level of congestion. Although approaches to modify demand and capacity exist, the possible limits of congestion alleviation by only modifying route choices have not been systematically studied. Here we couple the road networks of five diverse cities with the travel demand profiles in the morning peak hour...

  20. 干细胞治疗心脏病%Stem cells therapy in heart disease--update

    Institute of Scientific and Technical Information of China (English)

    李中言; 关青

    2009-01-01

    Chronic coronary artery disease and heart failure are associated with subsequent worsening of the cardiac pump function.Numerous studies within the past few years have been demonstrated,that the intracoronary stem cell therapy has to be considered as a safe therapeutic procedure in heart disease.Transplantation of autologous bone marrow cells or precursor cells improved cardiac function after myocardial infarction and in chronic coronary heart disease.The age of infarction seems to be irrelevant to regenerative potency of stem cells,since stem cells therapy in old infarctions(many years old)is almost equally effective in comparison to previous infarcts.Further indications are non-ischemic cardiomyopathy(dilative cardiomyopathy)and heart failure due to hypertensive heart disease.

  1. Construction of tissue-engineered heart valves by using decellularized scaffolds and endothelial progenitor cells

    Institute of Scientific and Technical Information of China (English)

    FANG Ning-tao; XIE Shang-zhe; WANG Song-mei; GAO Hong-yang; WU Chun-gen; PAN Luan-feng

    2007-01-01

    Background Tissue-engineered heart valves have the potential to overcome the limitations of present heart valve replacements. This study was designed to develop a tissue engineering heart valve by using human umbilical cord blood-derived endothelial progenitor cells (EPCs) and decellularized valve scaffolds.Methods Decellularized valve scaffolds were prepared from fresh porcine heart valves. EPCs were isolated from fresh human umbilical cord blood by density gradient centrifugation, cultured for 3 weeks in EGM-2-MV medium, by which time the resultant cell population became endothelial in nature, as assessed by immunofluorescent staining. EPC-derived endothelial cells were seeded onto the decellularized scaffold at 3 × 106 cells/cm2 and cultured under static conditions for 7 days. Proliferation of the seeded cells on the scaffolds was detected using the MTT assay. Tissue-engineered heart valves were analyzed by HE staining, immunofluorescent staining and scanning electron microscopy. The anti-thrombogenic function of the endothelium on the engineered heart valves was evaluated by platelet adhesion experiments and reverse transcription-polymerase chain reaction (RT-PCR) analysis for the expression of endothelial nitric oxide synthase (eNOS) and tissue-type plasminogen activator (t-PA).Results EPC-derived endothelial cells showed a histolytic cobblestone morphology, expressed specific markers of the endothelial cell lineage including von Willebrand factor (vWF) and CD31, bound a human endothelial cell-specific lectin,Ulex Europaeus agglutinin-1 (UEA-1), and took up Dil-labeled low density lipoprotein (Dil-Ac-LDL). After seeding on the decellularized scaffold, the cells showed excellent metabolic activity and proliferation. The cells formed confluent endothelial monolayers atop the decellularized matrix, as assessed by HE staining and immunostaining for vWF and CD31. Scanning electron microscopy demonstrated the occurrence of tight junctions between cells forming the

  2. An Experimental Study of the Noise Due to Traffic in a Congested Urban Area

    Science.gov (United States)

    Sangeetha, M.; Sankar, P.

    2016-03-01

    Noise pollution in an urban environment is an issue of serious concern in the major cities of India. There are various factors that contribute to the increase of noise levels in urban areas. The intensity of traffic is one of the factors which contributes to a drastic increase in environmental noise. The management of noise pollution has to be considered in the decision making process. In this paper, an attempt is made to study the existing noise level due to the traffic in Velachery which is declared as a sensitive area by the Ministry of Environment and Forestry (MoEF). The noise level data is collected using the MS6710 digital sound meter. The Custic simulation software version 3.2 is used for finding the propagation of noise. The spatial patterns of measurement were also calculated, in the sub-urban area of Velachery, Chennai, Tamilnadu, India. A means of transmitting this data to vehicles moving in the area, through a wireless medium is simulated using NCTUns 6.0 (network simulator), to enable drivers to understand the environmental conditions. A hardware was also designed which can be used to transmit and receive the noise data using the Zigbee module. A noise transmitting station is placed at a junction, so that it can transmit this noise data to the receivers which are fitted inside the vehicles.

  3. Understanding congested travel in urban areas.

    Science.gov (United States)

    Çolak, Serdar; Lima, Antonio; González, Marta C

    2016-01-01

    Rapid urbanization and increasing demand for transportation burdens urban road infrastructures. The interplay of number of vehicles and available road capacity on their routes determines the level of congestion. Although approaches to modify demand and capacity exist, the possible limits of congestion alleviation by only modifying route choices have not been systematically studied. Here we couple the road networks of five diverse cities with the travel demand profiles in the morning peak hour obtained from billions of mobile phone traces to comprehensively analyse urban traffic. We present that a dimensionless ratio of the road supply to the travel demand explains the percentage of time lost in congestion. Finally, we examine congestion relief under a centralized routing scheme with varying levels of awareness of social good and quantify the benefits to show that moderate levels are enough to achieve significant collective travel time savings. PMID:26978719

  4. Understanding congested travel in urban areas

    Science.gov (United States)

    Çolak, Serdar; Lima, Antonio; González, Marta C.

    2016-03-01

    Rapid urbanization and increasing demand for transportation burdens urban road infrastructures. The interplay of number of vehicles and available road capacity on their routes determines the level of congestion. Although approaches to modify demand and capacity exist, the possible limits of congestion alleviation by only modifying route choices have not been systematically studied. Here we couple the road networks of five diverse cities with the travel demand profiles in the morning peak hour obtained from billions of mobile phone traces to comprehensively analyse urban traffic. We present that a dimensionless ratio of the road supply to the travel demand explains the percentage of time lost in congestion. Finally, we examine congestion relief under a centralized routing scheme with varying levels of awareness of social good and quantify the benefits to show that moderate levels are enough to achieve significant collective travel time savings.

  5. Comparative study of heart sound localization algorithms

    Science.gov (United States)

    Moukadem, A.; Dieterlen, A.; Hueber, N.; Brandt, C.; Raymond, P.

    2011-05-01

    The purpose of this document is to present a comparative study of five algorithms of heart sound localization, one of which, is a method based on radial basis function networks applied in a novel approach. The advantages and disadvantages of each method are evaluated according to a data base of 50 subjects in which there are 25 healthy subjects selected from the University Hospital of Strasbourg (HUS) and from theMARS500 project (Moscow) and 25 subjects with cardiac pathologies selected from the HUS. This study is made under the control of an experienced cardiologist. The performance of each method is evaluated by calculating the area under a receiver operating curve (AUC) and the robustness is shown against different levels of additive white Gaussian noise.

  6. Cell Therapy in Chagas Disease

    Directory of Open Access Journals (Sweden)

    Antonio C. Campos de Carvalho

    2009-01-01

    Full Text Available Chagas disease which is caused by the parasite Trypanosoma cruzi is an important cause of cardiomyopathy in Latin America. In later stages chagasic cardiomyopathy is associated with congestive heart failure which is often refractory to medical therapy. In these individuals heart transplantation has been attempted. However, this procedure is fraught with many problems attributable to the surgery and the postsurgical administration of immunosuppressive drugs. Studies in mice suggest that the transplantation of bone-marrow-derived cells ameliorates the inflammation and fibrosis in the heart associated with this infection. Cardiac magnetic resonance imaging reveals that bone marrow transplantation ameliorates the infection induced right ventricular enlargement. On the basis of these animal studies the safety of autologous bone marrow transplantation has been assessed in patients with chagasic end-stage heart disease. The initial results are encouraging and more studies need to be performed.

  7. Increasing Regulatory T Cells With Interleukin-2 and Interleukin-2 Antibody Complexes Attenuates Lung Inflammation and Heart Failure Progression.

    Science.gov (United States)

    Wang, Huan; Hou, Lei; Kwak, Dongmin; Fassett, John; Xu, Xin; Chen, Angela; Chen, Wei; Blazar, Bruce R; Xu, Yawei; Hall, Jennifer L; Ge, Jun-Bo; Bache, Robert J; Chen, Yingjie

    2016-07-01

    Congestive heart failure (CHF) is associated with an increase of leukocyte infiltration, proinflammatory cytokines, and fibrosis in the heart and lung. Regulatory T cells (Tregs, CD4(+)CD25(+)FoxP3(+)) suppress inflammatory responses in various clinical conditions. We postulated that expansion of Tregs attenuates CHF progression by reducing cardiac and lung inflammation. We investigated the effects of interleukin-2 (IL-2) plus IL-2 monoclonal antibody clone JES6-1 complexes (IL2/JES6-1) on induction of Tregs, transverse aortic constriction-induced cardiac and lung inflammation, and CHF progression in mice. We demonstrated that end-stage CHF caused a massive increase of lung macrophages and T cells, as well as relatively mild left ventricular (LV) leukocyte infiltration. Administration of IL2/JES6-1 caused an ≈6-fold increase of Tregs within CD4(+) T cells in the spleen, lung, and heart of mice. IL2/JES6-1 treatment of mice with existing transverse aortic constriction-induced LV failure markedly reduced lung and right ventricular weight and improved LV ejection fraction and LV end-diastolic pressure. Mechanistically, IL2/JES6-1 treatment significantly increased Tregs; suppressed CD4(+) T-cell accumulation; dramatically attenuated leukocyte infiltration, including decreasing CD45(+) cells, macrophages, CD8(+) T cells, and effector memory CD8(+); and reduced proinflammatory cytokine expressions and fibrosis in the lung of mice. Furthermore, IL2/JES6-1 administered before transverse aortic constriction attenuated the development of LV hypertrophy and dysfunction in mice. Our data indicate that increasing Tregs through administration of IL2/JES6-1 effectively attenuates pulmonary inflammation, right ventricular hypertrophy, and further LV dysfunction in mice with existing LV failure, suggesting that strategies to properly expand Tregs may be useful in reducing CHF progression. PMID:27160197

  8. 胺碘酮治疗老年充血性心力衰竭伴快速房颤的疗效观察%Efficiency of intravenous amiodarone in congestive heart failure patients with atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    张荣生; 顾翔

    2015-01-01

    ObjectiveTo determine the effect of intravenous amiodarone on the rapid ventricular rate in the patients with atrial fibrillation (AF) and congestive heart failure (CHF).Methods Seventy elderly patients with AF and CHF [ventricular rate>120beats/min, New York Heart Association (NYHA) classⅡ−Ⅳ] hospitalized in theNorthern Jiangsu People’s Hospital from September 2012 to September 2013 were recruited in this study. They were randomized into 2 groups: amiodarone group (n=35, loading dosage of 150mg followed by a dose of 1.5mg/min) anddeslanoside group (n=35, loading dosage of 0.4 or 0.2mg in slow injection, and more 0.2mg should be medicated if no effect occurred in 1h later). The ventricular rate, mean response time, successful cardioversion ratio,brain natriuretic peptide (BNP) level, the adverse effects and follow-up outcomes were recorded after medication.Results The ventricular rate was significantly decreased in 1, 2 and 24h after treatment thanbefore inboth groups (P0.05). In 3 months after discharged from hospital, the ratio of persistent AFafter the medications (amiodarone, metoprorol and digoxin) was 60.0% (21/35) and 82.9% (29/35), respectively, and the rate of adverse effect was 8.6% and 11.4%, respectively, in the 2 groups (P>0.05).Conclusion Amiodarone isof safety, rapid effect andmild adverse effect in treatment of CHF patients with coexisting AF.%目的:观察胺碘酮治疗老年充血性心力衰竭(CHF)伴快速心房纤颤(AF)的疗效。方法选择2012年9月至2013年9月在苏北人民医院住院治疗的老年CHF伴快速AF患者70例,纽约心脏联合会分级(NYHA)Ⅱ~Ⅳ级,心室率≥120次/min;随机分为胺碘酮组和去乙酰毛花苷组,每组各35例。在常规治疗基础上,胺碘酮组首次剂量给予胺碘酮150mg缓慢静注,随后1.5mg/min微量泵维持;去乙酰毛花苷组首次剂量给予去乙酰毛花苷0.4mg或0.2mg缓慢静注,1h后无效者追加0.2mg。观察用药后

  9. Assessing the effect of perindopril combined with bisoprolol on chronic congestive heart failure%比索洛尔联合培哚普利治疗慢性收缩性心力衰竭的疗效观察

    Institute of Scientific and Technical Information of China (English)

    梁伟东; 钟毅

    2011-01-01

    Objective To observe and compare the effect of perindopril plus bisoprolol and perindopril on chronic congestive heart failure ( CHF ).Methods 75 cases of CHF were randomly divided into control group ( group A, 37 cases )and treatment group ( group B, 38 cases ).Heart rate, blood pressure, heart function, LVDd, LVEF, CO, SV, A/E rate and FS between the two groups on the time point of before and after the treatment were compared.Results The blood pressure had declined significantly after treatment in the two groups( P < 0.01 ), the heart rate had declined significantly in group B compared with group A( P < 0.01 ).The heart function was improved significantly after treatment in the two groups ( P < 0.01 ),and the improvement in group B was more significant than that in group A ( P <0.01 ).The LVDd didn't show significant difference between the two groups at the time point of before and after treatment( P > 0.05 ).The A/E rate significantly declined after treatment in the two groups( P <0.01 ),group B was better than that of group A( P <0.01 ).CO and SV significantly improved after treatment both in the two groups( P < 0.01 ), but didn' t show significant difference( P > 0.05 ) between the two groups.The LVEF significantly improved after treatment in the two groups( P < 0.01 ), and group B was better than that of group A( P < 0.05 ).Conclusion The treatment of combining perindopril and bisoprolol is more effective than only use perindopril in improving the prognosis of the patients with CHF.%目的 观察比较比索洛尔和培哚普利联合应用与单用培哚普利对慢性收缩性心力衰竭患者的疗效.方法 将75例慢性收缩性心力衰竭的患者随机分为培哚普利组(A组)37例和比索洛尔加培哚普利组(B组)38例,比较2组治疗前后心率、血压、心功能、左室舒张末内径(LVDd)、左室射血分数(LVEF)、心排出量(CO)、每搏量(SV)、A峰/E峰比值(A/E比值)、小轴缩短率 (FS).结果 2

  10. Intact individual heart cells isolated from human ventricular tissue.

    OpenAIRE

    Powell, T.; Sturridge, M F; Suvarna, S K; Terrar, D. A.; Twist, V. W.

    1981-01-01

    The intricate architecture of heart muscle, comprising irregularly shaped cells which interdigitate in a complex three-dimensional array, has often compromised clear interpretation of experimental data obtained from the whole organ. One approach to minimise some of the difficulties is to use individual muscle cells in suspension, and data have already been reported using myocytes isolated from mammalian ventricles. It is difficult, however, to extrapolate results obtained from animal tissues ...

  11. Human bone marrow-derived mesenchymal stem cells transplanted into damaged rabbit heart to improve heart function

    Institute of Scientific and Technical Information of China (English)

    WANG Jian-an; FAN You-qi; LI Chang-ling; HE Hong; SUN Yong; LV Bin-jian

    2005-01-01

    Objective: The present study was designed to test whether transplantation of human bone marrow-derived mesenchymal stem cells (hMSCs) in New Zealand rabbits with myocardial infarction can improve heart function; and whether engrafted donor cells can survive and transdifferentiated into cardiomyocytes. Methods: Twenty milliliters bone marrow was obtained from healthy men by bone biopsy. A gradient centrifugation method was used to separate bone marrow cells (BMCs) and red blood cells.BMCs were incubated for 48 h and then washed with phosphate-buffered saline (PBS). The culture medium was changed twice a week for 28 d. Finally, hematopoietic cells were washed away to leave only MSCs. Human MSCs (hMSCs) were premarked by BrdU 72 h before the transplantation. Thirty-four New Zealand rabbits were randomly divided into myocardial infarction (MI)control group and cell treated group, which received hMSCs (MI+MSCs) through intramyocardial injection, while the control group received the same volume of PBS. Myocardial infarction was induced by ligation of the left coronary artery. Cell treated rabbits were treated with 5× 106 MSCs transplanted into the infarcted region after ligation of the coronary artery for 1 h, and the control group received the same volume of PBS. Cyclosporin A (oral solution; 10 mg/kg) was provided alone, 24 h before surgery and once a day after MI for 4 weeks. Echocardiography was measured in each group before the surgery and 4 weeks after the surgery to test heart function change. The hearts were harvested for HE staining and immunohistochemical studies after MI and cell transplantation for 4 weeks. Results: Our data showed that cardiac function was significantly improved by hMSC transplantation in rabbit infarcted hearts 4 weeks after MI (ejection fraction: 0.695±0.038 in the cell treated group (n=12) versus0.554±0.065 in the control group (n=13) (P<0.05). Surviving hMSCs were identified by BrdU positive spots in infarcted region and

  12. California's congestion management program

    International Nuclear Information System (INIS)

    One of the hottest topics in transportation planning today is California's Congestion Management Program (CMP). California's program has been suggested as a model to the rest of the United States for addressing transportation problems and for conforming to the federal Clean Air Act. This article introduces California's Congestion Management Program, describes some problems related to California's CMP legislation, outlines the major CMP elements, and briefly explains the issue of the environmental impact of CMPs. This information might assist others in developing their own CMP programs

  13. Congestion in the bathtub

    DEFF Research Database (Denmark)

    Fosgerau, Mogens

    2015-01-01

    This paper presents a model of urban traffic congestion that allows for hypercongestion. Hypercongestion has fundamental importance for the costs of congestion and the effect of policies such as road pricing, transit provision and traffic management, treated in the paper. In the simplest version of...... the model, the unregulated Nash equilibrium is also the social optimum among a wide range of potential outcomes and any reasonable road pricing scheme will be welfare decreasing. Large welfare gains can be achieved through road pricing when there is hypercongestion and travelers are heterogeneous....

  14. How to Improve the Survival of Transplanted Mesenchymal Stem Cell in Ischemic Heart?

    Directory of Open Access Journals (Sweden)

    Liangpeng Li

    2016-01-01

    Full Text Available Mesenchymal stem cell (MSC is an intensely studied stem cell type applied for cardiac repair. For decades, the preclinical researches on animal model and clinical trials have suggested that MSC transplantation exerts therapeutic effect on ischemic heart disease. However, there remain major limitations to be overcome, one of which is the very low survival rate after transplantation in heart tissue. Various strategies have been tried to improve the MSC survival, and many of them showed promising results. In this review, we analyzed the studies in recent years to summarize the methods, effects, and mechanisms of the new strategies to address this question.

