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Sample records for intact adult ventricular

  1. Persistent truncus arteriosus with intact ventricular septum diagnosed by echocardiography

    Institute of Scientific and Technical Information of China (English)

    ZHANG Yu-qi; SHEN Rong; SUN Kun; ZHONG Shu-wen; WU Yu-rong

    2009-01-01

    Persistent truncus arteriosus (PTA) is a rare congenital cardiac anomaly, and has an incidence of about 0.5 to 0.9 per 10 000 live births. Almost all cases described in the literatures had a large ventricular septal defect, only few rare cases were reported with intact ventricular septum. From June 1998 to December 2008, cardiac angiography were performed in 10 880 patients with congenital heart disease in our hospital, 47 patients with PTA were diagnosed, one case with tricuspid atresia,hypoplastic right ventricle, and intact ventricular septum was encountered.

  2. Large Right Ventricular Clot in Pulmonary Atresia With Intact Ventricular Septum: In Defense of Biventricular Approach.

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    Dutta, Nilanjan; Ghosh, Rajarshi; Awasthy, Neeraj; Iyer, Parvathi U; Girotra, Sumir; Iyer, Krishna S

    2016-09-01

    Thrombus formation within the right ventricle (RV) in the setting of pulmonary atresia with intact ventricular septum (PAIVS) is not a very common occurrence and can be catastrophic. We present the case of a seven-month-old child with PAIVS and RV clot who successfully underwent biventricular repair. We discuss the interesting case and the rationale for management by means of biventricular repair over single ventricle repair when feasible in such a setting.

  3. Fertility, pregnancy, and delivery after biventricular repair for pulmonary atresia with an intact ventricular septum.

    NARCIS (Netherlands)

    Drenthen, W.; Pieper, P.G.; Roos-Hesselink, J.W.; Zoon, N.; Voors, A.A.; Mulder, B.J.M.; Dijk, A.P.J. van; Vliegen, H.W.; Sollie, K.M.; Ebels, T.; Veldhuisen, D.J. van

    2006-01-01

    The objective of the present study to investigate fertility, pregnancy, and delivery in women with biventricular repair for pulmonary atresia with an intact ventricular septum (PAIVS). Using a nationwide registry (CONCOR), 37 patients with pulmonary atresia were identified, 6 of whom (aged 21 to 34

  4. Assessment of contractility in intact ventricular cardiomyocytes using the dimensionless 'Frank-Starling Gain' index.

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    Bollensdorff, Christian; Lookin, Oleg; Kohl, Peter

    2011-07-01

    This paper briefly recapitulates the Frank-Starling law of the heart, reviews approaches to establishing diastolic and systolic force-length behaviour in intact isolated cardiomyocytes, and introduces a dimensionless index called 'Frank-Starling Gain', calculated as the ratio of slopes of end-systolic and end-diastolic force-length relations. The benefits and limitations of this index are illustrated on the example of regional differences in Guinea pig intact ventricular cardiomyocyte mechanics. Potential applicability of the Frank-Starling Gain for the comparison of cell contractility changes upon stretch will be discussed in the context of intra- and inter-individual variability of cardiomyocyte properties.

  5. Persistent Truncus Arteriosus With Intact Ventricular Septum: Clinical, Hemodynamic and Short-term Surgical Outcome

    Directory of Open Access Journals (Sweden)

    Gholamhossein Ajami

    2015-10-01

    Full Text Available Introduction: Truncus arteriosus with intact ventricular septum is a rare and unique variant of persistent truncus arteriosus (PTA which usually presents with central cyanosis and congestive heart failure in neonate and early infancy. Associated cardiac and non-cardiac anomalies may affect morbidity and mortality of these patients. Case Presentation: We describe clinical presentation, echocardiography and angiographic features of a 7-month old boy with PTA and intact ventricular septum who underwent surgical repair of the anomaly at our institution. Operative findings, surgical procedure and short-term outcome are reported. Conclusions: While our patient had systemic pulmonary arterial pressure at the time of complete surgical repair, it was improved after surgery.

  6. Transcatheter pulmonary valve perforation using chronic total occlusion wire in pulmonary atresia with intact ventricular septum

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    Bakhru, Shweta; Marathe, Shilpa; Saxena, Manish; Verma, Sudeep; Saileela, Rajan; Dash, Tapan K; Koneti, Nageswara Rao

    2017-01-01

    Background: Perforation of pulmonary valve using radiofrequency ablation in pulmonary atresia with intact ventricular septum (PA IVS) is a treatment of choice. However, significant cost of the equipment limits its utility, especially in the developing economies. Objective: To assess the feasibility, safety, and efficacy of perforation of pulmonary valve using chronic total occlusion (CTO) wires in patients with PA IVS as an alternative to radiofrequency ablation. Methods: This is a single-center, nonrandomized, retrospective study conducted during June 2008 to September 2015. Twenty-four patients with PA IVS were selected for the procedure during the study period. The median age and weight of the study population were 8. days and 2.65 kg, respectively. Four patients were excluded after right ventricular angiogram as they showed right ventricular-dependent coronary circulation. The pulmonary valve perforation was attempted using various types of CTO wires based on the tip load with variable penetrating characteristics. Results: The procedure was successful in 16 of twenty patients using CTO wires: Shinobi in nine, Miracle in four, CROSS-IT in two, and Conquest Pro in one. Two patients had perforation of right ventricular outflow tract (RVOT). Pericardiocentesis was required in one patient to relieve cardiac tamponade. Later, the same patient underwent successful hybrid pulmonary valvotomy. The other patient underwent ductus arteriosus (DA) stenting. Balloon atrial septostomy was needed in three cases with systemic venous congestion. Desaturation was persistent in five cases necessitating DA or RVOT stenting to augment pulmonary blood flow. There were two early and two late deaths. The mean follow-up was 22.66 ± 16 months. Three patients underwent one and half ventricle repair and one Blalock–Taussig shunt during follow-up. Conclusion: Perforation of the pulmonary valve can be done successfully using CTO wires in selected cases of pulmonary atresia with intact

  7. Effect of Autonomic Nervous System on the Transmurai Dispersion of Ventricular Repolarization in Intact Canine

    Institute of Scientific and Technical Information of China (English)

    张存泰; 徐大文; 李泱; 刘念; 王琳; 陆再英

    2004-01-01

    Summary: The effect of the autonomic nerves on the transmural dispersion of ventricular repolarization in intact canine was investigated. By using the monophasic action potential (MAP) recording technique, monophasic action potentials (MAPs) of the epicardium (Epi), midmyocardium (Mid)and endocardium (Endo) were recorded simultaneously by specially designed plunge-needle electrodes at the left ventricular free wall in 12 open-chest dogs. MAPD90 and transmural dispersion of repolarization among three myocardial layers as well as the incidence of the EAD before autonomic nervous stimulation and during autonomic nervous stimulation were compared. The results showed that the MAPD90 of Epi, Mid and Endo before autonomic nervous stimulation were 278±11 ms,316± 16 ms and 270± 12 ms respectively, the MAPD90of Mid was significantly longer than that of Epi or Endo (P<0.01). MAPD90 of Epi, Mid and Endo were shortened by 19±4 ms, 45±6 ms,18± 3 ms respectively during sympathetic stimulation. Compared with that of the control, the transmural dispersion of repolarization during sympathetic stimulation was shortened from 44 ± 4 ms to 15±3 ms (P<0. 01), but early afterdepolarizations were elicited in the Mid of 5 dogs (41 0%)during sympathetic stimulation. Parasympathetic stimulation did not significantly affect the MAPD90 in the three layers. It is concluded that there is the transmural dispersion of ventricular repolarization in intact canine. Sympathetic stimulation can reduce transmural dispersion of repolarization, but it can produce early afterdepolarizations in the Mid. Parasympathetic stimulation does not significantly affect the transmural dispersion of ventricular repolarization.

  8. Pulmonary Atresia with Intact Ventricular Septum and Absence of Tricuspid Valve. A Report of Four Cases

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    Adel E. González Morejón

    2013-12-01

    Full Text Available Pulmonary atresia with intact ventricular septum suggests a simple congenital heart malformation. However, nothing could be further from the truth. Among the morphological peculiarities of this condition, the presence of congenitally unguarded tricuspid valve orifice is rarely observed. The present paper aims at describing a series of four patients with both malformations detected in the William Soler Children’s Heart Center from 1986 through 2012. Echocardiographic diagnosis could be accurately performed in the last two patients; identification of the initial cases was established by the findings at necropsy. All patients underwent Blalock – Taussig shunt as initial palliative treatment, which was associated with balloon atrioseptostomy in two cases. Only one of the last children mentioned survived. Vital prognosis of patients suffering from this association of malformations lies in early echocardiographic detection.

  9. Morphology of tricuspid valve in pulmonary atresia with intact ventricular septum.

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    Choi, Y H; Seo, J W; Choi, J Y; Yun, Y S; Kim, S H; Lee, H J

    1998-01-01

    Pulmonary atresia with intact ventricular septum (PAIVS) is a rare congenital cardiac anomaly that has been classified into two types: one is a more frequent type having dysplasia of tricuspid valve (TV) with a small annulus, underdeveloped right ventricle (RV) with a hypoplastic cavity and a hypertrophic wall; the other type has severe dysplasia of TV and dilatation of RV, right atrium (RA), and right atrioventricular junction with thinning of the RV wall. We performed a morphologic study on 11 autopsied hearts with PAIVS, giving particular emphasis to the variation of morphology of the TV. We could classify these hearts into 3 groups according to the degree of right ventricular development. In the first group of 7 cases (type I), the RVs were underdeveloped. Thick leaflets, restricted valve apparatus with short chordae, and small annuli were characteristics of the TV. In the second group of 3 cases (type II), the RVs showed marked enlargement of the cavity and thinning of the wall. The TV showed redundant, dysplastic, sail-like anterior leaflets, and the downward displacement of septal leaflet and/or posterior leaflet, which are the findings frequently observed in Ebstein's malformation. The RVs were dilated and with partially unguarded tricuspid orifice. The septal leaflet of the TV was dysplastic and, in two cases, the septal leaflet showed chordal structure at the upper surface facing the RA, which is a peculiar finding that has not been described in the literature. The remaining case was a heart with a moderately developed RV (type III). The TV showed mildly dysplastic appearance and we classify this as a separate type, because we could expect the best surgical results in this type. This type had optimal size of RV and the mildest degree of dysplasia of TV. In PAIVS, the morphology of TV correlates well with the type of the right ventricular development.