  15. 数据报拥塞控制协议(DCCP)研究%A Study of Datagram Congestion Control Protocol(DCCP)

    Institute of Scientific and Technical Information of China (English)

    陈尚兵; 何小燕; 钱积新

    2003-01-01

    Datagram Congestion Control Protocol (DCCP) implements a congestion-controlled, unreliable flow ofdatagrams suitable for use by applications such as streaming media. This paper specifies its background, main ideas,ongoing research and future implementation.

  16. Diagnosis and quantitative estimation of pulmonary congestion or edema by pulmonary CT numbers

    International Nuclear Information System (INIS)

    Pulmonary computed tomography (CT) was performed in 25 patients with left heart failure and 10 healthy persons to diagnose pulmonary congestion or edema associated with left heart failure. In an analysis of histogram for pulmonary CT numbers obtained from CT scans, CT numbers indicating pulmonary edema were defined as -650 to -750 H.U. This allowed pulmonary edema to be quantitatively estimated early when abnormal findings were not available on chest X-ray film or pulmonary circulation studies. Histograms for CT numbers could be displayed by colors on CT scans. (Namekawa, K.)

  17. Embryonic and foetal Islet-1 positive cells in human hearts are also positive to c-Kit

    Directory of Open Access Journals (Sweden)

    C. Serradifalco

    2011-12-01

    Full Text Available During embryogenesis, the mammalian heart develops from a primitive heart tube originating from two bilateral primary heart fields located in the lateral plate mesoderm. Cells belongings to the pre-cardiac mesoderm will differentiate into early cardiac progenitors, which express early transcription factors which are also common to the Isl-1 positive cardiac progenitor cells isolated from the developing pharyngeal mesoderm and the foetal and post-natal mice hearts. A second population of cardiac progenitor cells positive to c-Kit has been abundantly isolated from adult hearts. Until now, these two populations have been considered two different sets of progenitor cells present in the heart in different stages of an individual life. In the present study we collected embryonic, foetal and infant hearts, and we tested the hypotheses that c-Kit positive cells, usually isolated from the adult heart, are also present in the intra-uterine life and persist in the adult heart after birth, and that foetal Isl-1 positive cells are also positive to c-Kit. Using immunohistochemistry we studied the temporal distribution of Isl-1 positive and c-Kit/CD105 double positive cells, and by immunofluorescence and confocal analysis we studied the co-localization of c-Kit and Isl-1 positive cells. The results indicated that cardiomyocytes and interstitial cells were positive for c-Kit from the 9th to the 19th gestational week, that cells positive for both c-Kit and CD105 appeared in the interstitium at the 17th gestational week and persisted in the postnatal age, and that the Isl-1 positive cells were a subset of the c-Kit positive population.

  18. Making the Traffic Operations Case for Congestion Pricing: Operational Impacts of Congestion Pricing

    Energy Technology Data Exchange (ETDEWEB)

    Chin, Shih-Miao [ORNL; Hu, Patricia S [ORNL; Davidson, Diane [ORNL

    2011-02-01

    delay, based on hours spent in traffic in a year, grew by 22% as the national average of hours spent in delay grew from 36 hours to 44 hours. Peak delay per traveler grew one-third in medium-size urban areas over the 10 year period. The traffic engineering community has developed an arsenal of integrated tools to mitigate the impacts of congestion on freeway throughput and performance, including pricing of capacity to manage demand for travel. Congestion pricing is a strategy which dynamically matches demand with available capacity. A congestion price is a user fee equal to the added cost imposed on other travelers as a result of the last traveler's entry into the highway network. The concept is based on the idea that motorists should pay for the additional congestion they create when entering a congested road. The concept calls for fees to vary according to the level of congestion with the price mechanism applied to make travelers more fully aware of the congestion externality they impose on other travelers and the system itself. The operational rationales for the institution of pricing strategies are to improve the efficiency of operations in a corridor and/or to better manage congestion. To this end, the objectives of this project were to: (1) Better understand and quantify the impacts of congestion pricing strategies on traffic operations through the study of actual projects, and (2) Better understand and quantify the impacts of congestion pricing strategies on traffic operations through the use of modeling and other analytical methods. Specifically, the project was to identify credible analytical procedures that FHWA can use to quantify the impacts of various congestion pricing strategies on traffic flow (throughput) and congestion.

  19. Ca(2+) sensitisation of force production by noradrenaline in femoral conductance and resistance arteries from rats with postinfarction congestive heart failure

    DEFF Research Database (Denmark)

    Trautner, Simon; Amtorp, Ole; Boesgaard, Soren;

    2006-01-01

    skeletal muscle resistance and conductance arteries (mean lumen diameters of 159 and 519 microm) from rats with CHF and sham-operated control rats were used. Isometric tension development and intracellular free calcium concentration ([Ca(2+)](i)) were measured simultaneously in isolated vessel segments...... application of extracellular Ca(2+) to arteries depolarised with 125 mM K(+) or activated with 30 microM NA, [Ca(2+)](i) and vessel wall tension were similar in CHF and control rats. However, the conductance arteries showed significantly higher calcium sensitivity than resistance arteries in these experiments....... We conclude that an abnormality in the sensitivity of the contractile apparatus to Ca(2+), or in NA-induced Ca(2+) sensitisation in arterial vascular smooth muscle cells is unlikely to contribute to the ubiquitously elevated vascular resistance associated with CHF. However, our data demonstrate...

  20. Road Congestion and Incident Duration

    OpenAIRE

    Adler, Martin W.; van Ommeren, Jos; Rietveld, Piet

    2013-01-01

    Non-recurrent congestion is frequently caused by accidents and other incidents. We estimate the causal effect of incident duration on drivers’ time losses through changes in non-recurrent road congestion on Dutch highways. We demonstrate that incident duration has a strong positive, but concave, effect on non-recurrent congestion. The duration elasticity of non-recurrent congestion is about 0.40 implying that a one minute duration reduction generates a €60 gain per incident. We also show that...

  1. Controlling Congestion on Complex Networks

    OpenAIRE

    Buzna, Lubos; Carvalho, Rui

    2015-01-01

    From the Internet to road networks and the power grid, modern life depends on controlling flows on critical infrastructure networks that often operate in a congested state. Yet, we have a limited understanding of the relative performance of the control mechanisms available to manage congestion and of the interplay between network topology, path layout and congestion control algorithms. Here, we consider two flow algorithms (max-flow and uniform-flow), and two more realistic congestion control...

  2. Stem Cell Therapy for Heart Disease

    OpenAIRE

    Puliafico, Shannon B.; Penn, Marc S.; Silver, Kevin H.

    2013-01-01

    Coronary artery disease is the leading cause of death in Americans. After myocardial infarction, significant ventricular damage persists despite timely reperfusion and pharmacological management. Treatment is limited, as current modalities do not cure this damage. In the past decade, stem cell therapy has emerged as a promising therapeutic solution to restore myocardial function. Clinical trials have demonstrated safety and beneficial effects in patients suffering from acute myocardial infarc...

  3. Standardized evaluation of lung congestion during COPD exacerbation better identifies patients at risk of dying

    Directory of Open Access Journals (Sweden)

    Høiseth AD

    2013-12-01

    Full Text Available Arne Didrik Høiseth,1 Torbjørn Omland,1 Bo Daniel Karlsson,2 Pål H Brekke,1 Vidar Søyseth11Cardiothoracic Research Group, Division of Medicine, Akershus University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway; 2Deptartment of Radiology, Akershus University Hospital, Lørenskog, NorwayBackground: Congestive heart failure is underdiagnosed in patients with chronic obstructive pulmonary disease (COPD. Pulmonary congestion on chest radiograph at admission for acute exacerbation of COPD (AECOPD is associated with an increased risk of mortality. A standardized evaluation of chest radiographs may enhance prognostic accuracy.Purpose: We aimed to evaluate whether a standardized, liberal assessment of pulmonary congestion is superior to the routine assessment in identifying patients at increased risk of long-term mortality, and to investigate the association of heart failure with N-terminal prohormone of brain natriuretic peptide (NT-proBNP concentrations.Material and methods: This was a prospective cohort study of 99 patients admitted for AECOPD. Chest radiographs obtained on admission were routinely evaluated and then later evaluated by blinded investigators using a standardized protocol looking for Kerley B lines, enlarged vessels in the lung apex, perihilar cuffing, peribronchial haze, and interstitial or alveolar edema, defining the presence of pulmonary congestion. Adjusted associations with long-term mortality and NT-proBNP concentration were calculated.Results: The standardized assessment was positive for pulmonary congestion in 32 of the 195 radiographs (16% ruled negative in the routine assessment. The standardized assessment was superior in predicting death during a median follow up of 1.9 years (P=0.022, and in multivariable analysis, only the standardized assessment showed a significant association with mortality (hazard ratio 2.4, 95% confidence interval [CI] 1.2–4.7 (P=0.016 and NT-proBNP (relative

  4. Mesenchymal stem cell transplantation for the infarcted heart: a role in minimizing abnormalities in cardiac-specific energy metabolism

    OpenAIRE

    Hughey, Curtis C.; Johnsen, Virginia L.; Ma, Lianli; James, Freyja D.; Young, Pampee P.; Wasserman, David H.; Rottman, Jeffrey N.; Hittel, Dustin S.; Shearer, Jane

    2011-01-01

    Intense interest has been focused on cell-based therapy for the infarcted heart given that stem cells have exhibited the ability to reduce infarct size and mitigate cardiac dysfunction. Despite this, it is unknown whether mesenchymal stem cell (MSC) therapy can prevent metabolic remodeling following a myocardial infarction (MI). This study examines the ability of MSCs to rescue the infarcted heart from perturbed substrate uptake in vivo. C57BL/6 mice underwent chronic ligation of the left ant...

  5. STUDY ON THE RELATIONSHIP AMONG THE HEART MERIDIAN,CARDIAC REFERRED PAIN AND THE HEART

    Institute of Scientific and Technical Information of China (English)

    RONGPeijing; ZHUBing

    2002-01-01

    Purpose:The referred pain of the somatic structure,a response of the visceralgia,is often seen in clinic.But ist underlying mechanisms are poorly understood.It is interested that cardiac referred pain ofter appears along the running course of the Heart Meridian(HM),while acupuncture of the acupoints of HM can effectively relieve cardiac pain.In the present study,the neural basis of the relationship among the HM,cardiac referred pain and the heart is investigated by using tri-labeling technique.Methods:Wistar rats are used in the present study.Three fluorescent dyes,fast blue(FB),propidium lodide(PI) and bibenzimide(Bb)are respectively injected into the pericardial sac,the left and right medial-middle band (HM) or lateral sides[rung Meridian(LM),used for control] of the rat forearms.Results:Examination of the sections of the dorsal ganglions shows that more doubly labeled neurons are found in the ipsilateral dorsal root ganglions of C8-T3 nerve segments from HM and the heart,while fewer double-labeled neurons found from LM and the heart.The facts provide direct evidence for existence of dichotomizing fibers of the ganglion neurons.There exists a relative specific connection between the HM and the heart.It also provides a morphological explanation for cardiogenic referred pain and for the specific interrelation between the heart Meridian and the heart of traditional Chinese medicine.

  6. Neonatal Heart-Enriched miR-708 Promotes Differentiation of Cardiac Progenitor Cells in Rats

    OpenAIRE

    Shengqiong Deng; Qian Zhao; Xianjin Zhou; Lin Zhang; Luer Bao; Lixiao Zhen; Yuzhen Zhang; Huimin Fan; Zhongmin Liu; Zuoren Yu

    2016-01-01

    Cardiovascular disease is becoming the leading cause of death throughout the world. However, adult hearts have limited potential for regeneration after pathological injury, partly due to the quiescent status of stem/progenitor cells. Reactivation of cardiac stem/progenitor cells to create more myocyte progeny is one of the key steps in the regeneration of a damaged heart. In this study, miR-708 was identified to be enriched in the neonatal cardiomyocytes of rats, but this has not yet been pro...

  7. Endogenous cardiac stem cells for the treatment of heart failure

    Directory of Open Access Journals (Sweden)

    Fuentes T

    2013-03-01

    Full Text Available Tania Fuentes, Mary Kearns-Jonker Department of Pathology and Human Anatomy, Loma Linda University School of Medicine, Loma Linda, CA, USA Abstract: Stem cell-based therapies hold promise for regenerating the myocardium after injury. Recent data obtained from phase I clinical trials using endogenous cardiovascular progenitors isolated directly from the heart suggest that cell-based treatment for heart patients using stem cells that reside in the heart provides significant functional benefit and an improvement in patient outcome. Methods to achieve improved engraftment and regeneration may extend this therapeutic benefit. Endogenous cardiovascular progenitors have been tested extensively in small animals to identify cells that improve cardiac function after myocardial infarction. However, the relative lack of large animal models impedes translation into clinical practice. This review will exclusively focus on the latest research pertaining to humans and large animals, including both endogenous and induced sources of cardiovascular progenitors. Keywords: Isl1, iPSC, large animal, c-kit, cardiosphere

  8. Interleukin-1β regulates cell proliferation and activity of extracellular matrix remodelling enzymes in cultured primary pig heart cells

    International Nuclear Information System (INIS)

    Research highlights: → Levels of IL-1β are increased in the pig myocardium after infarction. → Cultured pig heart cells possess IL-1 receptors. → IL-1β increases cell proliferation of pig heart cells in-vitro. → IL-1β increases MMP-2 and MMP-9 activity in pig heart cells in-vitro. → IL-1β may be important for tissue remodelling events after myocardial infarction. -- Abstract: After myocardial infarction, elevated levels of interleukins (ILs) are found within the myocardial tissue and IL-1β is considered to play a major role in tissue remodelling events throughout the body. In the study presented, we have established a cell culture model of primary pig heart cells to evaluate the effects of different concentrations of IL-1β on cell proliferation as well as expression and activity of enzymes typically involved in tissue remodelling. Primary pig heart cell cultures were derived from three different animals and stimulated with recombinant pig IL-1β. RNA expression was detected by RT-PCR, protein levels were evaluated by Western blotting, activity of matrix metalloproteinases (MMPs) was quantified by gelatine zymography and cell proliferation was measured using colorimetric MTS assays. Pig heart cells express receptors for IL-1 and application of IL-1β resulted in a dose-dependent increase of cell proliferation (P < 0.05 vs. control; 100 ng/ml; 24 h). Gene expression of caspase-3 was increased by IL-1β (P < 0.05 vs. control; 100 ng/ml; 3 h), and pro-caspase-3 but not active caspase was detected in lysates of pig heart cells by Western blotting. MMP-2 gene expression as well as enzymatic activities of MMP-2 and MMP-9 were increased by IL-1β (P < 0.05 vs. control; 100 ng/ml; 3 h for gene expression, 48 and 72 h for enzymatic activities of MMP-2 and MMP-9, respectively). Our in vitro data suggest that IL-1β plays a major role in the events of tissue remodelling in the heart. Combined with our recently published in vivo data (Meybohm et al., PLoS One

  9. Interleukin-1{beta} regulates cell proliferation and activity of extracellular matrix remodelling enzymes in cultured primary pig heart cells

    Energy Technology Data Exchange (ETDEWEB)

    Zitta, Karina; Brandt, Berenice [Department of Anesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel (Germany); Wuensch, Annegret [Institute of Molecular Animal Breeding and Biotechnology, Ludwig Maximilians University, Munich (Germany); Meybohm, Patrick; Bein, Berthold; Steinfath, Markus; Scholz, Jens [Department of Anesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel (Germany); Albrecht, Martin, E-mail: Albrecht@anaesthesie.uni-kiel.de [Department of Anesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel (Germany)

    2010-09-03

    Research highlights: {yields} Levels of IL-1{beta} are increased in the pig myocardium after infarction. {yields} Cultured pig heart cells possess IL-1 receptors. {yields} IL-1{beta} increases cell proliferation of pig heart cells in-vitro. {yields} IL-1{beta} increases MMP-2 and MMP-9 activity in pig heart cells in-vitro. {yields} IL-1{beta} may be important for tissue remodelling events after myocardial infarction. -- Abstract: After myocardial infarction, elevated levels of interleukins (ILs) are found within the myocardial tissue and IL-1{beta} is considered to play a major role in tissue remodelling events throughout the body. In the study presented, we have established a cell culture model of primary pig heart cells to evaluate the effects of different concentrations of IL-1{beta} on cell proliferation as well as expression and activity of enzymes typically involved in tissue remodelling. Primary pig heart cell cultures were derived from three different animals and stimulated with recombinant pig IL-1{beta}. RNA expression was detected by RT-PCR, protein levels were evaluated by Western blotting, activity of matrix metalloproteinases (MMPs) was quantified by gelatine zymography and cell proliferation was measured using colorimetric MTS assays. Pig heart cells express receptors for IL-1 and application of IL-1{beta} resulted in a dose-dependent increase of cell proliferation (P < 0.05 vs. control; 100 ng/ml; 24 h). Gene expression of caspase-3 was increased by IL-1{beta} (P < 0.05 vs. control; 100 ng/ml; 3 h), and pro-caspase-3 but not active caspase was detected in lysates of pig heart cells by Western blotting. MMP-2 gene expression as well as enzymatic activities of MMP-2 and MMP-9 were increased by IL-1{beta} (P < 0.05 vs. control; 100 ng/ml; 3 h for gene expression, 48 and 72 h for enzymatic activities of MMP-2 and MMP-9, respectively). Our in vitro data suggest that IL-1{beta} plays a major role in the events of tissue remodelling in the heart. Combined

  10. Survival after withdrawal of dofetilide in patients with congestive heart failure and a short baseline QTc interval; a follow-up on the Diamond-CHF QT substudy

    DEFF Research Database (Denmark)

    Brendorp, B; Torp-Pedersen, C; Elming, H;

    2003-01-01

    measurable QTc interval from a 12-lead standard ECG taken before randomization to placebo or dofetilide. An extended follow-up was performed from study closure, December 1996 until August 2001. RESULTS: Of the 418 patients entering the extended follow-up, 215 (51%) patients died during this 4.5 years of......% confidence interval 1.1-2.8)[corrected]. CONCLUSIONS: This follow-up study shows significant loss of survival benefit upon withdrawal of dofetilide in patients with CHF and a pre-treatment QTc interval below 429 ms. An independent randomized trial is warranted to validate these results....

  11. Ischaemic heart disease and Cag A strains of Helicobacter pylori in the Caerphilly heart disease study

    OpenAIRE

    Stone, A.; Risley, P; Markus, H; Butland, B.; Strachan, D.; Elwood, P; MENDALL, M

    2001-01-01

    OBJECTIVE—To look for the presence of the more virulent strains of Helicobacter pylori (H pylori) in men who developed ischaemic heart disease over a 10 year period and in controls.
DESIGN—The Caerphilly prospective heart disease study recruited 2512 men aged 45-59 years during 1979-83. Western blot analysis or enzyme linked immunosorbent assay (ELISA) was performed on serum taken from those who subsequently died of ischaemic heart disease, or developed non-fatal myocardial infarction, to det...