  10. Evolution of the management approach for pulmonary atresia with intact ventricular septum

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    Mi, Y P; Chau, A K T; Chiu, C S W; Yung, T C; Lun, K S; Cheung, Y F

    2005-01-01

    Objective: To review the evolution of the management approach for pulmonary atresia with intact ventricular septum (PAIVS) in the past two decades and to assess its impact on patient outcomes. Design and patients: Retrospective review of the management and outcomes of 94 patients (55 male patients) with PAIVS diagnosed between July 1980 and August 2003. Settings: Tertiary paediatric cardiac centre. Results: Seven patients died before interventions. Of the remaining 87 patients who underwent intervention at a median age of 9 days (from 1 day to 2 years), 12 had right ventricular outflow tract reconstruction (RVOTR), 42 had closed pulmonary valvotomy (CPV), and 15 had laser assisted valvotomy with balloon valvoplasty. A systemic–pulmonary shunt was inserted in 18 patients, six of whom had subsequent RVOTR (n  =  4) or laser assisted valvotomy (n  =  2). Since 1990, catheter intervention accounted for 38% (17 of 45) of the right ventricular outflow procedures. The mean (SEM) freedom from reintervention was 93 (7)%, 71 (12)%, and 57 (13)% after RVOTR, 75 (7)%, 40 (8)%, and 14 (6)% after CPV, and 54 (13)%, 24 (12)%, and 16 (10)% after laser assisted valvotomy at one month, six months, and one year, respectively (RVOTR versus CPV, p < 0.001; RVOTR versus laser assisted valvotomy, p  =  0.001). Low cardiac output syndrome was significantly less common after catheter intervention than after RVOTR (0% v 44%, p  =  0.003) or CPV (0% v 29%, p  =  0.01). The overall mean (SEM) survival was 77 (5)% and 70 (5)% at one and five years, respectively, and the overall mortality was 33% (29 of 87). There were no significant differences in survival between the three groups. Conclusions: Multiple interventions are often required in the treatment algorithm of PAIVS. The shift towards increased use of the transcatheter approach has reduced the occurrence of postprocedural low cardiac output syndrome. PMID:15831657

  11. Contemporary Assessment of Left Ventricular Diastolic Function in Older Adults

    DEFF Research Database (Denmark)

    Shah, Amil M; Claggett, Brian; Kitzman, Dalane

    2017-01-01

    BACKGROUND: Although age-associated changes in left ventricular diastolic function are well recognized, limited data exist characterizing measures of diastolic function in older adults, including both reference ranges reflecting the older adult population and prognostically relevant values for in...

  12. Covert spatial attention is functionally intact in amblyopic human adults.

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    Roberts, Mariel; Cymerman, Rachel; Smith, R Theodore; Kiorpes, Lynne; Carrasco, Marisa

    2016-12-01

    Certain abnormalities in behavioral performance and neural signaling have been attributed to a deficit of visual attention in amblyopia, a neurodevelopmental disorder characterized by a diverse array of visual deficits following abnormal binocular childhood experience. Critically, most have inferred attention's role in their task without explicitly manipulating and measuring its effects against a baseline condition. Here, we directly investigate whether human amblyopic adults benefit from covert spatial attention-the selective processing of visual information in the absence of eye movements-to the same degree as neurotypical observers. We manipulated both involuntary (Experiment 1) and voluntary (Experiment 2) attention during an orientation discrimination task for which the effects of covert spatial attention have been well established in neurotypical and special populations. In both experiments, attention significantly improved accuracy and decreased reaction times to a similar extent (a) between the eyes of the amblyopic adults and (b) between the amblyopes and their age- and gender-matched controls. Moreover, deployment of voluntary attention away from the target location significantly impaired task performance (Experiment 2). The magnitudes of the involuntary and voluntary attention benefits did not correlate with amblyopic depth or severity. Both groups of observers showed canonical performance fields (better performance along the horizontal than vertical meridian and at the lower than upper vertical meridian) and similar effects of attention across locations. Despite their characteristic low-level vision impairments, covert spatial attention remains functionally intact in human amblyopic adults.

  13. Management of Relocation in Cognitively Intact Older Adults.

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    Hertz, Judith E; Koren, Mary Elaine; Rossetti, Jeanette; Tibbits, Kathryn

    2016-11-01

    Relocation, a major life transition that can affect health positively and negatively, is moving from one permanent home to another. Many older adults will relocate at some time during their life. Relocation is also a complex process that requires careful consideration and planning before the move (i.e., pre-location) and adjustment to the new home after the move (i.e., post-relocation). The current article is a summary of content based on a comprehensive evidence-based practice guideline focused on management of relocation in cognitively intact older adults. The guideline was designed to be used across diverse settings by nurses and other providers. Pre-relocation guidelines include assessment for the need for relocation, interventions prior to moving, and outcomes for evaluation of the pre-relocation process. For post-relocation, content focuses on assessment of risks for not adjusting after the move as well as intervention guidelines to promote adjustment and outcomes for evaluation. Implications include advocacy for older adults by using the guideline, disseminating it, and conducting future research. [Journal of Gerontological Nursing, 42(11), 14-23.].

  14. Minimizing ventricular pacing by a novel atrioventricular (AV) delay hysteresis algorithm in patients with intact or compromised intrinsic AV conduction and different atrial and ventricular lead locations.

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    Pakarinen, Sami; Toivonen, Lauri

    2013-09-01

    To investigate if an advanced AV search hysteresis (AVSH) algorithm, Ventricular Intrinsic Preference (VIP(™)), reduces the incidence of ventricular pacing (VP) in sinus node dysfunction (SND) with both intact and compromised AV conduction and with intermittent AV block regardless of the lead positions in the right atria and the ventricle. Patients were classified as having intact AV (AVi) conduction if the PR interval was ≤ 210 ms on ECG and 1:1 AV conduction during atrial pacing up to 120 bpm with PR interval ≤ 350 ms. Otherwise the AV conduction was classified as compromised (AVc). Both AVi and AVc patients were randomized to VIP ON or OFF. VIP performed an intrinsic AV conduction search every 30 s for three consecutive atrial cycles with the extension of the sensed and paced AV (SAV/PAV) delays from basic values of 150/200 ms to 300/350 ms. Extended AV intervals were allowed for three cycles when VP occurred before returning to basic AV delays. The primary end-point was %VP at 12 months. Among 389 patients, 30.1% had intact and 69.9% had compromised AV conduction. The mean %VP at 12 months was 9.6% by VIP compared to 51.8% with standard AV settings in patients with AVi (P < 0.0001) and 28.0% versus 78.9% (P < 0.0001) with AVc. With VIP, excessive %VP among most used lead positions was not seen. Conversely, when VIP was off %VP was low only in patients who had leads in the RA septal-RV septal position (23.0%). VIP feature reduces VP both in patients with SND and with intermittent heart block regardless of the lead positions in the right atria and the ventricle.

  15. Comparison of the offset distance of the tricuspid septal leaflet in neonates with Ebstein's anomaly and neonates with pulmonary atresia with intact ventricular septum.

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    Kim, Min Jeong; Yu, Jeong Jin; Kang, So Yeon; Seo, Chang Deok; Baek, Jae Suk; Kim, Young-Hwue; Ko, Jae-Kon

    2015-01-01

    An indexed offset distance of the tricuspid septal leaflet ⩾8 mm/m2 is a quantitative criterion for the diagnosis of Ebstein's anomaly. The purpose of this study was to investigate the validity of this criterion for the discrimination of Ebstein's anomaly from pulmonary atresia with intact ventricular septum in neonatal patients. A total of 122 neonatal patients, 56 with Ebstein's anomaly and 66 with pulmonary atresia with intact ventricular septum, were enrolled. Diagnosis of each anomaly was based on typical morphologic features. Echocardiographic variables, including the offset distance of the tricuspid septal leaflet, were measured via an offline analysis of images recorded before 1 month of age. The offset distance of the tricuspid septal leaflet was indexed by the body surface area, and the indexed offset distances in the Ebstein's anomaly and pulmonary atresia with intact ventricular septum groups were 34.2 mm/m2 (7.1-119.1 mm/m2) and 7.2 mm/m2 (0.0-25.6 mm/m2), respectively. The indexed offset distance was ⩾8 mm/m2 in 29 (43.9%) of the patients with pulmonary atresia with intact ventricular septum; clinical and echocardiographic characteristics were comparable between these 29 patients and the remaining 37 patients with pulmonary atresia with intact ventricular septum. When an indexed offset distance ⩾8 mm/m2 was applied as a cut-off for the diagnosis of Ebstein's anomaly, the sensitivity was 0.963 and the specificity was 0.561. In conclusion, indexed offset distance ⩾8 mm/m2 cannot be used as a cut-off for the diagnosis of complicated Ebstein's anomaly in neonatal patients with pulmonary atresia with intact ventricular septum.

  16. Optimal Z-Score Use in Surgical Decision-Making in Pulmonary Atresia With Intact Ventricular Septum.

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    Awori, Mark Nelson; Mehta, Nikita P; Mitema, Frederick O; Kebba, Naomi

    2017-05-01

    In the surgical treatment of pulmonary atresia with intact ventricular septum, the size of the tricuspid valve annulus (as measured by z-scores) has emerged as a significant factor in deciding which repair to perform. Various tricuspid valve annulus z-scores are reported as "cutoffs" for successful biventricular repair. We aimed to determine whether the use of different z-score data sets contributed to the gross variation in "cutoffs" for successful biventricular repair reported in the literature. A single search was made of PubMed using the "advanced" setting with the following search terms: pulmonary, atresia, intact, septum, z, and score. The filters "title" and "title/abstract" were used for the first four and last two terms, respectively; the instruction "AND" combined all terms. Articles that identified which z-score data set was used in patients with biventricular repairs were included. From 13 articles, 1,392 patients were studied, 410 (29.5%) of which achieved biventricular repair. Three z-score data sets were quoted; mean tricuspid valve annulus z-scores in biventricular repair patients ranged between -0.53 and -5.1. After correcting for discrepancies between z-score data sets, no study reported a mean tricuspid valve annulus z-score -1.7. The use of varied tricuspid valve annuli z-score data sets may have contributed to gross variations in reported "cutoffs" for successful biventricular repair. This could lead to inappropriate surgical pathway allocation.

  17. Adult neurogenesis in the intact and epileptic dentate gyrus.

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    Parent, Jack M

    2007-01-01

    Neurogenesis persists throughout life in the adult mammalian dentate gyrus. Adult-born dentate granule cells integrate into existing hippocampal circuitry and may provide network plasticity necessary for certain forms of hippocampus-dependent learning and memory. Neural stem cells and neurogenesis in the adult dentate gyrus are regulated by a variety of environmental, physiological, and molecular factors. These include aging, stress, exercise, neurovascular components of the stem cell niche, growth factors, neurotransmitters, and hormones. Seizure activity also influences dentate granule cell neurogenesis. Production of adult-born neurons increases in rodent models of temporal lobe epilepsy, and both newborn and pre-existing granule neurons contribute to aberrant axonal reorganization in the epileptic hippocampus. Prolonged seizures also disrupt the migration of dentate granule cell progenitors and lead to hilar-ectopic granule cells. The ectopic granule neurons appear to integrate abnormally and contribute to network hyperexcitability. Similar findings of granule cell layer dispersion and ectopic granule neurons in human TLE suggest that aberrant neurogenesis contributes to epileptogenesis or learning and memory disturbances in this epilepsy syndrome.

  18. [Acute cerebral ischemia: an unusual clinical presentation of isolated left ventricular noncompaction in an adult patient].

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    Fiorencis, Andrea; Quadretti, Laura; Bacich, Daniela; Chiodi, Elisabetta; Mele, Donato; Fiorencis, Roberto

    2013-01-01

    Isolated left ventricular noncompaction in adults is uncommon. The most frequent clinical manifestations are heart failure due to left ventricular systolic dysfunction and supraventricular and ventricular arrhythmias, which may be sustained and associated with sudden death. Thromboembolic complications are also possible. We report the case of an adult patient with isolated left ventricular noncompaction who came to our observation because of acute cerebral ischemia, an initial presentation of the disease only rarely described.

  19. Right ventricular outflow tract reconstructive model in adult sheep.

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    Rakow, Nancy; Barka, Noah; Nelson, Dale; Allen, Nan; Gringaard, Robyn; Falkner, Phillip; Wahlberg, Phil; Lemmon, Jack; Phillips, Lynette; Billstrom, Tina; Hill, Alex; Shecterle, Linda M; St Cyr, J A

    2007-01-01

    Patients born with congenital right ventricular outflow tract lesions are faced with invasive procedures to establish hemodynamic and physiological stability. Commonly, multiple subsequent surgical procedures are required due to deterioration of a previous repair. These procedures carry additive risks of mortality and morbidity. Less aggressive procedures with accompanying lower risk is ideal. Success in percutaneously placing a transcatheter valve has previously been reported; however, continued safety and efficacy of any technique needs continual assessment. We developed a model for preclinical evaluation of a percutaneous placement of a pulmonic transcatheter valve in adult sheep, including preoperative, surgical, and postoperative techniques for long-term evaluation. Adult sheep were assessed and determined to be acceptable for study enrollment. Perioperative antibiotics and analgesics were given prior to a left thoracotomy. A Medtronic, Hancock 1 valve conduit was inserted for reconstruction of the right ventricular outflow tract. The Hancock 1 valve conduit alone represented the control group and the test animals comprised the addition of a Melodytrade mark transcatheter pulmonary valve (TPV), within the Hancock 1 valve conduit. Fifteen adult sheep survived the surgical implant procedure with no perioperative mortality. There were four early postoperative deaths, three due to infection and one due to heart failure, secondary to intraoperative heart block. The remaining 11 animals remained healthy, gained weight, and survived to termination at 5 months. An initial definite-sized valve conduit was implanted, followed by inserting a single size TPV, which allowed a more accurate physiological assessment of any chosen valve. Our developed adult sheep model for percutaneous TPV implantation for right ventricular outflow tract lesions was successful for long-term assessment by utilizing our preoperative, surgical, and postoperative techniques.

  20. Atrioventricular Left Ventricular Apical Pacing Improves Haemodynamic, Rotational, and Deformation Variables in Comparison to Pacing at the Lateral Wall in Intact Myocardium: Experimental Study

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    Savvas Toumanidis

    2014-01-01

    Full Text Available Aim. To assess the effect on left ventricular (LV function of atrioventricular (AV and ventricular pacing at the LV apical or lateral wall and to compare the normal torsional and deformation pattern of the intact LV myocardium with those created by the aforementioned LV pacing modes and sites. Methods. Experiments were conducted in pigs (n=21 with normal LV function to investigate the acute hemodynamic effects of epicardial AV and ventricular LV pacing at the LV apical or lateral wall. Torsional and deformation indices of LV function were assessed using speckle tracking echocardiography. Results. AV pacing at the apex revealed a significant reduction in the radial strain of the base (P<0.03, without affecting significantly the ejection fraction and the LV torsion or twist. In contrast, AV pacing at the lateral wall produced, in addition to the reduction of the radial strain of the base (P<0.01, significant reduction of the circumferential and the radial strain of the apex (both P<0.01 as well as of the ejection fraction (P<0.002 and twist (P<0.05. Conclusions. In pig hearts with intact myocardium, LV function is maintained at sinus rhythm level when AV pacing is performed at the LV apex.

  1. Neurodevelopment. Live imaging of adult neural stem cell behavior in the intact and injured zebrafish brain.

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    Barbosa, Joana S; Sanchez-Gonzalez, Rosario; Di Giaimo, Rossella; Baumgart, Emily Violette; Theis, Fabian J; Götz, Magdalena; Ninkovic, Jovica

    2015-05-15

    Adult neural stem cells are the source for restoring injured brain tissue. We used repetitive imaging to follow single stem cells in the intact and injured adult zebrafish telencephalon in vivo and found that neurons are generated by both direct conversions of stem cells into postmitotic neurons and via intermediate progenitors amplifying the neuronal output. We observed an imbalance of direct conversion consuming the stem cells and asymmetric and symmetric self-renewing divisions, leading to depletion of stem cells over time. After brain injury, neuronal progenitors are recruited to the injury site. These progenitors are generated by symmetric divisions that deplete the pool of stem cells, a mode of neurogenesis absent in the intact telencephalon. Our analysis revealed changes in the behavior of stem cells underlying generation of additional neurons during regeneration.

  2. Critical stenosis of a right ventricle to coronary artery fistula seen at dual-source CT in a newborn with pulmonary atresia and intact ventricular septum.

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    Séguéla, Pierre-Emmanuel; Houyel, Lucile; Loget, Philippe; Piot, Jean-Dominique; Paul, Jean-François

    2011-08-01

    We report the case of a newborn with pulmonary atresia with intact ventricular septum and right ventricle-dependent coronary circulation. He died several weeks after a Blalock-Taussig procedure because of a progressive stenosis of the main coronary artery. We present echocardiographic and dual-source CT images of the stenosis, with autopsy correlation. To our knowledge, CT images of this quality have never been reported in a newborn. This case illustrates the extreme difficulty in prognosticating the outcome for these patients and underlines the need for a detailed neonatal coronary mapping to assess right ventricle-dependent coronary circulation.

  3. Magnetic resonance imaging derived left ventricular global and region function parameters in healthy adults

    Institute of Scientific and Technical Information of China (English)

    穆莉莎

    2014-01-01

    Objective To establish cardiac magnetic resonance imaging(MRI)derived left ventricular(LV)global and region function parameters in normal adults.Methods Twenty normal adults were examined with fast imaging employing steady-state(Fiesta)acquisition sequence of cardiac MRI,LV global function and LV region function were measured at basal,middle,apical level and at 16

  4. Malnutrition among Cognitively Intact, non-Critically Ill Older Adults in the Emergency Department

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    Pereira, Greg F.; Bulik, Cynthia M.; Weaver, Mark A.; Holland, Wesley C.; Platts-Mills, Timothy F.