  12. Tracking Fusion of Human Mesenchymal Stem Cells After Transplantation to the Heart

    Science.gov (United States)

    Freeman, Brian T.; Kouris, Nicholas A.

    2015-01-01

    Evidence suggests that transplanted mesenchymal stem cells (MSCs) can aid recovery of damaged myocardium caused by myocardial infarction. One possible mechanism for MSC-mediated recovery is reprogramming after cell fusion between transplanted MSCs and recipient cardiac cells. We used a Cre/LoxP-based luciferase reporter system coupled to biophotonic imaging to detect fusion of transplanted human pluripotent stem cell-derived MSCs to cells of organs of living mice. Human MSCs, with transient expression of a viral fusogen, were delivered to the murine heart via a collagen patch. At 2 days and 1 week later, living mice were probed for bioluminescence indicative of cell fusion. Cell fusion was detected at the site of delivery (heart) and in distal tissues (i.e., stomach, small intestine, liver). Fusion was confirmed at the cellular scale via fluorescence in situ hybridization for human-specific and mouse-specific centromeres. Human cells in organs distal to the heart were typically located near the vasculature, suggesting MSCs and perhaps MSC fusion products have the ability to migrate via the circulatory system to distal organs and engraft with local cells. The present study reveals previously unknown migratory patterns of delivered human MSCs and associated fusion products in the healthy murine heart. The study also sets the stage for follow-on studies to determine the functional effects of cell fusion in a model of myocardial damage or disease. Significance Mesenchymal stem cells (MSCs) are transplanted to the heart, cartilage, and other tissues to recover lost function or at least limit overactive immune responses. Analysis of tissues after MSC transplantation shows evidence of fusion between MSCs and the cells of the recipient. To date, the biologic implications of cell fusion remain unclear. A newly developed in vivo tracking system was used to identify MSC fusion products in living mice. The migratory patterns of fusion products were determined both in the

  13. Distinctive left-sided distribution of adrenergic-derived cells in the adult mouse heart.

    Directory of Open Access Journals (Sweden)

    Kingsley Osuala

    Full Text Available Adrenaline and noradrenaline are produced within the heart from neuronal and non-neuronal sources. These adrenergic hormones have profound effects on cardiovascular development and function, yet relatively little information is available about the specific tissue distribution of adrenergic cells within the adult heart. The purpose of the present study was to define the anatomical localization of cells derived from an adrenergic lineage within the adult heart. To accomplish this, we performed genetic fate-mapping experiments where mice with the cre-recombinase (Cre gene inserted into the phenylethanolamine-n-methyltransferase (Pnmt locus were cross-mated with homozygous Rosa26 reporter (R26R mice. Because Pnmt serves as a marker gene for adrenergic cells, offspring from these matings express the β-galactosidase (βGAL reporter gene in cells of an adrenergic lineage. βGAL expression was found throughout the adult mouse heart, but was predominantly (89% located in the left atrium (LA and ventricle (LV (p<0.001 compared to RA and RV, where many of these cells appeared to have cardiomyocyte-like morphological and structural characteristics. The staining pattern in the LA was diffuse, but the LV free wall displayed intermittent non-random staining that extended from the apex to the base of the heart, including heavy staining of the anterior papillary muscle along its perimeter. Three-dimensional computer-aided reconstruction of XGAL+ staining revealed distribution throughout the LA and LV, with specific finger-like projections apparent near the mid and apical regions of the LV free wall. These data indicate that adrenergic-derived cells display distinctive left-sided distribution patterns in the adult mouse heart.

  14. Tissue engineered heart valves based on human cells

    OpenAIRE

    Schmidt, D.; Hoerstrup, S P

    2006-01-01

    Valvular heart disease is still a significant cause of morbidity and mortality worldwide. Clinically used valve replacements including mechanical valves as well as fixed biological xeno- or homografts are associated with several major disadvantages. Alternatively, tissue engineering aims at the fabrication of autologous living cardiovascular replacements with the potential to grow and to repair, particularly for paediatric applications. Therefore, autologous cells are harvested and seeded ont...

  15. Tissue engineered heart valves based on human cells

    OpenAIRE

    Schmidt, D.; Hoerstrup, S P

    2007-01-01

    Valvular heart disease is still a significant cause of morbidity and mortality worldwide. Clinically used valve replacements including mechanical valves as well as fixed biological xeno- or homografts are associated with several major disadvantages. Alternatively, tissue engineering aims at the fabrication of autologous living cardiovascular replacements with the potential to grow and to repair, particularly for paediatric applications. Therefore, autologous cells are harvested and seeded ont...

  16. STUDY ON THE RELATIONSHIP AMONG THE HEART MERIDIAN,CARDIAC REFERRED PAIN AND THE HEART

    Institute of Scientific and Technical Information of China (English)

    RONG Peijing; ZHU Bing

    2002-01-01

    @@ Purpose: The referred pain of the somatic structure, a response of the visceralgia, is often seen in clinic. But its underlying mechanisms are poorly understood. It is interested that cardiac referred pain often appears along the running course of the Heart Meridian (HM), while acupuncture of the acupoints of HM can effectively relieve cardiac pain. In the present study, the neural basis of the relationship among the HM, cardiac referred pain and the heart is investigated by using tri-labeling technique.

  17. A Study on Trafic Congestion in Metropolises of China from the Perspective of People’s Livelihood

    Institute of Scientific and Technical Information of China (English)

    YANG Xiangqian; QIAN Fang

    2012-01-01

    The traffic congestion is not only a social problem but also an issue about livelihood.To solve this problem,the key is to change the traffic model from "automobile-based" to "people-oriented" with focus on fair road rights and equalization of public service resources.Based on the understanding above,this paper puts forward some policy recommendations such as prior road right of public transport,limiting the use of private cars by economic levers,development of multi-level public transport system,improving slow traffic system,advocating green travel and friendly driving,achieving equalization of public resources,and so on.

  18. Compromised Cerebral Blood Flow(CBF) in Congestive Heart Failure (CHB): non-invasive quantification with {sup 99m}Tc-ECD radionuclide angiography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Seung; Kim, Jae Joong; Lim, Ki Chun; Lee, Hee Kyung; Moon, Dae Hyuk [Ulsan University College of Medicine, Seoul (Korea, Republic of)

    2002-07-01

    Recent reports revealed that cerebral metabolism in CHF was abnormally deranged and proposed as a potential marker of disease severity. Since deranged cerebral metabolism in CHF may result from compromised cerebral perfusion, quantification of CHF may be useful for accurate risk stratification of CHF. Therefore, we investigated whether CHF in patients with CHF is compromised and correlated with clinical parameters. Fifteen patients (M/F:11/5, 45{+-}9yr) with CHF (LVEF<40%) and 7 healthy controls (M/F:5/2, 41{+-}8yr) were prospectively studied. All patients underwent radionuclide angiography including cerebral hemispheres and aortic arch using {sup 99m}Tc-ECD. Global CBF was measured non-invasively by the application of Patlak graphical plot analysis. All patients were also evaluated using a standardized protocol that included echocardiography and clinical evaluation. Global CBF (40.3{+-}5.2 ml/min/100g) of the patients with CHF were significantly lower than those (49.7{+-}2.4 ml/min/100g) of controls (p<0.01). Global CBF were correlated with NYHA functional class (r=-0.617, p=0.43), but not correlated with other clinical parameters such as age (r=-0.463, p=0.082), duration (r=0.237, p>0.1), systolic BP (r=-0.063, p>0.5), LVEF (r=-0.13, p>0.1), LV dimension(r=0.139, p>0.5), and PV pressure gradients (r=0.072, p>0.5). Cerebral perfusion of the patients with CHF was compromised and not correlated with cardiopulmonary hemodynamic parameters.

  19. Could Cells from Your Nose Fix Your Heart? Transplantation of Olfactory Stem Cells in a Rat Model of Cardiac Infarction

    Directory of Open Access Journals (Sweden)

    Cameron McDonald

    2010-01-01

    Full Text Available This study examines the hypothesis that multipotent olfactory mucosal stem cells could provide a basis for the development of autologous cell transplant therapy for the treatment of heart attack. In humans, these cells are easily obtained by simple biopsy. Neural stem cells from the olfactory mucosa are multipotent, with the capacity to differentiate into developmental fates other than neurons and glia, with evidence of cardiomyocyte differentiation in vitro and after transplantation into the chick embryo. Olfactory stem cells were grown from rat olfactory mucosa. These cells are propagated as neurosphere cultures, similar to other neural stem cells. Olfactory neurospheres were grown in vitro, dissociated into single cell suspensions, and transplanted into the infarcted hearts of congeneic rats. Transplanted cells were genetically engineered to express green fluorescent protein (GFP in order to allow them to be identified after transplantation. Functional assessment was attempted using echocardiography in three groups of rats: control, unoperated; infarct only; infarcted and transplanted. Transplantation of neurosphere-derived cells from adult rat olfactory mucosa appeared to restore heart rate with other trends towards improvement in other measures of ventricular function indicated. Importantly, donor-derived cells engrafted in the transplanted cardiac ventricle and expressed cardiac contractile proteins.

  20. Beta-adrenoceptor antagonists enhance white blood cell aggregation in patients with ischaemic heart disease.

    OpenAIRE

    Bridges, A B; Pringle, T. H.; McNeill, G P; Tavendale, R; Belch, J J

    1992-01-01

    The effects of beta-adrenoceptor antagonists, calcium channel blockers and long acting nitrates on white blood cell (WBC) aggregation were studied in patients with ischaemic heart disease. WBC aggregation was significantly increased by beta-adrenoceptor antagonists (P = 0.011) but was unaffected by either calcium channel blockers or long acting nitrates. Enhanced WBC aggregation promotes microvascular occlusion and damage.

  1. Exploratory visualisation of congestion evolutions on urban transport networks

    OpenAIRE

    Cheng, Tao; Tanaksaranond, Garavig; Brunsdon, Chris; Haworth, James

    2013-01-01

    Visualisation is an effective tool for studying traffic congestion using massive traffic datasets collected from traffic sensors. Existing techniques can reveal where/when congested areas are formed, developed, and moved on one or several highway roads, but it is still challenging to visualise the evolution of traffic congestion on the whole road network, especially on dense urban networks. To address this challenge, this paper proposes three 3D exploratory visualisation techniques: the isosu...

  2. Congestion charging mechanisms for roads : an evaluation of current practice

    OpenAIRE

    Hau, Timothy D.

    1992-01-01

    The author explores 20 criteria for a good road pricing system and presents case studies illustrating the costs, revenues, and benefits of alternative congestion charging mechanisms. The author finds that manual tollbooths are not suitable for congestion charging because they are land-, labor-, and time-intensive. Cordon pricing (as in the Bergen toll ring) can be an effective instrument for charging for congestion if half the toll lanes are reserved for seasonal pass holders traveling throug...

  3. Congestion management utilizing concentric relaxation

    Directory of Open Access Journals (Sweden)

    Škokljev Ivan

    2007-01-01

    Full Text Available In the market-oriented power system environment, congestion management is a novel term connoting the power system steady state security functions. A large number of transmission transactions are dispatched in the regional day-ahead market and traverse the network adding to the power flow loading of the grid elements. Congestion is defined as a network security limit violation prospective due to transactions. Congestion management is a set of measures aimed at solving the congestion problem. This paper devises the concentric relaxation assisted approach to open access transmission network congestion management. The DC load flow symbolic simulator generates line power transfer functions. Congestion management is a systematic procedure based on linear programming. The DC load flow symbolic simulator generates all constraints and the black-box optimization library function is used to solve the problem of congestion on a sample IEEE RTS power system.

  4. A Review of Router based Congestion Control Algorithms

    Directory of Open Access Journals (Sweden)

    Vandana Kushwaha

    2013-11-01

    Full Text Available This paper presents a study of Router based Congestion control approaches in wired network. As network is considered as a distributed system, any problem arises in such a system requires a distributed solution. Thus for good congestion control in the network we also need a solution distributed at source as well as router ends. The purpose of this study is to review the router based Congestion control research for wired network and characterize the different approaches to Congestion control design, by considering their advantages and limitations.

  5. In vitro cultured progenitors and precursors of cardiac cell lineages from human normal and post-ischemic hearts

    Directory of Open Access Journals (Sweden)

    F Di Meglio

    2009-08-01

    Full Text Available The demonstration of the presence of dividing primitive cells in damaged hearts has sparked increased interest about myocardium regenerative processes. We examined the rate and the differentiation of in vitro cultured resident cardiac primitive cells obtained from pathological and normal human hearts in order to evaluate the activation of progenitors and precursors of cardiac cell lineages in post-ischemic human hearts. The precursors and progenitors of cardiomyocyte, smooth muscle and endothelial lineage were identified by immunocytochemistry and the expression of characteristic markers was studied by western blot and RT-PCR. The amount of proteins characteristic for cardiac cells (a-SA and MHC, VEGFR-2 and FVIII, SMA for the precursors of cardiomyocytes, endothelial and smooth muscle cells, respectively inclines toward an increase in both a-SA and MHC. The increased levels of FVIII and VEGFR2 are statistically significant, suggesting an important re-activation of neoangiogenesis. At the same time, the augmented expression of mRNA for Nkx 2.5, the trascriptional factor for cardiomyocyte differentiation, confirms the persistence of differentiative processes in terminally injured hearts. Our study would appear to confirm the activation of human heart regeneration potential in pathological conditions and the ability of its primitive cells to maintain their proliferative capability in vitro. The cardiac cell isolation method we used could be useful in the future for studying modifications to the microenvironment that positively influence cardiac primitive cell differentiation or inhibit, or retard, the pathological remodeling and functional degradation of the heart.

  6. Traffic Congestion Mechanism in Two Ramp Systems

    International Nuclear Information System (INIS)

    The aim of this paper is to study traffic properties in an on/off-ramp system with a bus stop close to the on/off ramp. The location of the bus stop in the on/off-ramp (thereafter downstream or upstream case) is discussed. The simulation results show that in the two ramp systems, the reasons for traffic congestions are different. In the on-ramp system, buses and cars coming from on-ramp interweave each other, while in the off-ramp system, buses interweave with cars exiting to off-ramp. Thus, in the on-ramp (off-ramp) system, the upstream (downstream) bus stop is helpful to reduce the interweaving situation. Moreover, the negative effect will disappear when the distance between the bus stop and the on/off-ramp is more than 20 cells (i.e. 150 m). These qualitative findings may provide some suggestions on traffic management and optimization. (general)

  7. Mitochondrial dynamics and cell death in heart failure.

    Science.gov (United States)

    Marín-García, José; Akhmedov, Alexander T

    2016-03-01

    The highly regulated processes of mitochondrial fusion (joining), fission (division) and trafficking, collectively called mitochondrial dynamics, determine cell-type specific morphology, intracellular distribution and activity of these critical organelles. Mitochondria are critical for cardiac function, while their structural and functional abnormalities contribute to several common cardiovascular diseases, including heart failure (HF). The tightly balanced mitochondrial fusion and fission determine number, morphology and activity of these multifunctional organelles. Although the intracellular architecture of mature cardiomyocytes greatly restricts mitochondrial dynamics, this process occurs in the adult human heart. Fusion and fission modulate multiple mitochondrial functions, ranging from energy and reactive oxygen species production to Ca(2+) homeostasis and cell death, allowing the heart to respond properly to body demands. Tightly controlled balance between fusion and fission is of utmost importance in the high energy-demanding cardiomyocytes. A shift toward fission leads to mitochondrial fragmentation, while a shift toward fusion results in the formation of enlarged mitochondria and in the fusion of damaged mitochondria with healthy organelles. Mfn1, Mfn2 and OPA1 constitute the core machinery promoting mitochondrial fusion, whereas Drp1, Fis1, Mff and MiD49/51 are the core components of fission machinery. Growing evidence suggests that fusion/fission factors in adult cardiomyocytes play essential noncanonical roles in cardiac development, Ca(2+) signaling, mitochondrial quality control and cell death. Impairment of this complex circuit causes cardiomyocyte dysfunction and death contributing to heart injury culminating in HF. Pharmacological targeting of components of this intricate network may be a novel therapeutic modality for HF treatment. PMID:26872674

  8. 96例慢性充血性心力衰竭患者临床治疗效果及安全性研究%Clinical Curative Effect in 96 patients with Chronic Congestive Heart Fail-ure and Its Safety

    Institute of Scientific and Technical Information of China (English)

    魏笑天

    2015-01-01

    Objective To discuss the treatment of patients with chronic congestive heart failure and its effect. Methods 96 patients suffering from chronic congestive heart failure admitted to our hospital between October 2013 and March 2015 were randomized into observation group in which the 48 patients were treated with carvedilol, and control group in which the 48 patients were treat-ed with metoprolol. The therapeutic effect and safety were compared between the two groups. Results Total improved efficiency of the heart function was higher in the observation group than in the control group (95.8%vs 81.3%), and the difference was statisti-cally significant(P0.05)。结论对于慢性充血性心力衰竭患者,使用卡维地洛进行治疗,其效果要明显优于美托洛尔,并且不良反应较少,所以值得临床推广。

  9. Study the relationship between adiponectin and coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    Xue-Hui Yang; Li-Xin Zhao; Yan-Hong Lu; Xiao-Jun Li; Jun Shi

    2015-01-01

    Objective: To study whether adiponectin in serum of patients with coronary heart disease is reduced, and compare with the test results in total cholesterol (TC), Triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), blood glucose (GLU), C-reactive protein (CRP). Method: We selected 80 cases of coronary heart disease patients as the experimental group, 50 healthy subjects as control group. The coronary heart disease group compared with the control group, we know the changes of adiponectin in coronary heart disease group and compared coronary heart disease group with control group in test results of blood lipid, blood glucose, C-reactive protein. Results: Adiponectin in coronary heart disease group was (0.47±0.09) mg/L, which decreased significantly comparing to control group’s level (t=-18.4, P<0.001), HDL-C in coronary heart disease group was (1.24±0.04) mmol/L, which decreased significantly comparing to control group’s level (t=-27.67, P<0.001). The difference was statistically significant (P<0.05). Conclusion: The level’s adiponectin in patients of coronary heart disease dropped, which lead to hypoadiponectinemia, Hypoadiponectinemia may be one of the risk factors of coronary heart disease.