    2014-01-01

    Objectives We estimate the prevalence of malnutrition among older patients presenting to an emergency department (ED) in the southeastern United States and identify subgroups at increased risk. Methods We conducted a cross-sectional study with random time block sampling of cognitively intact patients aged 65 years and older. Nutrition was assessed using the Mini Nutritional Assessment Short-Form (0–14 scale) with malnutrition defined as a score of 7 or less and at-risk for malnutrition defined as a score of 8–11. The presence of depressive symptoms was defined as a Center for Epidemiological Studies Depression-10 score of 4 or more (0–10 scale). Results Among 138 older adults, 16% (95% Confidence Interval [CI], 10%–22%) were malnourished and 60% (95% CI, 52%–69%) were either malnourished or at-risk for malnutrition. Seventeen of the 22 malnourished patients (77%) denied previously being diagnosed with malnutrition. The prevalence of malnutrition was not appreciably different between males and females, across levels of patient education, or between those living in urban and rural areas. However, the prevalence of malnutrition was higher among patients with depressive symptoms 52%, those residing in assisted living 50%, those with difficulty eating 38%, and those reporting difficulty buying groceries 33%. Conclusion Among a random sample of cognitively intact older ED patients, more than half were malnourished or at-risk for malnutrition, and the majority of malnourished patients had not previously been diagnosed. Higher rates of malnutrition among those with depression, difficulty eating, and difficulty buying groceries suggest the need to explore multifaceted interventions. PMID:25129819

  5. Malnutrition among cognitively intact, noncritically ill older adults in the emergency department.

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    Pereira, Greg F; Bulik, Cynthia M; Weaver, Mark A; Holland, Wesley C; Platts-Mills, Timothy F

    2015-01-01

    We estimate the prevalence of malnutrition among older patients presenting to an emergency department (ED) in the southeastern United States and identify subgroups at increased risk. We conducted a cross-sectional study with random time block sampling of cognitively intact patients aged 65 years and older. Nutrition was assessed with the Mini Nutritional Assessment Short-Form (0 to 14 scale), with malnutrition defined as a score of 7 or less and at risk for malnutrition defined as a score of 8 to 11. The presence of depressive symptoms was defined as a Center for Epidemiological Studies Depression-10 score of 4 or more (0 to 10 scale). Among 138 older adults, 16% (95% confidence interval [CI] 11% to 23%) were malnourished and 60% (95% CI 52% to 68%) were either malnourished or at risk for malnutrition. Seventeen of the 22 malnourished patients (77%) denied previously receiving a diagnosis of malnutrition. The prevalence of malnutrition was not appreciably different between men and women, across levels of patient education, or between those living in urban and rural areas. However, the prevalence of malnutrition was higher among patients with depressive symptoms (52%), those residing in assisted living (44%), those with difficulty eating (38%), and those reporting difficulty buying groceries (33%). Among a random sample of cognitively intact older ED patients, more than half were malnourished or at risk for malnutrition, and the majority of malnourished patients had not previously received a diagnosis. Higher rates of malnutrition among individuals with depression, difficulty eating, and difficulty buying groceries suggest the need to explore multifaceted interventions. Copyright © 2014 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  6. Exercise-induced polymorphic ventricular tachycardia in adults without structural heart disease.

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    Tan, Justin Hong-Jie; Scheinman, Melvin M

    2008-04-15

    Patients with catecholaminergic polymorphic ventricular tachycardia present at a young age with exercise-induced ventricular arrhythmias (VAs) and may have a positive family history. We describe 8 patients who presented with exercise-induced symptoms as adults, have a negative family history, and responded to beta-blocker therapy. The study evaluated exercise treadmill electrocardiographic data from patients referred for exercise-induced VA. Inclusion criteria consisted of development of bidirectional, pleomorphic, or polymorphic ventricular tachycardia with exercise, adult age at first onset, negative family history, and no evidence of structural heart disease. We correlated VA configurations with respect to heart rate before and after beta-blocker therapy. Patients displayed a pattern of increasing ventricular complexity with increasing heart rate. The appropriate beta blocker (n = 7) or calcium channel blocker (n = 1) was defined as the dose that resulted in control of symptoms. Three patients showed suppression of VA with sinus tachycardia at peak heart rate. Six patients had decreased VA defined as absence of higher complexity arrhythmias. With drug therapy, average heart rate associated with premature ventricular complex couplets/triplets increased, whereas duration and complexity of premature ventricular complexes decreased. One patient had an automatic implantable cardiac defibrillator placed but has had no discharges from the device since starting the appropriate beta blocker. In conclusion, these patients appear to respond well to beta-blocker or calcium channel blocker therapy with decreased ectopic complexity and an increased heart rate threshold for inducing VA.

  7. Language of administration and neuropsychological test performance in neurologically intact Hispanic American bilingual adults.

    Science.gov (United States)

    Gasquoine, Philip Gerard; Croyle, Kristin L; Cavazos-Gonzalez, Cynthia; Sandoval, Omar

    2007-11-01

    This study compared the performance of Hispanic American bilingual adults on Spanish and English language versions of a neuropsychological test battery. Language achievement test scores were used to divide 36 bilingual, neurologically intact, Hispanic Americans from south Texas into Spanish-dominant, balanced, and English-dominant bilingual groups. They were administered the eight subtests of the Bateria Neuropsicologica and the Matrix Reasoning subtest of the WAIS-III in Spanish and English. Half the participants were tested in Spanish first. Balanced bilinguals showed no significant differences in test scores between Spanish and English language administrations. Spanish and/or English dominant bilinguals showed significant effects of language of administration on tests with higher language compared to visual perceptual weighting (Woodcock-Munoz Language Survey-Revised, Letter Fluency, Story Memory, and Stroop Color and Word Test). Scores on tests with higher visual-perceptual weighting (Matrix Reasoning, Figure Memory, Wisconsin Card Sorting Test, and Spatial Span), were not significantly affected by language of administration, nor were scores on the Spanish/California Verbal Learning Test, and Digit Span. A problem was encountered in comparing false positive rates in each language, as Spanish norms fell below English norms, resulting in a much higher false positive rate in English across all bilingual groupings. Use of a comparison standard (picture vocabulary score) reduced false positive rates in both languages, but the higher false positive rate in English persisted.

  8. Hemoglobin A1c and arterial and ventricular stiffness in older adults.

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    Susan J Zieman

    Full Text Available OBJECTIVE: Arterial and ventricular stiffening are characteristics of diabetes and aging which confer significant morbidity and mortality; advanced glycation endproducts (AGE are implicated in this stiffening pathophysiology. We examined the association between HbA(1c, an AGE, with arterial and ventricular stiffness measures in older individuals without diabetes. RESEARCH DESIGN & METHODS: Baseline HbA(1c was measured in 830 participants free of diabetes defined by fasting glucose or medication use in the Cardiovascular Health Study, a population-based cohort study of adults aged ≥ 65 years. We performed cross-sectional analyses using baseline exam data including echocardiography, ankle and brachial blood pressure measurement, and carotid ultrasonography. We examined the adjusted associations between HbA(1c and multiple arterial and ventricular stiffness measures by linear regression models and compared these results to the association of fasting glucose (FG with like measures. RESULTS: HbA(1c was correlated with fasting and 2-hour postload glucose levels (r = 0.21; p<0.001 for both and positively associated with greater body-mass index and black race. In adjusted models, HbA(1c was not associated with any measure of arterial or ventricular stiffness, including pulse pressure (PP, carotid intima-media thickness, ankle-brachial index, end-arterial elastance, or left ventricular mass (LVM. FG levels were positively associated with systolic, diastolic and PP and LVM. CONCLUSIONS: In this sample of older adults without diabetes, HbA(1c was not associated with arterial or ventricular stiffness measures, whereas FG levels were. The role of AGE in arterial and ventricular stiffness in older adults may be better assessed using alternate AGE markers.

  9. Observational cohort study of ventricular arrhythmia in adults with Marfan syndrome caused by FBN1 mutations.

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    Ali Aydin

    Full Text Available BACKGROUND: Marfan syndrome is associated with ventricular arrhythmia but risk factors including FBN1 mutation characteristics require elucidation. METHODS AND RESULTS: We performed an observational cohort study of 80 consecutive adults (30 men, 50 women aged 42±15 years with Marfan syndrome caused by FBN1 mutations. We assessed ventricular arrhythmia on baseline ambulatory electrocardiography as >10 premature ventricular complexes per hour (>10 PVC/h, as ventricular couplets (Couplet, or as non-sustained ventricular tachycardia (nsVT, and during 31±18 months of follow-up as ventricular tachycardia (VT events (VTE such as sudden cardiac death (SCD, and sustained ventricular tachycardia (sVT. We identified >10 PVC/h in 28 (35%, Couplet/nsVT in 32 (40%, and VTE in 6 patients (8%, including 3 with SCD (4%. PVC>10/h, Couplet/nsVT, and VTE exhibited increased N-terminal pro-brain natriuretic peptide serum levels(P10/h and Couplet/nsVT also related to increased indexed end-systolic LV diameters (P = .024 and P = .020, to moderate mitral valve regurgitation (P = .018 and P = .003, and to prolonged QTc intervals (P = .001 and P = .006, respectively. Moreover, VTE related to mutations in exons 24-32 (P = .021. Kaplan-Meier analysis corroborated an association of VTE with increased NT-proBNP (P<.001 and with mutations in exons 24-32 (P<.001. CONCLUSIONS: Marfan syndrome with causative FBN1 mutations is associated with an increased risk for arrhythmia, and affected persons may require life-long monitoring. Ventricular arrhythmia on electrocardiography, signs of myocardial dysfunction and mutations in exons 24-32 may be risk factors of VTE.

  10. Cerebroventricular microinjection (CVMI into adult zebrafish brain is an efficient misexpression method for forebrain ventricular cells.

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    Caghan Kizil

    Full Text Available The teleost fish Danio rerio (zebrafish has a remarkable ability to generate newborn neurons in its brain at adult stages of its lifespan-a process called adult neurogenesis. This ability relies on proliferating ventricular progenitors and is in striking contrast to mammalian brains that have rather restricted capacity for adult neurogenesis. Therefore, investigating the zebrafish brain can help not only to elucidate the molecular mechanisms of widespread adult neurogenesis in a vertebrate species, but also to design therapies in humans with what we learn from this teleost. Yet, understanding the cellular behavior and molecular programs underlying different biological processes in the adult zebrafish brain requires techniques that allow manipulation of gene function. As a complementary method to the currently used misexpression techniques in zebrafish, such as transgenic approaches or electroporation-based delivery of DNA, we devised a cerebroventricular microinjection (CVMI-assisted knockdown protocol that relies on vivo morpholino oligonucleotides, which do not require electroporation for cellular uptake. This rapid method allows uniform and efficient knockdown of genes in the ventricular cells of the zebrafish brain, which contain the neurogenic progenitors. We also provide data on the use of CVMI for growth factor administration to the brain--in our case FGF8, which modulates the proliferation rate of the ventricular cells. In this paper, we describe the CVMI method and discuss its potential uses in zebrafish.

  11. Left ventricular hypertrophy in children, adolescents and young adults with sickle cell anemia

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    Gustavo Baptista de Almeida Faro

    2015-10-01

    Full Text Available OBJECTIVE: The aims of this study were to estimate the frequency of left ventricular hypertrophy and to identify variables associated with this condition in under 25-year-old patients with sickle cell anemia.METHODS: A cross-sectional study was performed of children, adolescents and young adults with sickle cell anemia submitted to a transthoracic Doppler echocardiography. The mass of the left ventricle was determined by the formula of Devereux et al. with correction for height, and the percentile curves of gender and age were applied. Individuals with rheumatic and congenital heart disease were excluded. The patients were divided into two groups according to the presence or absence of left ventricular hypertrophy and compared according to clinical, echocardiographic and laboratory variables.RESULTS: A total of 37.6% of the patients had left ventricular hypertrophy in this sample. There was no difference between the groups of patients with and without hypertrophy according to pathological history or clinical characteristics, except possibly for the use of hydroxyurea, more often used in the group without left ventricular hypertrophy. Patients with left ventricular hypertrophy presented larger left atria and lower hemoglobin and hematocrit levels, reticulocyte index and a higher albumin:creatinine ratio in urine.CONCLUSION: Left ventricular hypertrophy was observed in more than one-third of the young patients with sickle cell anemia with this finding being inversely correlated to the hemoglobin and hematocrit levels, and reticulocyte index and directly associated to a higher albumin/creatinine ratio. It is possible that hydroxyurea had had a protective effect on the development of left ventricular hypertrophy.

  12. [Isolated left ventricular muscular diverticulum in an adult. Value of non-invasive examinations].

    Science.gov (United States)

    Holeman, A; Bellorini, M; Lefevre, T; Lévy, M; Loiret, J; Huerta, F; Thébault, B; Funck, F

    1997-10-01

    The authors report a case of ventriculum in a 45 year old women investigated for chest pain. This was a congenital muscular left ventricular diverticulum confirmed by a complete imaging series including echocardiography, magnetic resonance imaging, angio-scintigraphy and conventional angiography. This diverticulum was unusual due to the fact that there was no associated congenital disease and that it was discovered in an adult. The authors review the literature and discuss the value of non-invasive imaging procedures.

  13. Metabolites of MDMA induce oxidative stress and contractile dysfunction in adult rat left ventricular myocytes.

    Science.gov (United States)

    Shenouda, Sylvia K; Varner, Kurt J; Carvalho, Felix; Lucchesi, Pamela A

    2009-03-01

    Repeated administration of 3,4-methylenedioxymethamphetamine (MDMA) (ecstasy) produces eccentric left ventricular (LV) dilation and diastolic dysfunction. While the mechanism(s) underlying this toxicity are unknown, oxidative stress plays an important role. MDMA is metabolized into redox cycling metabolites that produce superoxide. In this study, we demonstrated that metabolites of MDMA induce oxidative stress and contractile dysfunction in adult rat left ventricular myocytes. Metabolites of MDMA used in this study included alpha-methyl dopamine, N-methyl alpha-methyl dopamine and 2,5-bis(glutathion-S-yl)-alpha-MeDA. Dihydroethidium was used to detect drug-induced increases in reactive oxygen species (ROS) production in ventricular myocytes. Contractile function and changes in intracellular calcium transients were measured in paced (1 Hz), Fura-2 AM loaded, myocytes using the IonOptix system. Production of ROS in ventricular myocytes treated with MDMA was not different from control. In contrast, all three metabolites of MDMA exhibited time- and concentration-dependent increases in ROS that were prevented by N-acetyl-cysteine (NAC). The metabolites of MDMA, but not MDMA alone, significantly decreased contractility and impaired relaxation in myocytes stimulated at 1 Hz. These effects were prevented by NAC. Together, these data suggest that MDMA-induced oxidative stress in the left ventricle can be due, at least in part, to the metabolism of MDMA to redox active metabolites.

  14. 室间隔完整的肺动脉闭锁外科治疗%Surgical treatment of the pulmonary artery atresia with intact ventricular septum

    Institute of Scientific and Technical Information of China (English)

    吴松; 刘迎龙; 万峰; 闫军; 王强; 范祥明

    2012-01-01

    Objective:To evaluate the clinical results of hybrid and classic surgical procedure for the management of pulmonary artery atresia with intact ventricular septum (PAA/IVS) in children. Method: Forty children with PAA/IVS were divided into three groups according to the surgical procedure: group Al (n = 7, Z score 0 — 1) were received hybrid procedure with PDA ligation, and group A2 (n = 7, Z score 0——1) were received hybrid procedure and BT shunt with PDA ligation; group Bl (n=ll, Z score —0.5——2.0) were received ROVT reconstruction with PDA ligation, and group B2 (n = 4, Z score 0. 5——2. 0) were received ROVT reconstruction with PDA ligation and BT shunt; group Cl (n=3, Z score —2——3) were received one and a half ventricular repair; group C2 (n = 7, Z score —4——5) were received bi-directional Glenn bypass operation, and group C3 (n=l, Z score —5) were received BT shunt. Result: Five babies (5/40) died (1 from group A, and 4 from group B). The body weight, age, respiratory support time and postoperative hospital stay of babies were less in group A than group B (P<0. 05). Conclusion: In carefully selected babies with PAA/IVS according to the tri-cuspid valve diameter, right ventricular size and coronary anatomy, hybrid procedure is feasible and may represent a new alternative to classic surgery operation.%目的:总结分析40例室间隔完整的肺动脉闭锁(PAA/IVS)患儿的外科治疗,评价其临床疗效,并探讨适当的术式.方法:将40例PAA/IVS患儿根据手术治疗情况分为3组:①“杂交”技术组(14例,A组),包括“杂交”技术+动脉导管未闭(PDA)结扎7例(A1亚组,三尖瓣Z值0~-1)和“杂交”技术+PDA结扎+体肺分流术7例(A2亚组,三尖瓣Z值0~-1);②双心室手术矫治组(15例,B组),包括右室流出道跨环补片+PDA结扎术11例(B1亚组,三尖瓣Z值-0.5~-2.0)和右室流出道跨环补片+PDA结扎+体肺分流术4例(B2亚组,三尖瓣Z值0.5~-2.0)

  15. Evaluating a genetically encoded optical sensor of neural activity using electrophysiology in intact adult fruit flies

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    Gilles Laurent

    2007-11-01

    Full Text Available Genetically encoded optical indicators hold the promise of enabling non-invasive monitoring of activity in identified neurons in behaving organisms. However, the interpretation of images of brain activity produced using such sensors is not straightforward. Several recent studies of sensory coding used G-CaMP 1.3-a calcium sensor-as an indicator of neural activity; some of these studies characterized the imaged neurons as having narrow tuning curves, a conclusion not always supported by parallel electrophysiological studies. To better understand the possible cause of these conflicting results, we performed simultaneous in vivo 2-photon imaging and electrophysiological recording of G-CaMP 1.3 expressing neurons in the antennal lobe (AL of intact fruitflies. We find that G-CaMP has a relatively high threshold, that its signal often fails to capture spiking response kinetics, and that it can miss even high instantaneous rates of activity if those are not sustained. While G-CaMP can be misleading, it is clearly useful for the identification of promising neural targets: when electrical activity is well above the sensor's detection threshold, its signal is fairly well correlated with mean firing rate and G-CaMP does not appear to alter significantly the responses of neurons that express it. The methods we present should enable any genetically encoded sensor, activator, or silencer to be evaluated in an intact neural circuit in vivo in Drosophila.

  16. Narratives of Self-Neglect: Patterns of Traumatic Personal Experiences and Maladaptive Behaviors in Cognitively Intact Older Adults.

    Science.gov (United States)

    Lien, Cynthia; Rosen, Tony; Bloemen, Elizabeth M; Abrams, Robert C; Pavlou, Maria; Lachs, Mark S

    2016-11-01

    To identify patterns of personal experience or behavior in self-neglect by exploring narratives of cognitively intact older adults. Descriptive study involving semistructured interviews and unstructured narratives. A parent study of self-neglect characteristics. Cognitively intact, self-neglecting older adults referred from 11 community-based senior services agencies (N = 69). Interviews included a comprehensive psychiatric assessment using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Axis-I and II Disorders and an unstructured interview that allowed subjects to describe important elements of their life stories. Content analysis was used to identify personal experiences and behavior patterns in each subject's narrative. Four types of traumatic personal experiences (psychologically traumatic loss, separation or abandonment (29%); violent victimization, physical trauma, or sexual abuse (19%); exposure to war or political violence (9%); prolonged mourning (7%)) and five behavior patterns (significant financial instability (23%), severe lifelong mental illness (16%), mistrust of people or paranoia (13%), distrust and avoidance of the medical establishment (13%), substance abuse or dependence (13%)) were identified in the life stories. Patterns of traumatic personal experiences and maladaptive behaviors that self-neglecters frequently report were identified. Experiences, perceptions, and behaviors developed over a lifetime may contribute to elder self-neglect. Further exploration and better understanding of these patterns may identify potential risk factors and areas for future targeted screening, intervention, and prevention. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  17. Atrial-based pacing has no benefit over ventricular pacing in preventing atrial arrhythmias in adults with congenital heart disease

    NARCIS (Netherlands)

    Opic, P.; Yap, S.C.; Kranenburg, M. van; Dijk, A.P.J. van; Budts, W.; Vliegen, H.W.; Erven, L. van; Can, A.; Sahin, G.; Groot, N.M. de; Witsenburg, M.; Roos-Hesselink, J.W.