  10. Analysis of risk factor about ventricular remodeling of dilated cardiomyopathy with congestive heart failure%扩张型心肌病心室重构伴充血性心力衰竭的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    刘源; 唐其柱; 倪健

    2011-01-01

    To investigate the risk factor of ventricular remodeling (VRM) after dilated cardiomyop athy (DCM) with ventricular congestive heart failure (CHF). Method: 96 patients NYHA grade II-IIV with LVEF<40% were selected as observation group, and the rest 35 patients NYHA grade T with LVEF≥40% were selected as control group. Clinical data was compared. On the base of the single factor analysis, Logistic stepwise analysis was used to establish its independent risk factors. Result; Univariate analysis showed that com pared with the control group, male prevalence, atrial fibrillation, pulse pressureare ≥70 mmHg were significantly increased in observation group (P<0.01). Logistic stepwise analysis displayed that pulse pressureare ≥70 mmHg and atrial fibrillation were independent factors in observation group. Conclusion: Pulse pressureare ≥70 mmHg and atrial fibrillation are independent risk factors of VRM after DCM with CHF.%目的:探讨扩张型心肌病(DCM)后心室重构(VRM)伴充血性心力衰竭(CHF)的危险因素.方法:选择DCM患者NYHA分级Ⅱ~Ⅳ级,且左心室射血分数(LVEF)<40%的96例为观察组;心功能Ⅰ级,LVEF≥40%的35例患者为对照组,比较2组临床资料,在单因素分析基础上,采用Logistic多因素逐步分析方法确立DCM后VRM伴CHF的独立危险因素.结果:单因素分析结果显示,观察组中男性患病率、心房颤动(房颤)及脉压≥70 mmHg(1 mmHg=0.133 kPa)者较对照组高,差异有统计学意义(P<0.01).Logistic逐步回归分析脉压≥70 mmHg、房颤为DCM后VRM伴CHF的独立危险因素.结论:脉压≥70 mmHg、房颤是DCM后VRM伴CHF的独立危险因素.

  11. New Strategy for Congestion Control based on Dynamic Adjustment of Congestion Window

    Directory of Open Access Journals (Sweden)

    Gamal Attiya

    2012-03-01

    Full Text Available This paper presents a new mechanism for the end-to-end congestion control, called EnewReno. The proposed mechanism is based on the enhancement of both the congestion avoidance and the fast recovery algorithms of the TCP NewReno so as to improve its performance. The basic idea of the proposed mechanism is to adjust the congestion window of the TCP sender dynamically based on the level of congestion in the network so as to allow transferring more packets to the destination. The performance of the proposed mechanism is evaluated and compared with the most recent mechanisms by simulation studies using the well known Network Simulator NS-2 and the realistic topology generator GT-ITM.

  12. Inverse Correlation between Heart Rate Variability and Heart Rate Demonstrated by Linear and Nonlinear Analysis

    Science.gov (United States)

    Zhang, Henggui; Aziz, Wajid; Monfredi, Oliver; Abbas, Syed Ali; Shah, Saeed Arif; Kazmi, Syeda Sobia Hassan; Butt, Wasi Haider

    2016-01-01

    The dynamical fluctuations in the rhythms of biological systems provide valuable information about the underlying functioning of these systems. During the past few decades analysis of cardiac function based on the heart rate variability (HRV; variation in R wave to R wave intervals) has attracted great attention, resulting in more than 17000-publications (PubMed list). However, it is still controversial about the underling mechanisms of HRV. In this study, we performed both linear (time domain and frequency domain) and nonlinear analysis of HRV data acquired from humans and animals to identify the relationship between HRV and heart rate (HR). The HRV data consists of the following groups: (a) human normal sinus rhythm (n = 72); (b) human congestive heart failure (n = 44); (c) rabbit sinoatrial node cells (SANC; n = 67); (d) conscious rat (n = 11). In both human and animal data at variant pathological conditions, both linear and nonlinear analysis techniques showed an inverse correlation between HRV and HR, supporting the concept that HRV is dependent on HR, and therefore, HRV cannot be used in an ordinary manner to analyse autonomic nerve activity of a heart. PMID:27336907

  13. Prevalence of Heart Disease Demonstrated in 60 Years of the Arquivos Brasileiros de Cardiologia

    International Nuclear Information System (INIS)

    Considering the historical and academic relevance of the Brazilian Archives of Cardiology (ABC), as its MEDLINE indexing began in 1950, it was assumed as a hypothesis that the analysis of the publications over the last 60 years could reflect the changing trends of heart disease in Brazil. The study data were collected using a program developed for this purpose, allowing the automatic extraction of information from the MEDLINE database. The study information were collected by searching 'Brazilian Archives of Cardiology AND selected parameter in English'. Four observational groups were determined: (1) major groups of heart diseases (coronary artery disease, valvular heart disease, congenital heart disease and cardiomyopathies); (2) relevant diseases in clinical practice (cardiac arrhythmias, cor pulmonale, myocardial infarction and congestive heart failure); (3) cardiovascular risk factors (hypertension, diabetes, dyslipidemia and atherosclerosis); and (4) group determined due to the growing trend of publications on congestive heart failure seen in previous groups (congestive heart failure, myocardial infarction, rheumatic heart disease and Chagasic heart disease) All publications within the established groups were described, highlighting the increasing importance of heart failure and diabetes as risk factors. A relatively easy search was carried out, using the computer program developed for literature search covering six decades. Emphasizing the limitations of the study, we suggest the existence of an epidemiological link between cardiac diseases that are prevalent in Brazil and the publications of the Brazilian Archives of Cardiology

  14. Prevalence of Heart Disease Demonstrated in 60 Years of the Arquivos Brasileiros de Cardiologia

    Energy Technology Data Exchange (ETDEWEB)

    Evora, Paulo Roberto Barbosa, E-mail: prbevora@cardiol.br; Nather, Julio Cesar; Rodrigues, Alfredo José [Departamento de Cirurgia e Anatomia da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP (Brazil)

    2014-01-15

    Considering the historical and academic relevance of the Brazilian Archives of Cardiology (ABC), as its MEDLINE indexing began in 1950, it was assumed as a hypothesis that the analysis of the publications over the last 60 years could reflect the changing trends of heart disease in Brazil. The study data were collected using a program developed for this purpose, allowing the automatic extraction of information from the MEDLINE database. The study information were collected by searching 'Brazilian Archives of Cardiology AND selected parameter in English'. Four observational groups were determined: (1) major groups of heart diseases (coronary artery disease, valvular heart disease, congenital heart disease and cardiomyopathies); (2) relevant diseases in clinical practice (cardiac arrhythmias, cor pulmonale, myocardial infarction and congestive heart failure); (3) cardiovascular risk factors (hypertension, diabetes, dyslipidemia and atherosclerosis); and (4) group determined due to the growing trend of publications on congestive heart failure seen in previous groups (congestive heart failure, myocardial infarction, rheumatic heart disease and Chagasic heart disease) All publications within the established groups were described, highlighting the increasing importance of heart failure and diabetes as risk factors. A relatively easy search was carried out, using the computer program developed for literature search covering six decades. Emphasizing the limitations of the study, we suggest the existence of an epidemiological link between cardiac diseases that are prevalent in Brazil and the publications of the Brazilian Archives of Cardiology.

  15. Human Umbilical Cord Mesenchymal Stromal Cell Transplantation in Myocardial Ischemia (HUC-HEART Trial). A Study Protocol of a Phase 1/2, Controlled and Randomized Trial in Combination with Coronary Artery Bypass Grafting.

    Science.gov (United States)

    Can, Alp; Ulus, Ahmet Tulga; Cinar, Ozgur; Topal Celikkan, Ferda; Simsek, Erdal; Akyol, Mesut; Canpolat, Ugur; Erturk, Murat; Kara, Fadil; Ilhan, Osman

    2015-10-01

    Mesenchymal stem cells (MSCs), which may be obtained from the bone marrow, have been studied for more than a decade in the setting of coronary artery disease (CAD). Adipose tissue-derived MSCs have recently come into focus and are being tested in a series of clinical trials. MSC-like cells have also been derived from a variety of sources, including umbilical cord stroma, or HUC-MSCs. The HUC-HEART trail (ClinicalTrials.gov Identifier: NCT02323477) is a phase 1/2, controlled, multicenter, randomized clinical study of the intramyocardial delivery of allogeneic HUC-MSCs in patients with chronic ischemic cardiomyopathy. A total of 79 patients (ages 30-80) with left ventricle ejection fractions ranging between 25 and 45% will be randomized in a 2:1:1 pattern in order to receive an intramyocardial injection of either HUC-MSCs or autologous bone marrow-derived mononuclear cells (BM-MNCs) in combination with coronary arterial bypass grafting (CABG) surgery. The control group of patients will receive no cells and undergo CABG alone. Human HUC-MSCs will be isolated, propagated and banked in accordance with a cGMP protocol, whereas the autologous BM-MNCs will be isolated via aspiration from the iliac crest and subsequently process in a closed-circuit cell purification system shortly before cell transplantation. The cell injections will be implemented in 10 peri-infarct areas. Baseline and post-transplantation outcome measures will be primarily utilized to test both the safety and the efficacy of the administered cells for up to 12 months. PMID:26123356

  16. Estimating Urban Road Congestion Charges

    OpenAIRE

    Newbery, David M G; Santos, Georgina

    2002-01-01

    Economists wishing to analyse road congestion and road pricing have usually relied on link-based speed-flow relationships. These may provide a poor description of urban congestion, which mainly arises from delays at intersections. Using the simulation model SATURN, we investigate the second-best proportional traffic reduction and find that linear speed-flow relations describe network flows quite well in eight English towns, though the predicted congestion costs and charges overstate those app...

  17. Estimating Urban Road Congestion Costs

    OpenAIRE

    Newbery, David M.; Georgina Santos

    2002-01-01

    Economists wishing to analyse road congestion and road pricing have usually relied on link-based speed-flow relationships. These may provide a poor description of urban congestion, which mainly arises from delays at intersections. Using the simulation model SATURN, we investigate the second-best proportional traffic reduction and find that linear speed-flow relations describe network flows quite well in eight English towns, though the predicted congestion costs and charges overstate those app...

  18. Effect of Cardiac Resynchronization Therapy on Pulmonary Function in Patients With Heart Failure

    OpenAIRE

    Cundrle, Ivan; Johnson, Bruce D.; Somers, Virend K.; Scott, Christopher G; REA, ROBERT F.; Olson, Lyle J.

    2013-01-01

    Pulmonary congestion due to heart failure causes abnormal lung function. Cardiac resynchronization therapy (CRT) is a proven effective treatment for heart failure. The aim of this study was to test the hypothesis that CRT promotes increased lung volumes, bronchial conductance, and gas diffusion. Forty-four consecutive patients with heart failure were prospectively investigated before and after CRT. Spirometry, gas diffusion (diffusing capacity for carbon monoxide), cardiopulmonary exercise te...

  19. Slot allocation on congested motorways: An alternative to congestion pricing

    NARCIS (Netherlands)

    Koolstra, K.

    1999-01-01

    With respect to the prevailing congestion problems in the more urbanised regions of the European Union, transportation planners and policymakers are facing a dilemma. Supply-side measures, i.e. increasing the capacities, might shorten the congestion duration, especially if bottlenecks can be removed

  20. Study of RF Signal Attenuation of Human Heart

    OpenAIRE

    Kedar Nath Sahu; Challa Dhanunjaya Naidu; M. Satyam; K. Jaya Sankar

    2015-01-01

    A study of ultrawideband pulse propagation modeling through human body for all frequencies from 0.1 to 10.5 GHz is presented. Reflection coefficient and signal attenuation are computed from the model considering the variation of heart dimension with respect to time unlike a fixed dimension of heart used in earlier models. The performance of cardiac activity is studied from the change of signal attenuation. This estimation may help in the design of a noninvasive diagnostic system using ultrawi...

  1. Congestion management in Alberta

    International Nuclear Information System (INIS)

    The challenges facing Alberta regarding electricity market design and congestion management were described. The electricity market in the province consists of a central power pool, an open access transmission network, and a single pool price, unlike many other jurisdictions in North America which have adopted a location margin price (LMP) design with significant price differences between various locations within the power network. Alberta's transmission network is regulated and provides carrier functions. Power moves freely throughout Alberta's power pool network with no congestion, therefore the common pool price signals market participants throughout the entire network with no segregation into zones. Alberta is currently at a cross road in choosing between a single pool price model or a nodal price model. In the first instance, the province would have to strengthen the transmission network to maintain the market at a reasonable size. The alternative would permit Alberta to use market-based techniques to deal with the evolution of many smaller markets in the province, but these would be very small by North American standards and their ability to compete would be questionable

  2. Study on Effectiveness of Highway Congestion Pricing Based on the Price Elasticity of Transportation%基于运输价格弹性的高速公路拥挤收费有效性研究

    Institute of Scientific and Technical Information of China (English)

    王楠楠; 刘世铎

    2014-01-01

    Congestion pricing is designed to relieve traffic congestion.Because the influences of toll standard adjustment on the traffic flow led by differences in the characteristics of transportation are different,the effectiveness of highway congestion pricing will be affected.Based on the analysis of generation mechanism of traffic,and according to the differences of transport price elasticity of transportation demand,the effect of congestion pricing on traffic flow is studied,and the effectiveness of highway congestion pricing is analyzed.It has good guidance significance for the relief of highway traffic jams.%拥挤收费的目的是缓解交通拥堵。由于运输需求特性差异导致的交通流受通行费标准调整的影响不同,高速公路拥挤收费的有效性会受到影响。在分析交通量产生机理的基础上,根据运输需求的运输价格弹性差异,探讨拥挤收费对交通流的影响,并分析高速公路拥挤收费的有效性。对于缓解高速公路交通拥堵有良好的指导意义。

  3. CD133 antibody conjugation to decellularized human heart valves intended for circulating cell capture.

    Science.gov (United States)

    Vossler, John D; Min Ju, Young; Williams, J Koudy; Goldstein, Steven; Hamlin, James; Lee, Sang Jin; Yoo, James J; Atala, Anthony

    2015-09-01

    The long term efficacy of tissue based heart valve grafts may be limited by progressive degeneration characterized by immune mediated inflammation and calcification. To avoid this degeneration, decellularized heart valves with functionalized surfaces capable of rapid in vivo endothelialization have been developed. The aim of this study is to examine the capacity of CD133 antibody-conjugated valve tissue to capture circulating endothelial progenitor cells (EPCs). Decellularized human pulmonary valve tissue was conjugated with CD133 antibody at varying concentrations and exposed to CD133 expressing NTERA-2 cl.D1 (NT2) cells in a microflow chamber. The amount of CD133 antibody conjugated on the valve tissue surface and the number of NT2 cells captured in the presence of shear stress was measured. Both the amount of CD133 antibody conjugated to the valve leaflet surface and the number of adherent NT2 cells increased as the concentration of CD133 antibody present in the surface immobilization procedure increased. The data presented in this study support the hypothesis that the rate of CD133(+) cell adhesion in the presence of shear stress to decellularized heart valve tissue functionalized by CD133 antibody conjugation increases as the quantity of CD133 antibody conjugated to the tissue surface increases. PMID:26333364

  4. Intramyocardial transplantation of undifferentiated rat induced pluripotent stem cells causes tumorigenesis in the heart.

    Directory of Open Access Journals (Sweden)

    Yuzhen Zhang

    Full Text Available BACKGROUND: Induced pluripotent stem cells (iPSCs are a novel candidate for use in cardiac stem cell therapy. However, their intrinsic tumorigenicity requires further investigation prior to use in a clinical setting. In this study we investigated whether undifferentiated iPSCs are tumorigenic after intramyocardial transplantation into immunocompetent allogeneic recipients. METHODOLOGY/PRINCIPAL FINDINGS: We transplanted 2 × 10(4, 2 × 10(5, or 2 × 10(6 cells from the established rat iPSC line M13 intramyocardially into intact or infarcted hearts of immunocompetent allogeneic rats. Transplant duration was 2, 4, or 6 weeks. Histological examination with hematoxylin-eosin staining confirmed that undifferentiated rat iPSCs could generate heterogeneous tumors in both intracardiac and extracardiac sites. Furthermore, tumor incidence was independent of cell dose, transplant duration, and the presence or absence of myocardial infarction. CONCLUSIONS/SIGNIFICANCE: Our study demonstrates that allogeneic iPSC transplantation in the heart will likely result in in situ tumorigenesis, and that cells leaked from the beating heart are a potential source of tumor spread, underscoring the importance of evaluating the safety of future iPSC therapy for cardiac disease.

  5. Pharmacotherapy for atrial fibrillation in elderly hospitalized patients with comorbid congestive heart failure in australia: A retrospective study

    OpenAIRE

    Wang, Lexin; Curran, Shane; Ball, Patrick; White, Fiona

    2008-01-01

    Background: Despite the proven effectiveness of antiplatelet and anticoagulation treatment for atrial fibrillation (AF), their use has been suboptimal in practice, particularly in rural areas of Australia.

  6. Can stem cells really regenerate the human heart? Use your noggin, dickkopf! Lessons from developmental biology

    OpenAIRE

    Sommer, Paula

    2013-01-01

    Abstract The human heart is the first organ to develop and its development is fairly well characterised. In theory, the heart has the capacity to regenerate, as its cardiomyocytes may be capable of cell division and the adult heart contains a cardiac stem cell niche, presumably capable of differentiating into cardiomyocytes and other cardiac-associated cell types. However, as with most other organs, these mechanisms are not activated upon serious injury. Several experimental options to induce...

  7. Noise-induced synchronous stochastic oscillations in small scale cultured heart-cell networks

    International Nuclear Information System (INIS)

    This paper reports that the synchronous integer multiple oscillations of heart-cell networks or clusters are observed in the biology experiment. The behaviour of the integer multiple rhythm is a transition between super- and subthreshold oscillations, the stochastic mechanism of the transition is identified. The similar synchronized oscillations are theoretically reproduced in the stochastic network composed of heterogeneous cells whose behaviours are chosen as excitable or oscillatory states near a Hopf bifurcation point. The parameter regions of coupling strength and noise density that the complex oscillatory rhythms can be simulated are identified. The results show that the rhythm results from a simple stochastic alternating process between super- and sub-threshold oscillations. Studies on single heart cells forming these clusters reveal excitable or oscillatory state nearby a Hopf bifurcation point underpinning the stochastic alternation. In discussion, the results are related to some abnormal heartbeat rhythms such as the sinus arrest. (general)

  8. Keeping Your Heart Healthy After Treatment for Childhood Cancer

    Science.gov (United States)

    ... ventricles) within the heart that work together to pump blood. Valves direct the flow of blood through the ... arrhythmia), or an inability of the heart to pump blood properly (congestive heart failure). Which types of cancer ...

  9. Logistic Analysis of Risk Factor About Dilated Cardiomyopathy with Ventricular Congestive Heart Failure%扩张型心肌病合并充血性心力衰竭的相关因素Logistic分析

    Institute of Scientific and Technical Information of China (English)

    谢进; 李欣; 许臣洪; 胡沛; 卢洪涛

    2012-01-01

    目的:寻找扩张型心肌病(DCM)合并充血性心力衰竭(CHF)的独立危险因素,为临床预防和治疗扩心病患者的病情提供依据.方法:选择我院收治的扩张型心肌病患者125例,按照NYHA分级分组,将心功能Ⅱ-Ⅳ级同时左心室射血分数(LVEF)<40%的患者91例定义为观察组;将心功能Ⅰ级同时左心室射血分数≥40%的患者34例定义为对照组.在比较两组临床资料的基础上,采用logistic多因素分析方法确立扩张型心肌病合并心力衰竭的独立危险因素.结果:单因素分析结果发现,观察组中的“房颤”及“脉压≥70mmHg”这两个参数比对照组的数量明显增多,差异有统计学意义(P<0.05).logistic多因素分析发现“脉压≥70mmHg”、“房颤”是扩心病合并心力衰竭的独立危险因素.结论:“脉压≥70mmHg”、“房颤”是扩张型心肌病合并充血性心力衰竭的独立危险因素,需要在临床治疗扩心病患者时警惕这两项指标的异常.%Objective: To find the independent risk of factor of dilated cardiomyopathy (DCM) with ventricular congestive heart failure (CHF). Methods: 125 patients from our hospital were involved in this investigation. Patients were divided by NYHA. 91 patients with NYHA grade II -IV and LVEF<40% were selected as observation group, and the rest 34 patients with NYHA grade I with LVEF ≥40% were selected as control group. On the base of analyses of clinical data, logistic analyses were used to establish its independent risk factors. Results: Univariate analyses showed that "atrial fibrillation"and "pulse pressure ≥ 70mmHg" in the observation group were increased significantly than that in the control group (P<0.05). Logistic analyses showed that "pulse pressure≥ 70mmHg" and "atrial fibrillation"were independent factors. Conclusion: "pulse pressure ≥70mmHg" and "atrial fibrillation" were independent factors of DCM with CHF. It is necessary to be alert when these

  10. 冻干重组人脑利钠肽治疗充血性心力衰竭疗效观察%Clinical efficacy of lyophilized recombinant human brain natriuretic peptide in the treatment of patients with congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    苏素缺; 郑朝霞; 代东艳; 王鹏

    2014-01-01

    目的 探讨冻干重组人脑利钠肽治疗充血性心力衰竭的临床疗效和安全性.方法 选择120例充血性心力衰竭患者,按照随机数字分组法分为两组,观察组58例患者采用冻干重组人脑利钠肽进行治疗,对照组62例患者采用硝普钠进行治疗,比较两组患者的临床疗效、超声心动图指标、血流动力学指标的变化情况以及不良反应的发生情况.结果 治疗后,观察组总有效率为91.37%,明显高于对照组(x2=4.23,P<0.05),观察组治疗后的LVEF、氨基末端脑钠肽前体水平分别为(59.0±8.2)%和(535.4±123.8) ng/L,其改善程度较对照组更为明显(P<0.05),两组不良反应的发生率基本相当(P>0.05).结论 冻干重组人脑利钠肽在治疗充血性心力衰竭具有十分显著的疗效,其安全可靠.%Objective To investigate the clinical efficacy and safety of lyophilized recombinant human brain natriuretic peptide(rhBNP) in the treatment of patients with congestive heart failure (CHF).Methods 120 CHF patients were randomly divided into two groups.58 cases in the observation group were given lyophilized rhBNP,and 62 patients in the control group were given sodium nitroprusside.The clinical effect,changes of echocardiographic indicators and hemodynamic parameters,adverse reactions were observed.Results After treatment,the total effective rate of the observation group was 91.37%,which was significantly higher than that of the control group(x2 =4.23,P < 0.05).The LVEF and NT-proBNP levels in observation group were (59.0 ± 8.2)% and (535.4 ± 123.8)ng/L,which had higher improvement than control group (P < 0.05).The incidence rate of adverse reactions between the two groups had no significant difference (P> 0.05).Conclusion Lyophilized rhBNP in the treatment of CHF has significant effect,and it is worthy of clinical application and promotion.

  11. Adherence to self-care in patients with heart failure in the HeartCycle study

    Directory of Open Access Journals (Sweden)

    Stut W

    2015-08-01

    Full Text Available Wim Stut,1 Carolyn Deighan,2 John G Cleland,3 Tiny Jaarsma4 1Philips Research Europe, Eindhoven, the Netherlands; 2The Heart Manual Department, NHS Lothian, Edinburgh, UK; 3National Heart and Lung Institute, Royal Brompton and Harefield Hospitals Imperial College, London, UK; 4Department of Social and Welfare studies, Faculty of Health Sciences, Linköping University, Linköping, Sweden Purpose: The purpose of this study was to evaluate a novel online education and coaching program to promote self-care among patients with heart failure. In this program, education and coaching content is automatically tailored to the knowledge and behavior of the patient. Patients and methods: The evaluation of the program took place within the scope of the HeartCycle study. This multi-center, observational study examined the ability of a third generation telehealth system to enhance the management of patients recently (<60 days admitted to the hospital for worsening heart failure or outpatients with persistent New York Heart Association (NYHA Functional Classification III/IV symptoms. Self-reported self-care behavior was assessed at baseline and study-end by means of the 9-item European Heart Failure Self-care Behavior scale. Adherence to daily weighing, blood pressure monitoring, and reporting of symptoms was determined by analyzing the system’s database. Results: Of 123 patients enrolled, the mean age was 66±12 years, 66% were in NYHA III and 79% were men. Self-reported self-care behavior scores (n=101 improved during the study for daily weighing, low-salt diet, physical activity (P<0.001, and fluid restriction (P<0.05. Average adherence (n=120 to measuring weight was 90%±16%, to measuring blood pressure was 89%±17% and to symptom reporting was 66%±32%. Conclusion: Self-reported self-care behavior scores improved significantly during the period of observation, and the objective evidence of adherence to daily weight and blood pressure measurements was

  12. Heart rate increment analysis is not effective for sleep-disordered breathing screening in patients with chronic heart failure.

    OpenAIRE

    Damy, Thibaud; d'Ortho, Marie-Pia; Estrugo, Brigitte; Margarit, Laurent; Mouillet, Gauthier; Mahfoud, Mohannad; Roudot-Thoraval, Francoise; Vermes, Emmanuelle; Hittinger, Luc; Roche, Frederic; Macquin-Mavier, Isabelle

    2010-01-01

    Frequency domain analysis of heart rate variation has been suggested as an effective screening tool for sleep-disordered breathing (SDB) in the general population. The aim of this study was to assess this method in patients with chronic congestive heart failure (CHF). We included prospectively 84 patients with stable CHF, left ventricular ejection fraction (LVEF) or =15 h(-1) was diagnosed in 57.4% of patients. Percent VLFI was not correlated with AHI (r = 0.12). Receiver-operating character...

  13. Fibrinogen and albumin levels and risk of atrial fibrillation in men and women (the Copenhagen City Heart Study)

    DEFF Research Database (Denmark)

    Mukamal, KJ; Tolstrup, JS; Friberg, J; Grønbæk, M; Jensen, Gorm Boje

    2006-01-01

    Heart Study. We measured plasma fibrinogen and serum albumin levels at a study visit from 1991 to 1994. We identified 286 subsequent cases of AF during a mean of 7.5 years of follow-up by a validated nationwide registry of all hospitalizations. The fibrinogen levels at baseline were associated with a...... higher risk of AF, with a multivariate-adjusted hazard ratio for the highest versus lowest quartiles of 1.98 (95% confidence interval [CI] 0.94 to 4.17) among men and 2.14 (95% CI 1.15 to 3.96) among women. The albumin levels were inversely associated with the risk of AF among women (hazard ratio 0.......47, 95% CI 0.28 to 0.77) but not among men (hazard ratio 1.01, 95% CI 0.56 to 1.84). Additional adjustment for cases of coronary heart disease, congestive heart failure, and stroke that occurred during follow-up did not attenuate these associations. In conclusion, higher levels of fibrinogen and lower...

  14. Adaptive Agent Model with Hybrid Routing Selection Strategy for Improving the Road-Network Congestion Problem

    Institute of Scientific and Technical Information of China (English)

    Bin Jiang; Chao Yang; Takao Terano

    2015-01-01

    This paper proposes an adaptive agent model with a hybrid routing selection strategy for studying the road⁃network congestion problem. We focus on improving those severely congested links. Firstly, a multi⁃agent system is built, where each agent stands for a vehicle, and it makes its routing selection by considering the shortest path and the minimum congested degree of the target link simultaneously. The agent⁃based model captures the nonlinear feedback between vehicle routing behaviors and road⁃network congestion status. Secondly, a hybrid routing selection strategy is provided, which guides the vehicle routes adapting to the real⁃time road⁃network congestion status. On this basis, we execute simulation experiments and compare the simulation results of network congestion distribution, by Floyd agent with shortest path strategy and our proposed adaptive agent with hybrid strategy. The simulation results show that our proposed model has reduced the congestion degree of those seriously congested links of road⁃network. Finally, we execute our model on a real road map. The results finds that those seriously congested roads have some common features such as located at the road junction or near the unique road connecting two areas. And, the results also show an effectiveness of our model on reduction of those seriously congested links in this actual road network. Such a bottom⁃up congestion control approach with a hybrid congestion optimization perspective will have its significance for actual traffic congestion control.

  15. Recent Stem Cell Advances: Cord Blood and Induced Pluripotent Stem Cell for Cardiac Regeneration- a Review.

    Science.gov (United States)

    Medhekar, Sheetal Kashinath; Shende, Vikas Suresh; Chincholkar, Anjali Baburao

    2016-05-30

    Stem cells are primitive self renewing undifferentiated cell that can be differentiated into various types of specialized cells like nerve cell, skin cells, muscle cells, intestinal tissue, and blood cells. Stem cells live in bone marrow where they divide to make new blood cells and produces peripheral stem cells in circulation. Under proper environment and in presence of signaling molecules stem cells begin to develop into specialized tissues and organs. These unique characteristics make them very promising entities for regeneration of damaged tissue. Day by day increase in incidence of heart diseases including left ventricular dysfunction, ischemic heart disease (IHD), congestive heart failure (CHF) are the major cause of morbidity and mortality. However infracted tissue cannot regenerate into healthy tissue. Heart transplantation is only the treatment for such patient. Due to limitation of availability of donor for organ transplantation, a focus is made for alternative and effective therapy to treat such condition. In this review we have discussed the new advances in stem cells such as use of cord stem cells and iPSC technology in cardiac repair. Future approach of CB cells was found to be used in tissue repair which is specifically observed for improvement of left ventricular function and myocardial infarction. Here we have also focused on how iPSC technology is used for regeneration of cardiomyocytes and intiating neovascularization in myocardial infarction and also for study of pathophysiology of various degenerative diseases and genetic disease in research field. PMID:27426082

  16. Human Cardiac Tissue Engineering: From Pluripotent Stem Cells to Heart Repair

    Science.gov (United States)

    Jackman, Christopher P.; Shadrin, Ilya Y.; Carlson, Aaron L.; Bursac, Nenad

    2014-01-01

    Engineered cardiac tissues hold great promise for use in drug and toxicology screening, in vitro studies of human physiology and disease, and as transplantable tissue grafts for myocardial repair. In this review, we discuss recent progress in cell-based therapy and functional tissue engineering using pluripotent stem cell-derived cardiomyocytes and we describe methods for delivery of cells into the injured heart. While significant hurdles remain, notable advances have been made in the methods to derive large numbers of pure human cardiomyocytes, mature their phenotype, and produce and implant functional cardiac tissues, bringing the field a step closer to widespread in vitro and in vivo applications. PMID:25599018

  17. Multi-period Congestion Pricing Models and Efficient Tolls in Urban Road Systems

    OpenAIRE

    Liu Louie Nan

    2004-01-01

    This paper reviews recent advances in multi-period congestion pricing models in urban road system. Mathematical formulations of various congestion pricing problems for two time periods (peak and off-peak) and for a simple road network are presented. A procedure is provided for conducting a simulation study of the peak and off-peak congestion pricing models to examine congestion tolls and their effects on traffic allocations and social welfares. Major findings from the analysis results are sum...

  18. Transplanted Bone Marrow Cells Repair Heart Tissue and Reduce Myocarditis in Chronic Chagasic Mice

    OpenAIRE

    MILENA B. P. SOARES; Lima, Ricardo S.; Rocha, Leonardo L.; Takyia, Christina M; Pontes-de-Carvalho, Lain; Campos de Carvalho, Antonio C.; Ribeiro-dos-Santos, Ricardo

    2004-01-01

    A progressive destruction of the myocardium occurs in ∼30% of Trypanosoma cruzi-infected individuals, causing chronic chagasic cardiomyopathy, a disease so far without effective treatment. Syngeneic bone marrow cell transplantation has been shown to cause repair and improvement of heart function in a number of studies in patients and animal models of ischemic cardiopathy. The effects of bone marrow transplant in a mouse model of chronic chagasic cardiomyopathy, in the presence of the disease ...

  19. Large-Scale Transportation Network Congestion Evolution Prediction Using Deep Learning Theory

    OpenAIRE

    Ma, Xiaolei; Yu, Haiyang; Wang, YunPeng; Wang, Yinhai

    2015-01-01

    Understanding how congestion at one location can cause ripples throughout large-scale transportation network is vital for transportation researchers and practitioners to pinpoint traffic bottlenecks for congestion mitigation. Traditional studies rely on either mathematical equations or simulation techniques to model traffic congestion dynamics. However, most of the approaches have limitations, largely due to unrealistic assumptions and cumbersome parameter calibration process. With the develo...

  20. Cell-mediated retraction versus hemodynamic loading - A delicate balance in tissue-engineered heart valves.

    Science.gov (United States)

    van Loosdregt, Inge A E W; Argento, Giulia; Driessen-Mol, Anita; Oomens, Cees W J; Baaijens, Frank P T

    2014-06-27

    Preclinical studies of tissue-engineered heart valves (TEHVs) showed retraction of the heart valve leaflets as major failure of function mechanism. This retraction is caused by both passive and active cell stress and passive matrix stress. Cell-mediated retraction induces leaflet shortening that may be counteracted by the hemodynamic loading of the leaflets during diastole. To get insight into this stress balance, the amount and duration of stress generation in engineered heart valve tissue and the stress imposed by physiological hemodynamic loading are quantified via an experimental and a computational approach, respectively. Stress generation by cells was measured using an earlier described in vitro model system, mimicking the culture process of TEHVs. The stress imposed by the blood pressure during diastole on a valve leaflet was determined using finite element modeling. Results show that for both pulmonary and systemic pressure, the stress imposed on the TEHV leaflets is comparable to the stress generated in the leaflets. As the stresses are of similar magnitude, it is likely that the imposed stress cannot counteract the generated stress, in particular when taking into account that hemodynamic loading is only imposed during diastole. This study provides a rational explanation for the retraction found in preclinical studies of TEHVs and represents an important step towards understanding the retraction process seen in TEHVs by a combined experimental and computational approach. PMID:24268314

  1. Migration paths of cells different origins in the embryonic human heart

    OpenAIRE

    Voloshin N. A.; Chaykovsky Yu. B.

    2010-01-01

    Hearts of human embryos were investigated using immunohistochemical method with antibodies to neurofilaments from 4 to 8 week of prenatal development. It was found that the embryonic human heart there are NF-positive cells, which occupy its territory by two mechanisms: through the migration of intercellular spaces and on the mechanism immersion out of heart cavity. In the second case neurofilaments-positive cells through the endothelium of blood vessels or endocardium immersion into the myoca...

  2. Genome-wide association study of electrocardiographic and heart rate variability traits: the Framingham Heart Study

    OpenAIRE

    Newton-Cheh, Christopher; Guo, Chao-Yu; Wang, Thomas J.; O'Donnell, Christopher J.; Levy, Daniel; Larson, Martin G.

    2007-01-01

    Background Heritable electrocardiographic (ECG) and heart rate variability (HRV) measures, reflecting pacemaking, conduction, repolarization and autonomic function in the heart have been associated with risks for cardiac arrhythmias. Whereas several rare monogenic conditions with extreme phenotypes have been noted, few common genetic factors contributing to interindividual variability in ECG and HRV measures have been identified. We report the results of a community-based genomewide associati...

  3. Phase 4 Studies in Heart Failure - What is Done and What is Needed?

    Science.gov (United States)

    Iyngkaran, Pupalan; Liew, Danny; McDonald, Peter; Thomas, Merlin C; Reid, Christopher; Chew, Derek; Hare, David L

    2016-01-01

    Congestive heart failure (CHF) therapeutics is generated through a well-described evidence generating process. Phases 1 - 3 of this process are required prior to approval and widespread clinical use. Phase 3 in almost all cases is a methodologically sound randomized controlled trial (RCT). After this phase it is generally accepted that the treatment has a significant, independent and prognostically beneficial effect on the pathophysiological process. A major criticism of RCTs is the population to whom the result is applicable. When this population is significantly different from the trial cohort the external validity comes into question. Should the continuation of the evidence generating process continue these problems might be identified. Post marketing surveillance through phase 4 and comparative effectiveness studies through phase 5 trials are often underperformed in comparison to the RCT. These processes can help identify remote adverse events and define new hypotheses for community level benefits. This review is aimed at exploring the post-marketing scene for CHF therapeutics from an Australian health system perspective. We explore the phases of clinical trials, the level of evidence currently available and options for ensuring greater accountability for community level CHF clinical outcomes. PMID:27280303

  4. HSUPA Transport Network Congestion Control

    Directory of Open Access Journals (Sweden)

    Szilveszter Nádas

    2009-01-01

    Full Text Available The introduction of High Speed Uplink Packet Access (HSUPA greatly improves achievable uplink bitrate but it presents new challenges to be solved in the WCDMA radio access network. In the transport network, bandwidth reservation for HSUPA is not efficient and TCP cannot efficiently resolve congestion because of lower layer retransmissions. This paper proposes an HSUPA transport network flow control algorithm that handles congestion situations efficiently and supports Quality of Service differentiation. In the Radio Network Controller (RNC, transport network congestion is detected. Relying on the standardized control frame, the RNC notifies the Node B about transport network congestion. In case of transport network congestion, the Node B part of the HSUPA flow control instructs the air interface scheduler to reduce the bitrate of the flow to eliminate congestion. The performance analysis concentrates on transport network limited scenarios. It is shown that TCP cannot provide efficient congestion control. The proposed algorithm can achieve high end-user perceived throughput, while maintaining low delay, loss, and good fairness in the transport network.