    2013-01-01

    AIMS: To determine whether atrial-based pacing prevents atrial arrhythmias in adults with congenital heart disease (CHD) compared with ventricular pacing. METHODS AND RESULTS: All adult CHD patients from four participating centres with a permanent pacemaker were identified. Patients with permanent a

  18. Evaluation of left ventricular systolic function in young adults with mitral valve prolapse

    Science.gov (United States)

    Malev, Eduard; Zemtsovsky, Eduard; Pshepiy, Asiyet; Timofeev, Eugeny; Reeva, Svetlana; Prokudina, Maria

    2012-01-01

    OBJECTIVE: To evaluate left ventricular function in young adults with mitral valve prolapse (MVP) without significant mitral regurgitation using two-dimensional strain imaging. METHODS AND RESULTS: A total of 58 asymptomatic young subjects (mean [± SD] age 19.7±1.6 years; 72% male) with MVP were compared with 60 sex- and age-matched healthy subjects. MVP was diagnosed by billowing one or both mitral leaflets >2 mm above the mitral annulus in the long-axis parasternal view. Longitudinal, radial and circumferential strain and strain rate were determined using speckle tracking with a grey-scale frame rate of 50 fps to 85 fps. There were no significant differences in the global systolic left ventricular function of the subjects with MVP compared with the control group. In the MVP group, most of the global myocardial systolic deformation indexes were not reduced. Only the global circumferential strain showed a decrease in the prolapse subjects. Regional, longitudinal, circumferential and radial strain and strain rate were decreased only in septal segments. A decrease in the rotation of the same septal segments at the basal level was also observed. CONCLUSION: Regional septal myocardial deformation indexes decrease in subjects with MVP. These changes may be the first sign indicating the deterioration of left ventricular systolic function as well as the existence of primary cardiomyopathy in asymptomatic young subjects with MVP. PMID:23592928

  19. Fear of falling, but not gait impairment, predicts subjective memory complaints in cognitively intact older adults.

    Science.gov (United States)

    Sakurai, Ryota; Suzuki, Hiroyuki; Ogawa, Susumu; Kawai, Hisashi; Yoshida, Hideyo; Hirano, Hirohiko; Ihara, Kazushige; Obuchi, Shuichi; Fujiwara, Yoshinori

    2017-07-01

    Understanding the risk factors for developing subjective memory complaints (SMC) could help with early screening and treatment for cognitive impairment. The aim of the present study was to explore the risk factors for developing SMC, by focusing on gait-related variables. A total of 406 community-dwelling older adults aged 65-85 years without impending cognitive impairment participated in baseline and 1-year follow-up evaluations. A comprehensive evaluation was carried out, and included gait speed and fear of falling (FoF) assessments, and the Montreal Cognitive Assessment test. Logistic regression analyses were carried out to independently evaluate the risk factors at baseline and follow-up evaluations. At baseline, 45.1% of older adults had SMC. The presence of SMC at baseline was associated with being female, subjective hearing loss and FoF. Of 223 participants who did not report SMC at baseline, 48 had newly developed SMC at follow up (21.5%). The significant predictors for developing SMC were being female and FoF, but not gait speed, and were independent of depression symptoms. The Montreal Cognitive Assessment total score at baseline was a marginally significant predictor for developing SMC at follow up (P = 0.06), but a lower score in the language domain was a significant predictor in further analysis. FoF was a significant risk for future development of SMC, suggesting that FoF might reflect the risk of cognitive impairment at an earlier stage, or that FoF and SMC could share the same basis of anxiety for daily activities. The mechanisms and consequence of this longitudinal relationship require further study. Geriatr Gerontol Int 2017; 17: 1125-1131. © 2016 Japan Geriatrics Society.

  20. Quantification of left ventricular myocardial collagen system in children, young adults, and the elderly

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    Andrea Bogoslavsky Levy Mendes

    2012-06-01

    Full Text Available Studies on the collagen system of the human myocardium are still limited compared to those on small laboratory animals. The aim of this work was to observe the collagen tissue of the myocardium of the human heart as a function of age. The types of collagen, as well as the density of collagen tissue and the diameter of collagen fibrils, were examined. Fragments of the left ventricular wall from 15 hearts, 5 from children, 5 from young adults, and 5 from elderly individuals, were analyzed by using the Picrosirius-polarization method and by transmission electron microscopy (TEM. The results showed the presence of collagen type III and collagen type I, both in the endomysium and perimysium of the 3 groups studied. Measurements of collagen content in myocardial tissue displayed that both endomysial and perimysial collagen increase in number and thickness in the adult and elderly. These histochemical results coincided with the observations obtained with the electron microscope in showing an increase in the number of collagen fibrils with a large diameter in the adult and elderly hearts. The present results on cardiac collagen may be important for assessing the pathogenesis of several cardiopathies in the hearts of children, young adults, and the elderly.

  1. Epidemiology of heart failure : The prevalence of heart failure and ventricular dysfunction in older adults over time. A systematic review

    NARCIS (Netherlands)

    van Riet, Evelien E S; Hoes, Arno W.; Wagenaar, Kim P.; Limburg, Alexander; Landman, Marcel A J; Rutten, Frans H.

    2016-01-01

    Aims: The 'epidemic' of heart failure seems to be changing, but precise prevalence estimates of heart failure and left ventricular dysfunction (LVD) in older adults, based on adequate echocardiographic assessment, are scarce. Systematic reviews including recent studies on the prevalence of heart fai

  2. Quantitative assessment of systolic left ventricular function with speckle-tracking echocardiography in adult patients with repaired aortic coarctation

    NARCIS (Netherlands)

    M.E. Menting (Myrthe); R.W.J. van Grootel (Roderick W. J.); A.E. van den Bosch (Annemien); J.A. Eindhoven (Jannet); J.S. McGhie (Jackie); J.A.A.E. Cuypers (Judith); M. Witsenburg (Maarten); W.A. Helbing (Willem); J.W. Roos-Hesselink (Jolien)

    2016-01-01

    textabstractDespite successful aortic coarctation (CoA) repair, systemic hypertension often recurs which may influence left ventricular (LV) function. We aimed to detect early LV dysfunction using LV global longitudinal strain (GLS) in adults with repaired CoA, and to identify associations with pati

  3. Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy in the Pediatric Population Clinical Characterization and Comparison with Adult-Onset Disease

    NARCIS (Netherlands)

    Te Riele, Anneline S J M; James, Cynthia A.; Sawant, Abhishek C.; Bhonsale, Aditya; Groeneweg, Judith A.; Mast, Thomas P.; Murray, Brittney; Tichnell, Crystal; Dooijes, Dennis; Van Tintelen, J. Peter; Judge, Daniel P.; van der Heijden, Jeroen F.; Crosson, Jane; Hauer, Richard N W; Calkins, Hugh; Tandri, Harikrishna

    2015-01-01

    Objectives The aims of this study were to determine the clinical characteristics and outcomes of pediatric-onset arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) and to compare these with those of adult-onset ARVD/C. Background Improved early detection and increased awareness of AR

  4. Left ventricular noncompaction: a rare disorder in adults and its association with 1p36 chromosomal anomaly.

    Science.gov (United States)

    Dod, Harvinder S; Bhardwaj, Ravindra; Hummel, Marybeth; Morise, Anthony P; Batish, Satdev; Warden, Bradford E; Beto, Robert J; Jain, Abnash C

    2010-01-01

    We report on a case of a 25-year-old male with 1p36 deletion syndrome, who was diagnosed with left ventricular noncompaction (LVNC). The association of this rare chromosomal abnormality with LVNC is reported in the pediatric literature, but it has not previously been specifically reported in adults. It is important to diagnose this unclassified cardiomyopathy in the adult population with this chromosomal abnormality for appropriate management and treatment as highlighted in our case.

  5. Ventricular arrhythmias and sudden cardiac death in adults with congenital heart disease.

    Science.gov (United States)

    Khairy, Paul

    2016-11-01

    Remarkable gains in survival have led to an unprecedented number of adults with congenital heart disease. Arrhythmias collectively comprise the most common complication encountered. Recognising the unique issues and challenges involved in managing arrhythmias in adults with congenital heart disease and the consequential decisions surrounding sudden death prevention, expert societies have proposed evidence-based recommendations. On the whole, acute ventricular arrhythmias are managed according to general cardiology guidelines, while taking into consideration congenital heart disease-specific issues, such as positioning of patches or paddles according to location of the heart. Implantable cardioverter-defibrillators (ICDs) are indicated for secondary prevention in patients with sustained ventricular tachycardia or resuscitated cardiac arrest in the absence of a reversible cause. Pharmacological therapy and catheter ablation can be effective in reducing recurrent ICD shocks. Risk-benefit assessment for primary prevention ICDs is a major challenge. Although a clearer picture has emerged of the high-risk patient with tetralogy of Fallot, ICD indications for those with systemic right ventricles or univentricular hearts remain contentious. Challenges to ICD implantation include obstructed veins, conduits and baffles, atrioventricular valve disease and intracardiac shunts. In selected patients, customised systems with epicardial and/or subcutaneous coils may represent a viable solution. Alternatively, the subcutaneous ICD is an attractive option for patients in whom transvenous access is not feasible or desirable and in whom bradycardia and antitachycardia pacing features are not essential. Continued advances in risk stratification and device technologies carry the potential to further improve efficacy and safety outcomes in this growing population of patients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence

  6. Continual electric field stimulation preserves contractile function of adult ventricular myocytes in primary culture.

    Science.gov (United States)

    Berger, H J; Prasad, S K; Davidoff, A J; Pimental, D; Ellingsen, O; Marsh, J D; Smith, T W; Kelly, R A

    1994-01-01

    To model with greater fidelity the electromechanical function of freshly isolated heart muscle cells in primary culture, we describe a technique for the continual electrical stimulation of adult myocytes at physiological frequencies for several days. A reusable plastic cover was constructed to fit standard, disposable 175-cm2 tissue culture flasks and to hold parallel graphite electrodes along the long axis of each flask, which treated a uniform electric field that resulted in a capture efficiency of ventricular myocytes of 75-80%. Computer-controlled amplifiers were designed to be capable of driving a number of flasks concurrently, each containing up to 4 x 10(6) myocytes, over a range of stimulation frequencies (from 0.1 to 7.0 Hz) with reversal of electrode polarity after each stimulus to prevent the development of pH gradients around each electrode. Unlike quiescent, unstimulated myocytes, the amplitude of contraction, and velocities of shortening and relaxation did not change in myocytes paced at 3-5 Hz for up to 72 h. The maintenance of normal contractile function in paced myocytes required mechanical contraction per se, since paced myocytes that remained quiescent due to the inclusion of 2.5 microM verapamil in the culture medium for 48 h also exhibited a decline in contractility when paced after verapamil removal. Similarly, pacing increased peak calcium current compared with quiescent cells that had not been paced. Thus myocyte contraction at physiological frequencies induced by continual uniform electric field stimulation in short-term primary culture in defining medium maintains some biophysical parameters of myocyte phenotype that are similar to those observed in freshly isolated adult ventricular myocytes.