  5. Mathematical principles of road congestion pricing

    Directory of Open Access Journals (Sweden)

    WJ Pienaar

    2009-06-01

    Full Text Available This paper briefly considers the objectives of road congestion pricing and identifies prerequisites to the successful application of such a pricing scheme. The paper is divided into two sections. In the first section, a mathematical analysis of the constituents of an optimal road congestion price is offered. The eliminated inefficiency loss achieved by the introduction of a congestion levy is usually evaluated by means of an integral involving marginal trip cost, travel demand and average trip cost in two-dimensional (travel time, traffic flow-space. In this section we show that this loss may, in fact, be evaluated more easily for a general marginal trip cost function and a linear demand function as the difference between the areas of a rectangle (representing the part of road agency revenue that lies below the original trip cost and a triangle (representing the loss of consumer surplus of the reduced traffic in (travel time, traffic flow-space, eliminating the need to use integration. The next section deals with the application of the illustrated mathematical principles and proofs to a hypothetical case study relating to road congestion pricing in Cape Town.

  6. Application Effect of Amiodarone on Patients With Congestive Heart Failure and Arrhythmias%心力衰竭并心律失常患者胺碘酮的应用效果观察

    Institute of Scientific and Technical Information of China (English)

    雷娜

    2015-01-01

    目的 研究探讨对心力衰竭合并心律失常患者应用胺碘酮的临床疗效.方法 选择我院心内科自2013年1月~2015年1月收治的80例心力衰竭合并心律失常的患者作为研究对象,所有患者均予以胺碘酮进行治疗,对其临床效果进行回顾性分析.结果 经胺碘酮治疗研究患者的总有效率为90.0%,不良反应发生率为8.7%,且心脏功能较治疗前改善(P<0.05),差异具有统计学意义.结论 在临床中应用胺碘酮治疗心力衰竭合并心律失常患者具有有效率高及不良反应率低等优点,并且可显著改善患者的心脏功能.%Objective To investigate the clinical efifcacy in patients with heart failure, arrhythmia amiodarone. Methods Hospital Cardiology from 80 cases of patients with heart failure with cardiac arrhythmia from January 2013 to January 2015 admitted to the study, all patients were to be treated with amiodarone were retrospectively analyzed clinical Results . Results Amiodarone therapy in patients with total effective rate was 90.0% incidence of adverse reactions was 8.7%, and heart function was significantly improved compared with before treatment (P < 0.05), a statistically significant difference. Conclusion The clinical application of amiodarone treatment of heart arrhythmia the patient has high efficiency and low adverse reaction rate, etc., and can significantly improve the patient's cardiac function.

  7. Time Consistency of Congestion Tolls

    OpenAIRE

    Glazer, Amihai

    2000-01-01

    Consider users who can choose between using two modes of travel (say a road and mass transit), and who can choose to incur a fixed cost that reduces the future cots of using mass transit. A congestion toll on the road may serve two purposes. First, it can induce users in the current period to use transit instead of the congested road. Second, users who anticipate the imposition of tolls may be induced to incur the aforementioned fixed cost, thereby reducing demand for use of the congested roa...

  8. Time Consistency of Congestion Tolls

    OpenAIRE

    Glazer, Amihai

    2000-01-01

    Consider users who can choose between using two modes of travel (say a road and mass transit), and who can choose to incur a fixed cost that reduces the future costs of using mass transit. A congestion toll on the road may serve two purposes. First, it can induce users in the current period to use transit instead of the congested road. Second, users who anticipate the imposition of tolls may be induced to incur the aforementioned fixed cost, thereby reducing demand for use of the congested ro...

  9. Time Consistency of Congestion Tolls

    OpenAIRE

    Glazer, Amihai

    1999-01-01

    Consider users who can choose between using two modes of travel (say a road and mass transit), and who can choose to incur a fixed cost that reduces the future costs of using mass transit. A congestion toll on the road may serve two purposes. First, it can induce users in the current period to use transit instead of the congested road. Second, users who anticipate the imposition of tolls may be induced to incur the aforementioned fixed cost, thereby reducing demand for use of the congested ro...

  10. Embryonic stem cell transplantation: promise and progress in the treatment of heart disease.

    Science.gov (United States)

    Zhang, Feixiong; Pasumarthi, Kishore B S

    2008-01-01

    Cardiovascular diseases remain the leading cause of death worldwide, and the burden is equally shared between men and women around the globe. Cardiomyocytes that die in response to disease processes or aging are replaced by scar tissue instead of new muscle cells. Although recent reports suggest an intrinsic capacity for the mammalian myocardium to regenerate via endogenous stem/progenitor cells, the magnitude of such a response appears to be minimal and has yet to be realized fully in cardiovascular patients. Despite the advances in pharmacotherapy and new biomedical technologies, the prognosis for patients diagnosed with end-stage heart failure appears to be grave. While heart transplantation is a viable option, this life-saving intervention suffers from an acute shortage of cardiac organ donors. In view of these existing issues, donor cell transplantation is emerging as a promising strategy to regenerate diseased myocardium. Studies from multiple laboratories have shown that transplantation of donor cells (e.g. fetal cardiomyocytes, skeletal myoblasts, smooth muscle cells, and adult stem cells) can improve the function of diseased hearts over a short period of time (1-4 weeks). While long-term follow-up studies are warranted, it is generally perceived that the beneficial effects of transplanted cells are mainly due to increased angiogenesis or favorable scar remodeling in the engrafted myocardium. Although skeletal myoblasts and bone marrow stem cells hold the highest potential for implementation of autologous therapies, initial results from phase I trials are not promising. In contrast, transplantation of fetal cardiomyocytes has been shown to confer protection against the induction of ventricular tachycardia in experimental myocardial injury models. Furthermore, results from multiple laboratories suggest that fetal cardiomyocytes can couple functionally with host myocytes, stimulate formation of new blood vessels, and improve myocardial function. While it is

  11. Human Mesenchymal Stem Cells Reendothelialize Porcine Heart Valve Scaffolds: Novel Perspectives in Heart Valve Tissue Engineering

    OpenAIRE

    Lanuti, Paola; Serafini, Francesco; Pierdomenico, Laura; Simeone, Pasquale; Bologna, Giuseppina; Ercolino, Eva; Di Silvestre, Sara; Guarnieri, Simone; Canosa, Carlo; Impicciatore, Gianna Gabriella; Chiarini, Stella; Magnacca, Francesco; Mariggiò, Maria Addolorata; Pandolfi, Assunta; Marchisio, Marco

    2015-01-01

    Abstract Heart valve diseases are usually treated by surgical intervention addressed for the replacement of the damaged valve with a biosynthetic or mechanical prosthesis. Although this approach guarantees a good quality of life for patients, it is not free from drawbacks (structural deterioration, nonstructural dysfunction, and reintervention). To overcome these limitations, the heart valve tissue engineering (HVTE) is developing new strategies to synthesize novel types of valve substitutes,...

  12. NMR Study of Damage on Isolated Perfused Rat Heart Exposed to Ischemia and Hypoxia

    Institute of Scientific and Technical Information of China (English)

    罗雪春; 闫永彬; 张日清; 王小寅; 范礼理

    2001-01-01

    Myocardial ischemia is the most common and primary cause of myocardium damage. Numerous conventional techniques and methods have been developed for ischemia and reperfusion studies. However, because of damage to the heart sample, most of these techniques can not be used to continuously monitor the full dynamic course of the myocardial metabolic pathway. The nuclear magnetic resonnance (NMR) surface coil technique, which overcomes the limitations of conventional instrumentation, can be used to quantitatively study every stage of the perfused heart (especially after perfusion stoppage) continuously, dynamically, and without damage under normal or designed physiological conditions at the molecular level. In this paper, 31p-NMR was used to study the effects of ischemia and hypoxia on isolated perfused hearts. The results show that complete hypoxia caused more severe functional damage to the myocardial cells than complete ischemia.

  13. NMR study of damage on isolated perfused rat heart exposed to ischemia and hypoxia

    International Nuclear Information System (INIS)

    Myocardial ischemia is the most common and primary cause of myocardium damage. Numerous conventional techniques and methods have been developed for ischemia and reperfusion studies. However, because of damage to the heart sample, most of these techniques can not be used to continuously monitor the full dynamic course of the myocardial metabolic pathway. The nuclear magnetic resonance (NMR) surface coil technique, which overcomes the limitations of conventional instrumentation, can be used to quantitatively study every stage of the perfused heart (especially after perfusion stoppage) continuously, dynamically, and without damage under normal or designed physiological conditions at the molecular level. In this paper, 31P-NMR was used to study the effects of ischemia and hypoxia on isolated perfused hearts. The results show that complete hypoxia caused more severe functional damage to the myocardial cells than complete ischemia

  14. How Does the Ca2+-paradox Injury Induce Contracture in the Heart?—A Combined Study of the Intracellular Ca2+ Dynamics and Cell Structures in Perfused Rat Hearts—

    International Nuclear Information System (INIS)

    The calcium (Ca2+)-paradox injury of the heart, induced by restoration of extracellular Ca2+ after its short-term depletion, is known to provoke cardiomyocyte contracture. However, undetermined is how the Ca2+-paradox provokes such a distinctive presentation of myocytes in the heart. To address this, we imaged sequential intracellular Ca2+ dynamics and concomitant structures of the subepicardial ventricular myocytes in fluo3-loaded, Langendorff-perfused rat hearts produced by the Ca2+ paradox. Under rapid-scanning confocal microscopy, repletion of Ca2+ following its depletion produced high-frequency Ca2+ waves in individual myocytes with asynchronous localized contractions, resulting in contracture within 10 min. Such alterations of myocytes were attenuated by 5-mM NiCl2, but not by verapamil, SEA0400, or combination of ryanodine and thapsigargin, indicating a contribution of non-specific transmembrane Ca2+ influx in the injury. However, saponin-induced membrane permeabilization of Ca2+ showed no apparent contracture despite the emergence of high-frequency Ca2+ waves, indicating an essential role of myocyte-myocyte and myocyte-extracellular matrix (ECM) mechanical connections in the Ca2+ paradox. In immunohistochemistry Ca2+ depletion produced separation of the intercalated disc that expresses cadherin and dissipation of β-dystroglycan located along the sarcolemma. Taken together, along with the trans-sarcolemmal Ca2+ influx, disruption of cell-cell and cell-ECM connections is essential for contracture in the Ca2+-paradox injury

  15. Congestion and Flow Control in Homogeneous and Heterogeneous Networks: Discrete Event Simulation Model

    Directory of Open Access Journals (Sweden)

    Ajay Kumar

    2007-07-01

    Full Text Available This Paper provides a study and review of existing congestion control algorithms in various types of homogenous and heterogeneous networks. To test the new methodology for the congestion and flow control we have used the two different discrete event simulation tools. The OPNET simulation tool is used to find out performance of the TCP reliable protocol for built-in congestion control mechanism. The second part is for simulation of existing congestion control algorithm (AIMD-Additive Increase Multiplicative Decrease and new suggested congestion and flow control algorithm using OMNeT++ discrete event simulation.

  16. Airport Congestion When Carriers Have Market Power

    OpenAIRE

    Brueckner, Jan K.

    2002-01-01

    This paper analyzes airport congestion when carriers are nonatomistic, showing how the results of the road-pricing literature are modified when the economic agents causing congestion have market power. The analysis shows that when an airport is dominated by a monopolist, congestion is fully internalized, yielding no role for congestion pricing under monopoly conditions. Under a Cournot oligopoly, however, carriers are shown to internalize only the congestion they impose on themselves. A toll ...

  17. Measuring Urban Traffic Congestion – A Review

    OpenAIRE

    Amudapuram Mohan Rao; Kalaga Ramachandra Rao

    2012-01-01

    Traffic congestion has been one of major issues that most metropolises are facing. It is believed that identification of congestion is the first step for selecting appropriate mitigation measures. Congestion - both in perception and in reality - impacts the movement of people. Traffic congestion wastes time, energy and causes pollution. There are broadly two factors, which effect the congestion; (a) micro-level factors (b) macro-level factors that relate to overall demand for road use. Conges...

  18. Congestion Propagation among Routers with TCP Flows

    OpenAIRE

    Hiroyuki Ohsaki; Kouhei Sugiyama; Makoto Imase

    2009-01-01

    In recent years, various non-linear phenomena of the Internet have been discovered. For instance,it is reported that congestion of a router propagates to neighboring routers like a wave. Severalresearches on congestion propagation among routers have been performed. However, in theseresearches, cause of congestion propagation and condition that congestion propagation occurshave not been sufficiently investigated. In this paper, we reveal a cause of congestion propagation,and also investigate u...

  19. Multigated radionuclide study of the total artificial heart

    International Nuclear Information System (INIS)

    A permanent total artificial heart, the Jarvik-7, was implanted into a 61-year-old male with a severe cardiomyopathy. Gated radionuclide studies were performed in the patient both prior to surgery and following implantation. Preoperative gated radionuclide cardiac studies revealed marked left ventricular enlargement, severe hypokinesis and a left ventricular ejection fraction of 10%. The right ventricle was moderately enlarged with a 27% ejection fraction. Following implantation of the Jarvik-7 artificial heart, gated cardiac studies were performed with a computer gated by a signal from the heart controller. The left ventricular ejection fraction was 69% and the right ventricular ejection fraction was 62%. This compared to a theoretical ejection fraction of 74% for each ventricle based on chamber anatomy. There was excellent ventricular emptying. Phase analysis showed uniform diaphragm motion. The use of gated cardiac studies in humans may prove helpful in evaluating mechanical problems with the artificial heart, such as manlfunction of the diaphragm, before they become clinically apparent. (orig.)

  20. Thromboembolism and mechanical heart valves : A randomized study revisited

    NARCIS (Netherlands)

    Kuntze, CEE; Blackstone, EH; Ebels, T

    1998-01-01

    Background. This study was designed to revise and substantiate previous inferences, based on short-term follow-up, about differences in the incidence of anticoagulant-related events after heart valve replacement among patients who had been randomly assigned to receive either a Bjork-Shiley, Edwards-

  1. Bone Marrow Mesenchymal Stem Cells (BM-MSCs) Improve Heart Function in Swine Myocardial Infarction Model through Paracrine Effects

    OpenAIRE

    Min Cai; Rui Shen; Lei Song; Minjie Lu; Jianguang Wang; Shihua Zhao; Yue Tang; Xianmin Meng; Zongjin Li; Zuo-Xiang He

    2016-01-01

    Stem cells are promising for the treatment of myocardial infarction (MI) and large animal models should be used to better understand the full spectrum of stem cell actions and preclinical evidences. In this study, bone marrow mesenchymal stem cells (BM-MSCs) were transplanted into swine heart ischemia model. To detect glucose metabolism in global left ventricular myocardium and regional myocardium, combined with assessment of cardiac function, positron emission tomography-computer tomography ...

  2. Congested interregional infrastructure, road pricing and regional labour markets

    OpenAIRE

    McArthur, David Philip; Thorsen, Inge; Ubøe, Jan

    2009-01-01

    Traffic congestion and the policies to combat it have been studied extensively. However, most studies neglect the labour market impacts of congestion. Many also fail to account for the simultaneity between commuting and migration. This paper models impacts such as unemployment disparities, changes in commuting flows and changes in the flow of migrants by adopting an agent based simulation approach. This approach has the strength that it allows the simultaneous consideration of commuting, migr...

  3. Congestion pricing of multi-modal transportation systems

    OpenAIRE

    Dong-Joo Moon; Chang-Ho Park

    2002-01-01

    This paper deals with the pricing and investment decision problem of multi-modal transportation systems in which the congestion is a significant factor in the assessment of system costs. This study approaches this congestion pricing problem with a number of social welfare maximization problems, all of which have the identical structure except financial constraints. One welfare maximization problem examined in this study yields the pricing and investment decision, which can attain the first-be...

  4. O impacto do CPAP na reabilitação cardíaca de pacientes com ICC: relato de caso El impacto del CPAP en la rehabilitación cardíaca de pacientes con ICC: caso clínico The impact of continuous positive airway pressure (CPAP on the cardiac rehabilitation of patients with congestive heart failure: case report

    Directory of Open Access Journals (Sweden)

    Murillo Frazão de Lima e Costa

    2010-07-01

    Full Text Available A insuficiência cardíaca congestiva é uma patologia que limita a função física do paciente. Neste estudo foi analisada uma paciente, realizando um programa de reabilitação cardíaca associado à pressão positiva contínua nas vias aéreas, aferindo-se antes do estudo e após 6 semanas, o teste de caminhada de 6 minutos (TC6M, questionário de qualidade de vida e ecocardiograma. A paciente aumentou a distância no TC6M de 152,5 m para 520,44 m. O questionário Minnesota reduziu de 62 para 18. A fração de ejeção subiu de 33% para 36%. Na paciente estudada a conduta melhorou o desempenho físico e a qualidade de vida.La insuficiencia cardíaca congestiva es una patología que limita la función física del paciente. En este estudio fue analizada una paciente, realizando un programa de rehabilitación cardíaca asociado a la presión positiva continua en las vías aéreas, realizando antes del estudio y después de 6 semanas, el test de caminata de 6 minutos (TC6M, cuestionario de calidad de vida y ecocardiograma. La paciente aumentó la distancia en el TC6M de 152,5 m a 520,44 m. El cuestionario Minnesota redujo de 62 a 18. La fracción de eyección subió de 33% a 36%. En la paciente estudiada la conducta mejoró el desempeño físico y la calidad de vida.Congestive heart failure is a pathology that limits the patient's physical function. This study analyzed one patient who was submitted to a cardiac rehabilitation program associated to Continuous Positive Airway Pressure (CPAP, by assessing the results of the six-minute walk test (6MWT and a questionnaire on the quality of life and performing an echocardiographic assessment before the study and after six weeks. The distance walked by the patient increased from 152.5 m to 520.44 m at the 6MWT. The Minnesota questionnaire score decreased from 62 to 18. Ejection fraction increased from 33% to 36%. Therefore, the management chosen for this case improved the patient's physical performance

  5. Heart rate awareness in patients with chronic stable heart failure. A multi-center observational study.

    LENUS (Irish Health Repository)

    Moran, D

    2014-08-23

    We assessed adherence to European Society of Cardiology heart rate guidelines (i.e. heart rates less than 70bpm) in patients with chronic stable heart failure. We also investigated the percent of patients on target doses of rate controlling drugs.

  6. Study of Patient Pain Management after Heart Surgery

    Directory of Open Access Journals (Sweden)

    Mohammadreza Sattari

    2013-08-01

    Full Text Available Purpose: To investigate postoperative pain control and analgesic use after heart surgery. Methods: 120 patients undergone heart surgery, randomly entered the study. Each patient was asked to score his pain intensity on visual analog scale (VAS at four different occasions. Results: 120 patients aged 59 year-old; including 81 male were enrolled in the study. 69.2% had coronary artery disease and 16.7% had heart-valve problem. Main types of surgeries were coronary artery bypass surgery (70.5% and valve repairement (23%. Duration of ICU stay was 4.78±2.7 days and duration of intubations was 17.38 ± 36.46 hours. Pre-surgery pain relief was administrated to 42% of the subjects and morphine and promethazine was the main pre-surgery analgesia medication. Post surgery analgesic included morphine (injection, petidine (injection and NSAIDS (oral or rectal. According to VAS, mean pain level, 1 and 4 hours after extubation, and before and one hour after transferring to wards was 5.05±2.5, 4.09±2.0, 3.52±1.8, 2.36±1.89, respectively. Although the level of pain reported was mostly moderate, 80% were reported satisfaction with their post-surgery pain management. Conclusion: A closer pain management control is needed for patients after heart surgery. Introduction of newer pain management techniques, medications and dosages could reduce the pain and suffering.

  7. Issue 10: Perceptions of Congestion Not Universal

    OpenAIRE

    Ong, Paul M.; Haselhoff, Kim

    2005-01-01

    According to a 2005 survey sponsored by the UCLA Ralph and Goldy Lewis Center for Regional Policy Studies, Southern California residents perceive traffic congestion as one of the most pressing daily inconveniences. Delays on freeways and streets impose a cost on residents in terms of lost time, higher fuel bills, and greater air pollution. The problem is not unique to this region, but Southern California has more than its share. Key findings from the survey are that a majority frequently enco...

  8. Dynamic voltage stability constrained congestion management framework for deregulated electricity markets

    International Nuclear Information System (INIS)

    Highlights: ► A new congestion management method for electricity markets is proposed. ► The proposed method includes dynamic models of generators and loads. ► Dynamic voltage stability limits are properly modeled in the proposed method. ► The proposed method is compared with several other congestion management methods. ► It leads to a more robust power system with a lower congestion management cost. - Abstract: Congestion management is an important part of power system operation in today deregulated electricity markets. However, congestion management is traditionally performed based on static analysis tools, while these tools may not correctly capture dynamic voltage stability limits of a power system. In this paper, a new congestion management framework considering dynamic voltage stability boundary of power system is proposed. For this purpose, precise dynamic modeling of power system equipment, including generators and loads, is incorporated into the proposed congestion management framework. The proposed method alleviates congestion with a lower congestion management cost and more dynamic voltage stability margin, resulting in a more robust power system, compared with the previous congestion management methods. The validity of proposed congestion management framework is studied based on the New England 39-bus power system. The obtained results confirm the validity of the developed approach.

  9. Fixed transmission rights for zonal congestion management

    International Nuclear Information System (INIS)

    Declaring that engineering studies and experience are the criteria to defining zonal boundaries, or to define a zone based on the fact that it is a densely interconnected area and paths connecting these densely interconnected areas are interzonal lines, will render insufficient and fuzzy definitions. The zone definition is given a certain criterion based on the locational marginal price (LMP). This concept is used to define zonal boundaries and to decide whether any zone should be merged with another zone or split into new zones. The paper combines zonal and fixed transmission rights (FTR) schemes to manage congestion. This combined scheme is utilised with LMPs to define zonal boundaries more appropriately. The scheme presented gains the best features of the FTR scheme, which are providing financial certainty, maximising the efficient use of the system and making users pay for the actual use of congested paths. (author)

  10. 慢性充血性心力衰竭外周甲状腺素水平变化%Alteration of peripheral thyroid hormone in patients with chronic congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    姜腾勇; 吴学思

    2001-01-01

    Objective:This study is to ev aluate the prevelence and the pathophysiological significance of sick euthyroid syndro me in patients with chronic cardiovascular diseases,especially in chronic conges tive heart fa ilure(CHF).Method:The study population included 54 patients with ch ronic heart f ailure and 20 patients with chronic cardiovascular diseases.Blood sample were as sessed after a fast-night.SES was defined as the serum total triiodothyronine(T 3) l evel was less than the lowest normal limit (<0.8ng/ml)with the normal serum thy roid stimulating hormone and quiiodothyronine(T4).Result:SES was founded in 33/74(4 4%)patients,as high as 51%(28/54)in CHF patients.The prevalence of SES increase d as th e degree of chronic heart failure increased.The function status(NYHA),end diasto l ic diameter and ejecton fraction of left ventricle and T4 concentration in ser um exited a significantly difference.between the CHF patients with and without S ES,and the functional index of liver and kindey.physical characteristics did not exist significantly difference.Conclusion:The sick euthyroid syndro me presents i n chronic cardiovascular diseases,and the higher of its prevalvence,the more sev erve of cardiac function insufficiency.The functional status of liver and kidney was not the major determinant of SES in CHF patients.To recognize the phenomeno n of SES in patients with CHF may offer a valuable train of thought in management of CHF.%目的: 观察评价慢性心血管病,尤其是慢性心衰患者甲状腺功能正常病态综合症(SES)发生情况 并探讨其病理生理意义。方法:病史大于2年的慢 性心衰(CHF)病人54例和同期住院非CHF的慢性心血管病人20例,病情平稳后抽取空腹血临床 生化检验和甲状腺素测定。SES定义为血清总3-碘甲腺原氨酸(T3)低于正常值的低限(<0 .8 ng/ml),4-碘甲腺原氨酸(T4)和促甲状腺素正常。结果:74 例受试者中有33例发生SES,CH F

  11. The need for congestion pricing in medellin: an economic perspective

    OpenAIRE

    CARLOS A. GONZÁLEZ-CALDERÓN; JOHN JAIRO POSADA HENAO; IVÁN DARÍO SÁNCHEZ-DÍAZ

    2011-01-01

    This paper presents a brief description of vehicular congestion in Medellin, Colombia, and discusses the need to implement congestion pricing (CP) from an economic point of view. It describes the license plate-based traffic restriction (Pico y Placa) in the city, showing that the measure is palliative, and that the implementation of CP is necessary. A cost-benefit analysis is presented to assess the effects of implementing a hypothetical CP strategy based on data from previous studies. The fi...

  12. Stochastic Congestion Pricing among Multiple Regions: Competition and Cooperation

    OpenAIRE

    Hua Wang; Wei Mao; Hu Shao

    2013-01-01

    Previous studies of road congestion pricing problem assume that transportation networks are managed by a central administrative authority with an objective of improving the performance of the whole network. In practice, a transportation network may be comprised of multiple independent local regions with relative independent objectives. In this paper, we investigate the cooperative and competitive behaviors among multiple regions in congestion pricing considering stochastic conditions; especia...

  13. Congestion pricing, slot sales and slot trading in aviation

    OpenAIRE

    Verhoef, E.T.

    2008-01-01

    This paper studies the regulation of an airline duopoly on a congested airport. Regulation should then address two market failures: uninternalized congestion, and overpricing due to market power. We find that first-best charges are differentiated over airlines if asymmetric, and completely drive out the least efficient airline from the market. This is not generally the case for an undifferentiated charge, which is found to be a weighted average of first-best charge rules for the two airlines,...

  14. Market Based Criteria for Congestion Management and Transmission Pricing

    Directory of Open Access Journals (Sweden)

    Miss. Archana Jaisisngpure

    2014-07-01

    Full Text Available -Congestion Management is one of the major tasks performed by system operator to ensure the operation of transmission system within operating limits. In the emerging electric power market, the congestion management becomes extremely important and it can impose a barrier to the electricity trading. In the present paper, a concept of transmission congestion penalty factors is developed and implemented to control power overflows in transmission lines for congestion management. Here we presents a Re-dispatch methodology for cost of transmission network to its user. The transmission price computation considers the physical impact caused by the market agents in the transmission network. The paper includes case study for IEEE 5 bus power system.

  15. Model Following Predictive Control for Network Congestion System

    Directory of Open Access Journals (Sweden)

    Dazhong Wang

    2012-12-01

    Full Text Available The goal of congestion control is to avoid congestion in network elements. This study derives an MFCS (Model Following Control System-based control methodology for networks congestion system. The features of this design method are: Bounded property of the inner states for the control system is given and the utility of this control de because there is no necessary to make transformation of this system; It is confirmed on basis of a sign is guaranteed; Both the physical structure of the system and the physical system variables properties can be preserved because there is no necessary to make transformation of this system. It is confirmed on basis of a numerical example of the network congestion system that the output signal of the control system asymptotically follows the reference model signal in the case of the existence of disturbances.

  16. A global take on congestion in urban areas

    CERN Document Server

    Barthelemy, Marc

    2016-01-01

    We analyze the congestion data collected by a GPS device company (TomTom) for almost 300 urban areas in the world. Using simple scaling arguments and data fitting we show that congestion during peak hours in large cities grows essentially as the square root of the population density. This result, at odds with previous publications showing that gasoline consumption decreases with density, confirms that density is indeed an important determinant of congestion, but also that we need urgently a better theoretical understanding of this phenomena. This incomplete view at the urban level leads thus to the idea that thinking about density by itself could be very misleading in congestion studies, and that it is probably more useful to focus on the spatial redistribution of activities and residences.

  17. Endogenous scheduling preferences and congestion

    DEFF Research Database (Denmark)

    Fosgerau, Mogens; Small, Kenneth

    2010-01-01

    Dynamic models of congestion so far rely on exogenous scheduling preferences of travelers, based for example on disutility of deviation from a preferred departure or arrival time for a trip. This paper provides a more fundamental view in which travelers derive utility just from consumption and...... leisure, but agglomeration economies at home and at work lead to scheduling preferences forming endogenously. Using bottleneck congestion technology, we obtain an equilibrium queuing pattern consistent with a general version of the Vickrey bottleneck model. However, the policy implications are different....... Compared to the predictions of an analyst observing untolled equilibrium and taking scheduling preferences as exogenous, we find that both the optimal capacity and the marginal external cost of congestion have changed. The benefits of tolling are greater, and the optimal time varying toll is different....

  18. Human Placenta-Derived Adherent Cells Improve Cardiac Performance in Mice With Chronic Heart Failure

    Science.gov (United States)

    Chen, Hong-Jung; Chen, Chien-Hsi; Chang, Ming-Yao; Tsai, Da-Ching; Baum, Ellen Z.; Hariri, Robert

    2015-01-01

    Human placenta-derived adherent cells (PDACs) are a culture-expanded, undifferentiated mesenchymal-like population derived from full-term placental tissue, with immunomodulatory, anti-inflammatory, angiogenic, and neuroprotective properties. PDA-001 (cenplacel-L), an intravenous formulation of PDAC cells, is in clinical development for the treatment of autoimmune and inflammatory diseases. We tested the therapeutic effects of PDA-001 in mice with chronic heart failure (CHF). Three weeks after transaortic constriction surgery to induce CHF, the mice underwent direct intramyocardial (IM) or i.v. injection of PDA-001 at a high (0.5 × 106 cells per mouse), medium (0.5 × 105 cells per mouse), or low (0.5 × 104 cells per mouse) dose. The mice were sacrificed 4 weeks after treatment. Echocardiography and ventricular catheterization showed that IM injection of PDA-001 significantly improved left ventricular systolic and diastolic function compared with injection of vehicle or i.v. injection of PDA-001. IM injection of PDA-001 also decreased cardiac fibrosis, shown by trichrome staining in the vicinity of the injection sites. Low-dose treatment showed the best improvement in cardiac performance compared with the medium- and high-dose groups. In another independent study to determine the mechanism of action with bromodeoxyuridine labeling, the proliferation rates of endothelial cells and cardiomyocytes were significantly increased by low or medium IM dose PDA-001. However, no surviving PDA-001 cells were detected in the heart 1 month after injection. In vivo real-time imaging consistently revealed that the PDA-001 cells were detectable only within 2 days after IM injection of luciferase-expressing PDA-001. Together, these results have demonstrated the cardiac therapeutic potential of PDA-001, likely through a paracrine effect. PMID:25673767

  19. A study on the normal heart volume of Korean adolescents

    International Nuclear Information System (INIS)

    Cardiac volume mensuration by the roentgenological method was carried out in healthy 220 Korean adolescent, 116 males and 104 females. Predicted heart volume (PHV) and relative heart volume (RHV) were obtained from the following formulae: PHV = K X Broad diameter X Long diameter X Greatest horizontal depth RHV = PHV (total volume in ml)/body surface area (meter squared) The constant, K, represents the product of an ellipsoid area factor and a correction factor for magnification of the cardiac image. Therefore, K value used in this study is 0.42 for 200 cm and 150 cm of the focal-film distance in posterior-anterior and lateral views, respectively. The broad diameter was measured from the junction of the right atrium and the diaphragm to the junction of the pulmonary artery and left atrial appendage. The long diameter was taken from the junction of the superior vena cava and right atrium to the cardiac apex. The greatest horizontal depth of the heart was measured on lateral view. Body surface area was obtained by use of the Du Bolis nomogram. The results were as follows: 1. Predicted roentgenological heart volumes at 16 years to 20 years of age was 449 ± 11.1 ml in makes and 418 ± 7.7 ml in females. It increased with advantage age and height, but was not significantly influenced by changes in body weight in both sexes. 2. Relative heart volume at 16 years to 20 years was 275 ± 5.6 ml/m2 in males, 327 ± 4.1 ml/m2 in females. It increased with advantage age and height, but was not significantly influenced by changes in body weight in both sexes. 3. Roentgenological mensuration was a simple and reliable method in determining the cardiac volume.

  20. Migration paths of cells different origins in the embryonic human heart

    Directory of Open Access Journals (Sweden)

    Voloshin N. A.

    2010-01-01

    Full Text Available Hearts of human embryos were investigated using immunohistochemical method with antibodies to neurofilaments from 4 to 8 week of prenatal development. It was found that the embryonic human heart there are NF-positive cells, which occupy its territory by two mechanisms: through the migration of intercellular spaces and on the mechanism immersion out of heart cavity. In the second case neurofilaments-positive cells through the endothelium of blood vessels or endocardium immersion into the myocardium or mesenchymal areas. Mesenchyme in the heart contain neurofilamentpositive cells, migrating here from both mechanisms. Similar cells have been found by us in the liver of human embryo, beginning at 5 weeks of prenatal development.

  1. Human Heart Failure: Is Cell Therapy a Valid Option?

    OpenAIRE

    Rota, Marcello; Leri, Annarosa; Anversa, Piero

    2013-01-01

    The concept of the heart as a terminally differentiated organ incapable of replacing damaged myocytes has been at the center of cardiovascular research and therapeutic development for the last fifty years. The progressive decline in myocyte number with aging and the formation of scarred tissue following myocardial infarction have been interpreted as irrefutable proofs of the post-mitotic characteristics of the adult heart. However, emerging evidence supports a more dynamic view of the myocard...

  2. MORPHO - HISTOLOGICAL STUDY OF MYOCARDIAL BRIDGES OF CADAVERIC HEARTS

    Directory of Open Access Journals (Sweden)

    Nalinakumari

    2015-02-01

    Full Text Available INTRODUCTION: A band overlying the in tramural segment of coronary artery - a place where the artery goes through myocardium instead of epicardium is called myocardial bridging (MB. A wide variation of 0.5% - 90.4% occurs in the incidence of MB by the cadaveric and angiographic study. More over the occurrence of atherosclerosis in coronary artery segments under myocardial bridges still remains controversial. And so, the incidence of myocardial brid g es and their association to atherosclerosis formation in cadaveric hearts was done morphologically and histological in this study. METHODS: 30 cadaveric hearts from department of Anatomy were examined. After cleaning the fat from epicardium, course of all three coronary arteries were delineated and observed for presence of MB. In the hearts that exhibited MB, the location, length of MB, its distance from the coronary ostium was measured. Sections were made proximal to MB, under MB and distal to MB in the vessels. The perimeter of the vessels were measured. The section was processed for histological study of intimal – media thickness ratio. RESULT: 24 hearts showed MB in the left anterior interventricular artery. One showed MB in right coronary artery. Multiple MB in single artery was seen rarely. The length of the MB segment was around 4 cm on an average. Mostly the MB is seen in the mid to distal part of the artery. The intima was found to be thinned out in the section of the vessel underneath the MB. CONCLUSION: This study concludes that Left coronary artery is the commonest to have myocardial bridges. But the occurrence of this MB in the distal part of the vessel in contrast to previous studies is an important finding to be noted. The presence of intimal thinning underlying the myocardial bridges questions the previous studies that claimed MB‟s protection of vessels from atherosclerosis

  3. Anatomy studies for an artificial heart. Final summary report

    International Nuclear Information System (INIS)

    In the interval from February of 1972 through December of 1977, studies were conducted relating to the anatomical feasibility of implanting a total artificial heart system. These studies included both the calf as an experimental animal as well as the ultimate human recipient of the artificial heart system. Studies with the calf included definition of the thoracic anatomy relative to the size, shape, and vascular connections for implanting the blood pump. To test the animal's tolerance to an implanted engine system, mockups of the thermal converter were implanted chronically in various locations within the calf. No problems developed in retroperitoneal or intraperitoneal implants ranging from 8 to 15 months. A study to determine accelerations experienced by an abdominally implanted thermal converter was performed in calves. Under the most severe conditions, accelerations of a maximum of 34 Gs were experienced. The largest effort was devoted to defining the human anatomy relative to implanting an artificial heart in the thorax. From a number of data sources, including cadavers as well as living patients, a quantitative, statistical analysis of the size and shape of the male thorax was obtained. Finally, an in vivo study of a functional intrathoracic compliance bag in a calf demonstrated the feasibility of this method

  4. Chronic heart failure in Japan: Implications of the CHART studies

    Directory of Open Access Journals (Sweden)

    Nobuyuki Shiba

    2008-03-01

    Full Text Available Nobuyuki Shiba, Hiroaki ShimokawaDepartment of Cardiovascular Medicine, Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai City, JapanAbstract: The prognosis of patients with chronic heart failure (CHF still remains poor, despite the recent advances in medical and surgical treatment. Furthermore, CHF is a major public health problem in most industrialized countries where the elderly population is rapidly increasing. Although the prevalence and mortality of CHF used to be relatively low in Japan, the disorder has been markedly increasing due to the rapid aging of the society and the Westernization of lifestyle that facilitates the development of coronary artery disease. The Chronic Heart Failure Analysis and Registry in the Tohoku District (CHART-1 study was one of the largest cohorts in Japan. The study has clarified the characteristics and prognosis of Japanese patients with CHF, demonstrating that their prognosis was similarly poor compared with those in Western countries. However, we still need evidence for the prevention and treatment of CHF based on the large cohort studies or randomized treatment trials in the Japanese population. Since the strategy for CHF management is now changing from treatment to prevention, a larger-size prospective cohort, called the CHART-2 study, has been initiated to evaluate the risk factors of CHF in Japan. This review summarizes the current status of CHF studies in Japan and discusses their future perspectives.Keywords: heart failure, aging, Japanese

  5. Distribution of Cardiac Stem Cells in the Human Heart

    OpenAIRE

    Mani Arsalan; Felix Woitek; Volker Adams; Axel Linke; Markus J. Barten; Stefan Dhein; Thomas Walther; Friedrich-Wilhelm Mohr; Jens Garbade

    2012-01-01

    Introduction. The existence of human cardiac stem cells (hCSC) and their regenerative capacity are not fully defined. The aim of this study was to identify and analyse the distribution of hCSCs by flow cytometry (FCM). Methods. Tissue samples from the left ventricle (LV) and the appendages of the right atrium (RA) and left atrium (LA) were taken during cardiac surgery. Mononuclear cells (MNCs) were isolated, labelled for the stem-cell-marker c-kit and hematopoietic-lineage markers and analyse...