  7. Hedgehog Controls Quiescence and Activation of Neural Stem Cells in the Adult Ventricular-Subventricular Zone

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    Mathieu Daynac

    2016-10-01

    Full Text Available Identifying the mechanisms controlling quiescence and activation of neural stem cells (NSCs is crucial for understanding brain repair. Here, we demonstrate that Hedgehog (Hh signaling actively regulates different pools of quiescent and proliferative NSCs in the adult ventricular-subventricular zone (V-SVZ, one of the main brain neurogenic niches. Specific deletion of the Hh receptor Patched in NSCs during adulthood upregulated Hh signaling in quiescent NSCs, progressively leading to a large accumulation of these cells in the V-SVZ. The pool of non-neurogenic astrocytes was not modified, whereas the activated NSC pool increased after a short period, before progressively becoming exhausted. We also showed that Sonic Hedgehog regulates proliferation of activated NSCs in vivo and shortens both their G1 and S-G2/M phases in culture. These data demonstrate that Hh orchestrates the balance between quiescent and activated NSCs, with important implications for understanding adult neurogenesis under normal homeostatic conditions or during injury.

  8. Effect of hydration status on atrial and ventricular volumes and function in healthy adult volunteers

    Energy Technology Data Exchange (ETDEWEB)

    Schantz, Daryl I. [The Hospital for Sick Children, The Labatt Family Heart Centre in the Department of Paediatrics, Toronto, ON (Canada); University of Manitoba, Variety Children' s Heart Centre, Winnipeg, MB (Canada); Dragulescu, Andreea [The Hospital for Sick Children, The Labatt Family Heart Centre in the Department of Paediatrics, Toronto, ON (Canada); Memauri, Brett [University of Manitoba, Department of Radiology, St. Boniface General Hospital, Winnipeg, MB (Canada); Grotenhuis, Heynric B. [The Hospital for Sick Children, The Labatt Family Heart Centre in the Department of Paediatrics, Toronto, ON (Canada); Wilhelmina Children' s Hospital, Utrecht (Netherlands); Seed, Mike; Grosse-Wortmann, Lars [The Hospital for Sick Children, The Labatt Family Heart Centre in the Department of Paediatrics, Toronto, ON (Canada); The Hospital for Sick Children, Department of Diagnostic Imaging, Toronto, ON (Canada)

    2016-10-15

    Assessment of cardiac chamber volumes is a fundamental part of cardiac magnetic resonance (CMR) imaging. While the effects of inter- and intraobserver variability have been studied and have a recognized effect on the comparability of serial cardiac MR imaging studies, the effect of differences in hydration status has not been evaluated. To evaluate the effects of volume administration on cardiac chamber volumes. Thirteen healthy adults underwent a baseline cardiac MR to evaluate cardiac chamber volumes after an overnight fast. They were then given two saline boluses of 10 ml/kg of body weight and the cardiac MR was repeated immediately after each bolus. From the baseline scan to the final scan there was a significant increase in all four cardiac chamber end-diastolic volumes. Right atrial volumes increased 8.0%, from 61.1 to 66.0 ml/m2 (P<0.001), and left atrial volumes increased 10.0%, from 50.0 to 55.0 ml/m2 (P<0.001). Right ventricular volumes increased 6.0%, from 91.1 to 96.5 ml/m2 (P<0.001), and left ventricular volumes increased 3.2%, from 87.0 to 89.8 ml/m2 (P<0.001). Hydration status has a significant effect on the end-diastolic volumes of all cardiac chambers assessed by cardiac MR. Thus, hydration represents a ''variable'' that should be taken into account when assessing cardiac chamber volumes, especially when performing serial imaging studies in a patient. (orig.)

  9. Congenital left ventricular wall abnormalities in adults detected by gated cardiac multidetector computed tomography: Clefts, aneurysms, diverticula and terminology problems

    Energy Technology Data Exchange (ETDEWEB)

    Erol, Cengiz, E-mail: drcengizerol@yahoo.com [Selcuk University, Selcuklu Faculty of Medicine, Department of Radiology, Alaeddin Keykubat Central Campus, Selcuklu, 42250 Konya (Turkey); Koplay, Mustafa, E-mail: koplaymustafa@hotmail.com [Selcuk University, Selcuklu Faculty of Medicine, Department of Radiology, Alaeddin Keykubat Central Campus, Selcuklu, 42250 Konya (Turkey); Olcay, Ayhan, E-mail: drayhanolcay@gmail.com [29 May Hospital, Department of Cardiology, Vatan Street, Fatih, 34150 Istanbul (Turkey); Kivrak, Ali Sami, E-mail: alisamikivrak@hotmail.com [Selcuk University, Selcuklu Faculty of Medicine, Department of Radiology, Alaeddin Keykubat Central Campus, Selcuklu, 42250 Konya (Turkey); Ozbek, Seda, E-mail: dsadr@hotmail.com [Selcuk University, Selcuklu Faculty of Medicine, Department of Radiology, Alaeddin Keykubat Central Campus, Selcuklu, 42250 Konya (Turkey); Seker, Mehmet, E-mail: hikmet.irfan@hotmail.com [29 May Hospital, Department of Radiology, Vatan Street, Fatih, 34150 Istanbul (Turkey); Paksoy, Yahya, E-mail: yahyapaksoy@yahoo.com [Selcuk University, Selcuklu Faculty of Medicine, Department of Radiology, Alaeddin Keykubat Central Campus, Selcuklu, 42250 Konya (Turkey)

    2012-11-15

    Objectives: Our aim was to evaluate congenital left ventricular wall abnormalities (clefts, aneurysms and diverticula), describe and illustrate imaging features, discuss terminology problems and determine their prevalence detected by cardiac CT in a single center. Materials and methods: Coronary CT angiography images of 2093 adult patients were evaluated retrospectively in order to determine congenital left ventricular wall abnormalities. Results: The incidence of left ventricular clefts (LVC) was 6.7% (141 patients) and statistically significant difference was not detected between the sexes regarding LVC (P = 0.5). LVCs were single in 65.2% and multiple in 34.8% of patients. They were located at the basal to mid inferoseptal segment of the left ventricle in 55.4%, the basal to mid anteroseptal segment in 24.1%, basal to mid inferior segment in 17% and septal-apical septal segment in 3.5% of cases. The cleft length ranged from 5 to 22 mm (mean 10.5 mm) and they had a narrow connection with the left ventricle (mean 2.5 mm). They were contractile with the left ventricle and obliterated during systole. Congenital left ventricular septal aneurysm that was located just under the aortic valve was detected in two patients (0.1%). No case of congenital left ventricular diverticulum was detected. Conclusion: Cardiac CT allows us to recognize congenital left ventricular wall abnormalities which have been previously overlooked in adults. LVC is a congenital structural variant of the myocardium, is seen more frequently than previously reported and should be differentiated from aneurysm and diverticulum for possible catastrophic complications of the latter two.

  10. Estrogen receptor-beta colocalizes extensively with parvalbumin-labeled inhibitory neurons in the cortex, amygdala, basal forebrain, and hippocampal formation of intact and ovariectomized adult rats.

    Science.gov (United States)

    Blurton-Jones, Mathew; Tuszynski, Mark H

    2002-10-21

    Estrogen has been reported to regulate the activity of gamma-aminobutyric acid (GABA)ergic interneurons within the hippocampus, basal forebrain, and hypothalamus of adult rodents. Although estrogen receptor-alpha bearing GABAergic interneurons have been identified previously, the neurotransmitter phenotype of cells that express the more recently characterized estrogen receptor-beta (ER-beta) has not been examined in vivo. We, therefore, have used fluorescent immunohistochemistry to further characterize the phenotype of ER-beta-bearing cells by double labeling for the GABAergic-associated calcium-binding protein, parvalbumin (PV). We find that a large proportion of ER-beta-immunoreactive cells within the cortex, amygdala, basal forebrain, and hippocampal formation of intact and ovariectomized (ovx) adult rats are PV-immunoreactive. Within the infralimbic, agranular insular, primary motor, parietal association, perirhinal, and lateral entorhinal cortices, an average of 95.6% +/- 0.8% (intact) and 94.5% +/- 1.4% (ovx) of all ER-beta-immunoreactive cells coexpress parvalbumin, and this proportion is strikingly similar across these diverse cortical regions. ER-beta/PV double-labeled cells represent 23.3% +/- 1.6% (intact) and 25.8% +/- 2.0% (ovx) of all PV-labeled cells within these regions. ER-beta/PV double-labeled cells are also observed within the lateral, accessory basal, and posterior cortical nuclei of the amygdala, and periamygdaloid cortex. Within the basal forebrain, 31.0% +/- 3.1% (intact) and 26.0% +/- 5.2 % (ovx) of ER-beta-immunoreactive cells coexpress PV. Almost all ER-beta-immunoreactive cells within the subiculum, a major output region of the hippocampal formation, double label for PV (intact = 97.2% +/- 2.8%; ovx = 100% +/- 0.0%). Thus, ER-beta exhibits extensive colocalization with a subclass of inhibitory neurons, suggesting a potential mechanism whereby estrogen can regulate neuronal excitability in diverse and broad brain regions by modulating

  11. Obesity and exercise-induced ectopic ventricular arrhythmias in apparently healthy middle aged adults.

    Science.gov (United States)

    Sabbag, Avi; Sidi, Yechezkel; Kivity, Shaye; Beinart, Roy; Glikson, Michael; Segev, Shlomo; Goldenberg, Ilan; Maor, Elad

    2016-03-01

    Obesity and overweight are strongly associated with cardiovascular morbidity and mortality. However, there are limited data on the association between excess weight and the risk of ectopic ventricular activity. We investigated the association between body mass index (BMI) and the risk for ectopic ventricular activity (defined as multiple ventricular premature beats (≥3), ventricular bigeminy, nonsustained ventricular tachycardia or sustained ventricular tachycardia) during exercise stress testing among 22,516 apparently healthy men and women who attended periodic health screening examinations between the years 2000 and 2014. All subjects had completed maximal exercise stress testing annually according to the Bruce protocol. Subjects were divided at baseline into three groups: normal weight (BMI ≥ 18.5 kg/m(2) andobese (BMI ≥ 30; N = 2,906). The mean age of study subjects was 47 ± 10 years and 72% were men. Kaplan-Meier survival analysis showed that the cumulative probability for the development of exercise-induced ectopic ventricular activity arrhythmias was highest among obese subjects, intermediate among overweight subjects and lowest among subjects with normal weight (3.4%, 2.7% and 2.2% respectively; p obese subjects were 33% more likely to have ectopic ventricular arrhythmias during exercise compared with subjects with normal weight (p = 0.005), and that each 1 kg/m(2) increase in BMI was associated with a significant 4% (p = 0.002) increased adjusted risk for exercise-induced ventricular arrhythmias. Obesity is independently associated with increased likelihood of ectopic ventricular arrhythmia during exercise. © The European Society of Cardiology 2015.