  6. Endogenous scheduling preferences and congestion

    DEFF Research Database (Denmark)

    Fosgerau, Mogens; Small, Kenneth

    2010-01-01

    Dynamic models of congestion so far rely on exogenous scheduling preferences of travelers, based for example on disutility of deviation from a preferred departure or arrival time for a trip. This paper provides a more fundamental view in which travelers derive utility just from consumption and....... Compared to the predictions of an analyst observing untolled equilibrium and taking scheduling preferences as exogenous, we find that both the optimal capacity and the marginal external cost of congestion have changed. The benefits of tolling are greater, and the optimal time varying toll is different....

  7. Human Cardiosphere-Derived Cells From Advanced Heart Failure Patients Exhibit Augmented Functional Potency in Myocardial Repair

    Science.gov (United States)

    Shen, Deliang; Sun, Baiming; Blusztajn, Agnieszka; Xie, Yucai; Ibrahim, Ahmed; Aminzadeh, Mohammad Amin; Liu, Weixin; Li, Tao-Sheng; De Robertis, Michele A.; Marbán, Linda; Czer, Lawrence S. C.; Trento, Alfredo; Marbán, Eduardo

    2014-01-01

    Objectives This study sought to compare the regenerative potency of cells derived from healthy and diseased human hearts. Background Results from pre-clinical studies and the CADUCEUS (CArdiosphere-Derived aUtologous stem CElls to reverse ventricUlar dySfunction) trial support the notion that cardiosphere-derived cells (CDCs) from normal and recently infarcted hearts are capable of regenerating healthy heart tissue after myocardial infarction (MI). It is unknown whether CDCs derived from advanced heart failure (HF) patients retain the same regenerative potency. Methods In a mouse model of acute MI, we compared the regenerative potential and functional benefits of CDCs derived from 3 groups: 1) non-failing (NF) donor: healthy donor hearts post-transplantation; 2) MI: patients who had an MI 9 to 35 days before biopsy; and 3) HF: advanced cardiomyopathy tissue explanted at cardiac transplantation. Results Cell growth and phenotype were identical in all 3 groups. Injection of HF CDCs led to the greatest therapeutic benefit in mice, with the highest left ventricular ejection fraction, thickest infarct wall, most viable tissue, and least scar 3 weeks after treatment. In vitro assays revealed that HF CDCs secreted higher levels of stromal cell-derived factor 1 (SDF-1), which may contribute to the cells’ augmented resistance to oxidative stress, enhanced angiogenesis, and improved myocyte survival. Histological analysis indicated that HF CDCs engrafted better, recruited more endogenous stem cells, and induced greater angiogenesis and cardiomyocyte cell-cycle re-entry. CDC-secreted SDF-1 levels correlated with decreases in scar mass over time in CADUCEUS patients treated with autologous CDCs. Conclusions CDCs from advanced HF patients exhibit augmented potency in ameliorating ventricular dysfunction post-MI, possibly through SDF-1–mediated mechanisms. PMID:24511463

  8. Assessment of DNA synthesis in Islet-1+ cells in the adult murine heart

    International Nuclear Information System (INIS)

    Highlights: • Islet-1 was expressed in the adult heart. • Islet-1-positive cells did not proliferate in the adult heart. • Sinoatrial node cells did not proliferate in the adult heart. - Abstract: Rationale: Islet-1 positive (Islet-1+) cardiac progenitor cells give rise to the right ventricle, atria and outflow tract during murine cardiac development. In the adult heart Islet-1 expression is limited to parasympathetic neurons, few cardiomyocytes, smooth muscle cells, within the proximal aorta and pulmonary artery and sinoatrial node cells. Its role in these cells is unknown. Here we tested the hypothesis that Islet-1+ cells retain proliferative activity and may therefore play a role in regenerating specialized regions in the heart. Methods and results: DNA synthesis was analyzed by the incorporation of tritiated thymidine (3H-thymidine) in Isl-1-nLacZ mice, a transgenic model with an insertion of a nuclear beta-galactosidase in the Islet-1 locus. Mice received daily injections of 3H-thymidine for 5 days. DNA synthesis was visualized throughout the heart by dipping autoradiography of cryosections. Colocalization of an nLacZ-signal and silver grains would indicate DNA synthesis in Islet-1+ cells. Whereas Islet− non-myocyte nuclei were regularly marked by accumulation of silver grains, colocalization with nLacZ-signals was not detected in >25,000 cells analyzed. Conclusions: Islet-1+ cells are quiescent in the adult heart, suggesting that, under normal conditions, even pacemaking cells do not proliferate at higher rates than normal cardiac myocytes

  9. Assessment of DNA synthesis in Islet-1{sup +} cells in the adult murine heart

    Energy Technology Data Exchange (ETDEWEB)

    Weinberger, Florian, E-mail: f.weinberger@uke.de; Mehrkens, Dennis, E-mail: dennis.mehrkens@uk-koeln.de; Starbatty, Jutta, E-mail: starbatty@uke.uni-hamburg.de; Nicol, Philipp, E-mail: Philipp.Nicol@gmx.de; Eschenhagen, Thomas, E-mail: t.eschenhagen@uke.de

    2015-01-02

    Highlights: • Islet-1 was expressed in the adult heart. • Islet-1-positive cells did not proliferate in the adult heart. • Sinoatrial node cells did not proliferate in the adult heart. - Abstract: Rationale: Islet-1 positive (Islet-1{sup +}) cardiac progenitor cells give rise to the right ventricle, atria and outflow tract during murine cardiac development. In the adult heart Islet-1 expression is limited to parasympathetic neurons, few cardiomyocytes, smooth muscle cells, within the proximal aorta and pulmonary artery and sinoatrial node cells. Its role in these cells is unknown. Here we tested the hypothesis that Islet-1{sup +} cells retain proliferative activity and may therefore play a role in regenerating specialized regions in the heart. Methods and results: DNA synthesis was analyzed by the incorporation of tritiated thymidine ({sup 3}H-thymidine) in Isl-1-nLacZ mice, a transgenic model with an insertion of a nuclear beta-galactosidase in the Islet-1 locus. Mice received daily injections of {sup 3}H-thymidine for 5 days. DNA synthesis was visualized throughout the heart by dipping autoradiography of cryosections. Colocalization of an nLacZ-signal and silver grains would indicate DNA synthesis in Islet-1{sup +} cells. Whereas Islet{sup −} non-myocyte nuclei were regularly marked by accumulation of silver grains, colocalization with nLacZ-signals was not detected in >25,000 cells analyzed. Conclusions: Islet-1{sup +} cells are quiescent in the adult heart, suggesting that, under normal conditions, even pacemaking cells do not proliferate at higher rates than normal cardiac myocytes.

  10. Transcriptional changes in bone marrow stromal cells of patients with heart failure

    OpenAIRE

    Minullina, Izida R.; Alexeyeva, Nina P; Anisimov, Sergey V.; Puzanov, Maxim V; Kozlova, Svetlana N; Sviryaev, Yurii V; Zaritskey, Andrey Yu.; Shlyakhto, Eugeniy V.

    2014-01-01

    It is proposed that patients with heart failure may have not only myocardial dysfunction, but also a reduced regenerative capacity of stem cells. However, very little is known about bone marrow stromal cell (BMSC) characteristics in heart failure and its comorbidities (obesity and/or diabetes). We hypothesized that metabolic alterations associated with the latter will be reflected in altered expression of key genes related to angiogenesis, inflammation, and tissue remodeling in patient-derive...

  11. Cell Death in the Myocardium: My Heart Won’t Go On

    OpenAIRE

    Orogo, Amabel M.; Gustafsson, Åsa B.

    2013-01-01

    Loss of cardiomyocytes plays a critical role in the pathogenesis of heart failure. With fewer myocytes, the heart is unable to sustain efficient contraction. Much attention has been focused on understanding mechanisms of cell death in myocytes with the ultimate goal being to reduce the extent of injury and improve function in the failing myocardium. Both necrosis and apoptosis contribute to loss of myocytes, and this loss of cells is a hallmark of cardiac pathologies, including ischemia/reper...

  12. Intracoronary bone marrow cell application for terminal heart failure in children

    OpenAIRE

    Rupp, Stefan; Jux, Christian; Bönig, Halvard; Bauer, Jürgen; Tonn, Torsten; Seifried, Erhard; Dimmeler, Stefanie; Zeiher, Andreas M.; Schranz, Dietmar

    2012-01-01

    Introduction In spite of tremendous progress in the medical and surgical treatment of children with congenital heart disease and dilated cardiomyopathy achieved during the past few decades, for some children a heart transplant remains the only option. Clinically relevant benefits of intracoronary injection of autologous stem cells on cardiac function and remodelling have been demonstrated in adult patients with acute myocardial infarction. Experience with autologous stem cell therapy in child...

  13. Sitagliptin and risk of heart failure hospitalization in patients with type 2 diabetes on dialysis: A population-based cohort study.

    Science.gov (United States)

    Hung, Yi-Chih; Lin, Che-Chen; Huang, Wei-Lun; Chang, Man-Ping; Chen, Ching-Chu

    2016-01-01

    The incidence of heart failure hospitalization (HHF) after taking sitagliptin in type 2 diabetes (T2DM) patients with end stage renal disease (ESRD) on dialysis is unclear. In this population-based cohort study, we identified individuals with T2DM and ESRD on dialysis who were treated with sitagliptin between 2009 and 2011 and randomly selected a control cohort matched by age, sex, duration of T2DM, hypertension medications, use of statin and aspirin, sulfonylureas, glinides, and insulin usage, atherosclerotic heart disease, congestive heart failure and chronic obstructive pulmonary disease at a 1:4 ratio. Multivariable Cox proportional hazards regression analysis was used to evaluate HHF risk. The overall incidence of HHF was higher in the sitagliptin cohort than in the control cohort (1130 vs. 754 per 10000 person-years; adjusted hazard ratio (HR): 1.52, 95% CI = 1.21-1.90). There was a significant trend towards increased HHF risk associated with increased sitagliptin dose (p for trend ACE inhibitors treatment, with history of heart failure or receiving hemodialysis rather than peritoneal dialysis. In conclusion, use of sitagliptin was associated with an increased risk of HHF in patients with T2DM on dialysis. PMID:27460913

  14. Sitagliptin and risk of heart failure hospitalization in patients with type 2 diabetes on dialysis: A population-based cohort study

    Science.gov (United States)

    Hung, Yi-Chih; Lin, Che-Chen; Huang, Wei-Lun; Chang, Man-Ping; Chen, Ching-Chu

    2016-01-01

    The incidence of heart failure hospitalization (HHF) after taking sitagliptin in type 2 diabetes (T2DM) patients with end stage renal disease (ESRD) on dialysis is unclear. In this population-based cohort study, we identified individuals with T2DM and ESRD on dialysis who were treated with sitagliptin between 2009 and 2011 and randomly selected a control cohort matched by age, sex, duration of T2DM, hypertension medications, use of statin and aspirin, sulfonylureas, glinides, and insulin usage, atherosclerotic heart disease, congestive heart failure and chronic obstructive pulmonary disease at a 1:4 ratio. Multivariable Cox proportional hazards regression analysis was used to evaluate HHF risk. The overall incidence of HHF was higher in the sitagliptin cohort than in the control cohort (1130 vs. 754 per 10000 person-years; adjusted hazard ratio (HR): 1.52, 95% CI = 1.21–1.90). There was a significant trend towards increased HHF risk associated with increased sitagliptin dose (p for trend < 0.01). Subjects at greater risk of HHF after taking sitagliptin were those without severe hypoglycemia, without ACE inhibitors treatment, with history of heart failure or receiving hemodialysis rather than peritoneal dialysis. In conclusion, use of sitagliptin was associated with an increased risk of HHF in patients with T2DM on dialysis. PMID:27460913

  15. Pathomorphological and microbiological studies in sheep with special emphasis on gastrointestinal tract disorders

    Directory of Open Access Journals (Sweden)

    Sarvan Kumar

    2015-08-01

    Full Text Available Aim: The present study was envisaged to elucidate the pathomorphological and microbiological aspects of gastrointestinal tract (GIT disorders of sheep/lambs. Materials and Methods: Samples for research were collected from 12 sheep died with a history of GIT disorders which were brought for post-mortem examination to the Department of Veterinary Pathology, Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar, for pathomorphological and microbiological examination. Results: Gross pathological changes in various organs noticed were abomasitis, congestion and hemorrhages in intestine; necrotic foci on liver surface; enlarged, hard, and indurated mesenteric lymph nodes, hydropericardium, congestion, hemorrhages and consolidation of lungs and congestion and soft kidneys as the major change. On histopathological examination, there were abomasitis with leukocyte infiltration, enteritis with desquamation of mucosal epithelium and goblet cell hyperplasia, lymphadenitis with depletion of lymphocytes in the germinal center of lymphoid follicle, and splenitis with depletion of lymphocytes in the white pulp. In the liver congestion, degenerative changes in hepatocytes including cloudy swelling, fatty changes, congestion in sinusoids, and dilatation of sinusoids leading to atrophy of hepatocytes. Lungs evidenced edema, congestion, emphysema, serous inflammation, thickening of interlobular septa, fibrinous pleuritis, and peribronchiolar lymphoid follicle formation. Heart revealed sarcocystosis, fibrinous pericarditis, and hyalinization of the myocardium. In kidneys, congestion, focal interstitial nephritis, hyaline degeneration, and coagulative necrosis were seen. For microbiological aspects; cultural isolation was done from samples of liver, abomasum, mesenteric lymph nodes, spleen, heart blood, lungs, and kidneys from the carcasses of sheep/lambs. Escherichia coli was the only bacterium isolated during present studies. E. coli isolates from

  16. Pedigree and genotype errors in the Framingham Heart Study

    OpenAIRE

    Almasy Laura; Brush Gerry

    2003-01-01

    Abstract The pedigree and genotype data from the Framingham Heart Study were examined for errors. Errors in 21 of 329 pedigrees were detected with the program PREST, and of these the errors in 16 pedigrees were resolved. Genotyping errors were then detected with SIMWALK2. Five Mendelian errors were found following the pedigree corrections. Double-recombinant errors were more common, with 142 being detected at mistyping probabilities of 0.25 or greater.

  17. Ivabradine, heart failure and chronic kidney disease

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    Luca Di Lullo

    2015-12-01

    Full Text Available The incidence and prevalence of congestive heart failure are actually increasing worldwide, especially in Western countries. In Europe and the United States, congestive heart failure represents a disabling clinical disease, accountable for increased hospitalization and health care costs. European guidelines have underlined the importance of pharmacological treatment to improve both patients’ outcomes and quality of life. The latest clinical trials to evaluate ivabradine’s efficacy have underlined its usefulness as a stand-alone medication and in combination with conventional congestive heart failure therapy, including in chronic kidney disease patients.

  18. Pulmonary studies

    International Nuclear Information System (INIS)

    Radionuclide studies of the lung are described, as regards perfusion studies, ventilation studies and physiological considerations. The four principal applications for radionuclide studies of the lungs are outlined and the uses of these discussed in relation to particular entities including pulmonary embolic disease, congestive heart failure, asthma, acute, nonasthmatic, bronchial obstruction, chronic pulmonary disease and cancer. (Auth./C.F.)

  19. Do tax incentives affect households' adoption of ‘green’ cars? A panel study of the Stockholm congestion tax

    International Nuclear Information System (INIS)

    Policymakers have made several attempts to introduce local and national policies to reduce CO2 emissions and stimulate the consumer adoption of alternative fuel vehicles (ethanol/E85 cars). The purpose of this paper is to analyze how a local policy measure impacts the composition of the car fleet over time. More specifically, we take advantage of the natural experiment setting caused by the introduction of the Stockholm congestion tax (2006) to analyze how the tax affected purchases of ethanol cars that were exempted from the tax. To estimate effects, we employ a Difference-in-differences methodology. By using a comprehensive database of the car fleet and car owners, sociodemographic and geographic factors are analyzed, which is unique in the existing literature. Our results suggest that the congestion tax had a significant impact on ethanol car purchases although the effect fades away over time. Furthermore, there is a positive relationship between the level of education and ethanol car purchases. Previous adoption of an ethanol car is found to be the strongest predictor of ethanol car purchases. Finally, data indicate that Stockholmers substantially increased purchases of ethanol cars half a year before the introduction of the congestion tax, which we refer to as an anticipation effect. - Highlights: • Uses a database of car owners to analyze impacts of a congestion tax on car fleet. • Results show that the tax had a significant effect on ethanol car purchases. • Prior ownership of ethanol car and education correlates with ethanol car purchases

  20. A STUDY OF CORRELATION OF ESOPHAGEAL VARICES IN CIRRHOTIC PATIENTS WITH PORTAL HAEMODYNAMICS WITH SPECIAL REFERENCE TO PORTAL VEIN DIAMETER, PORTAL VEIN VELOCITY, CONGESTION INDEX, LIVER VASCULAR INDEX

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    Arvind

    2014-12-01

    Full Text Available OBJECTIVE : Approximately two thirds of patients with decompensated cirrhosis and one third of those with compensated cirrhosis have varices at the time of diagnosis. Therefore , it is essential to identify and treat those patients at highest risk because each episode of variceal hemorrhage carries a 20% to 30% risk of death , and 70% of patients not receiving treatment will die within 1 year of the initial bleeding episode . (1 METH OD S: For this study , patients with cirrhosis with or without the evidence of any upper Gastrointestinal bleed , admitted in the department of medicine , JA Group of Hospitals , GR Medical College were taken. The study was conducted between September 2011 and November 2012 and cases were evaluated on the basis of clinical , haematological , ultrasonographic and endoscopic findings. Total number of cases were 100. RESULT : The prevalence of esophageal varices was 75% in cirrhotic patients out of which 28% had bleeding. The prevalence of gastric varices was 1.33%. The portal vein diameter correlated with the presence of varices while portal vein velocity , congestion index and liver vascular index had no significant correlation with esophageal varices. The Portal vein diameter more than 1.4 cm can predict varices with sensitivity 76 % (p<0.05 and Portal vein diameter more than 1.5 cm can detect bleeding varices in cirrhotic patients with sensitivity 55.56% and specificity 80.70% . CONCLUSION : This study showed tha t duration of illness , spleen size and tense ascitis on ultrasonography and portal vein diameter correlated with the presence of esophageal varices. The duration of illness and portal vein diameter are also correlated with bleeding manifestation