  12. EVALUACIÓN ECOCARDIOGRÁFICA DEL GASTO CARDÍACO SISTÉMICO EN LA ATRESIA PULMONAR CON SEPTO INTERVENTRICULAR INTACTO / Echocardiographic evaluation of cardiac output in pulmonary atresia with intact ventricular septum

    Directory of Open Access Journals (Sweden)

    Giselle Serrano Ricardo

    2013-07-01

    Full Text Available Resumen: Introducción: El estudio de la atresia pulmonar con septo interventricular intacto no ha prestado suficiente atención al carácter dual del ventrículo izquierdo como receptor circulatorio y su repercusión sobre la hemodinámica sistémica. Objetivo: Identificar, mediante la ecocardiografía, los elementos fisiopatológicos propios de esa enfermedad que perfilan su actuación hemodinámica de base, influyen sobre el gasto cardíaco y generan condiciones potenciales para el pronóstico a corto plazo. Método: Se realizó una investigación con carácter descriptivo, prospectivo y aplicado, donde se estudiaron 43 pacientes con diagnóstico de la enfermedad remitidos al Cardiocentro Pediátrico "William Soler" desde enero de 1992 a noviembre de 2011. Se evaluaron, en cada sujeto, los perfiles de ocho variables ecocardiográficas y de la frecuencia cardíaca. Se analizaron los niveles de asociación y dependencia entre ellas mediante la aplicación estadística de modelos de regresión simple. Resultados: Existen variaciones considerables en la frecuencia cardíaca, en el índice volumétrico y en la fracción de eyección correspondientes al ventrículo izquierdo de los pacientes respecto al grupo control de referencia. Conclusiones: El mayor tamaño de la comunicación interauricular y la prolongación de la diastasis transmitral favorecen el incremento volumétrico del ventrículo izquierdo. La frecuencia cardíaca, el carácter restrictivo del miocardio ventricular izquierdo y su fracción de eyección son factores reguladores del gasto cardíaco en esta enfermedad. / Abstract: Introduction: In the study of pulmonary atresia with intact ventricular septum, not enough attention has been paid to the dual nature of the left ventricle as a circulatory receptor, and its impact on systemic hemodynamics. Objective: To identify, by echocardiography, the pathophysiological elements that characterize the disease and that determine its basic

  13. Morfología ecocardiográfica de la atresia pulmonar con septum interventricular intacto, estudio de dos decenios Echocardiographic morphology of the pulmonary atresia with intact ventricular septum. A 20-year study

    Directory of Open Access Journals (Sweden)

    Adel Eladio González Morejón

    2013-03-01

    Full Text Available Introducción: la atresia pulmonar con septum interventricular intacto es una malformación cardiovascular que representa el 1 % de las cardiopatías congénitas observadas en vida extrauterina, y, dados sus resultados desfavorables, constituye un verdadero reto para la medicina contemporánea. Objetivo: la investigación condujo a la aplicación de pautas clasificatorias, a la caracterización del tracto de salida atrésico, al estudio morfológico ventricular derecho, a la valoración del anillo tricuspídeo y a la determinación de la presencia de anomalías en la circulación coronaria. Métodos: se estudiaron 43 pacientes con diagnóstico confirmado de la entidad remitidos al Cardiocentro Pediátrico "William Soler" entre enero de 1992 y noviembre de 2011. Se practicó a cada caso el examen ecocardiográfico bidimensional y doppler con codificación en colores. Resultados y conclusiones: se corroboró el predominio de la variante morfológica valvular de la entidad y la existencia de niveles moderados o severos de hipoplasia ventricular derecha en asociación con capacitancia volumétrica limitada de dicha cámara, con hipodesarrollo valvular tricuspídeo y con presencia de circulación coronaria anómala sinusoides dependiente. El foramen oval permeable constituyó el defecto septal interatrial más vinculado a la enfermedad, y se evidenciaron diversas anomalías estructurales del aparato tricuspídeo en conjunción o no con el hipodesarrollo anular imperante.Introduction: pulmonary atresia with intact ventricular system is a cardiovascular malformation accounting for 1% of congenital cardiopathies seen in the extrauterine life; due to its unfavorable outcomes, this disease is a true challenge for the contemporary medicine. Objectives: the research study comprised the application of the classification guidelines, the characterization of the atresia outlet track, the morphological study of the right ventricle, the assessment of the

  14. Subcellular heterogeneity of sodium current properties in adult cardiac ventricular myocytes.

    Science.gov (United States)

    Lin, Xianming; Liu, Nian; Lu, Jia; Zhang, Jie; Anumonwo, Justus M B; Isom, Lori L; Fishman, Glenn I; Delmar, Mario

    2011-12-01

    Sodium channel α-subunits in ventricular myocytes (VMs) segregate either to the intercalated disc or to lateral membranes, where they associate with region-specific molecules. To determine the functional properties of sodium channels as a function of their location in the cell. Local sodium currents were recorded from adult rodent VMs and Purkinje cells by using the cell-attached macropatch configuration. Electrodes were placed either in the cell midsection (M) or at the cell end (area originally occupied by the intercalated disc [ID]). Channels were identified as tetrodotoxin (TTX)-sensitive (TTX-S) or TTX-resistant (TTX-R) by application of 100 nM of TTX. Average peak current amplitude was larger in ID than in M and largest at the site of contact between attached cells. TTX-S channels were found only in the M region of VMs and not in Purkinje myocytes. TTX-R channels were found in both M and ID regions, but their biophysical properties differed depending on recording location. Sodium current in rat VMs was upregulated by tumor necrosis factor-alpha. The magnitude of current increase was largest in the M region, but this difference was abolished by application of 100 nM of TTX. Our data suggest that (a) a large fraction of TTX-R (likely Na(v)1.5) channels in the M region of VMs are inactivated at normal resting potential, leaving most of the burden of excitation to TTX-R channels in the ID region; (b) cell-cell adhesion increases functional channel density at the ID; and (c) TTX-S (likely non-Na(v)1.5) channels make a minimal contribution to sodium current under control conditions, but they represent a functional reserve that can be upregulated by exogenous factors. Copyright © 2011 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  15. 3D Printing to Guide Ventricular Assist Device Placement in Adults With Congenital Heart Disease and Heart Failure.

    Science.gov (United States)

    Farooqi, Kanwal M; Saeed, Omar; Zaidi, Ali; Sanz, Javier; Nielsen, James C; Hsu, Daphne T; Jorde, Ulrich P

    2016-04-01

    As the population of adults with congenital heart disease continues to grow, so does the number of these patients with heart failure. Ventricular assist devices are underutilized in adults with congenital heart disease due to their complex anatomic arrangements and physiology. Advanced imaging techniques that may increase the utilization of mechanical circulatory support in this population must be explored. Three-dimensional printing offers individualized structural models that would enable pre-surgical planning of cannula and device placement in adults with congenital cardiac disease and heart failure who are candidates for such therapies. We present a review of relevant cardiac anomalies, cases in which such models could be utilized, and some background on the cost and procedure associated with this process.

  16. Assessment of ventricular function in adults with sickle cell disease: role of two-dimensional speckle-tracking strain.

    Science.gov (United States)

    Barbosa, Marcia M; Vasconcelos, Maria Carmen M; Ferrari, Teresa Cristina A; Fernandes, Bárbara Martins; Passaglia, Luiz Guilherme; Silva, Célia Maria; Nunes, Maria Carmo P

    2014-11-01

    Sickle cell disease (SCD) is a hemoglobinopathy that is common worldwide. It usually presents with cardiac involvement, although data on systolic function are somewhat controversial. The aim of this study was to investigate the value of speckle-tracking strain, a deformation index, in detecting ventricular dysfunction in SCD. Ninety adult patients with SCD were compared with 20 healthy controls. Doppler echocardiography with Doppler tissue imaging was performed in all, and the left and right ventricles were analyzed by the use of two-dimensional speckle-tracking strain. The mean age of the patients with SCD was 26 years, and 43% were men. Left ventricular (LV) dimensions and mass were higher in patients with SCD, whereas LV ejection fraction did not differ from the controls. E and A waves, as well as E/e' ratio, were also higher in patients with SCD. Two-dimensional speckle-tracking strain of both ventricles in the patients with SCD was not different from that of controls. The factors independently associated with LV longitudinal strain were age (P = .009), oximetry (P = .001), lactate dehydrogenase (P = .014), LV ejection fraction (P speckle-tracking strain of both ventricles was similar in patients and controls, suggesting normal myocardial contractility in patients with SCD. LV global longitudinal strain was associated with age, intensity of hemolysis, and ventricular function. Copyright © 2014 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.

  17. Ventricular assist device for failing systemic ventricle in an adult with prior mustard procedure.

    Science.gov (United States)

    Neely, Robert C; Davis, Robert Patrick; Stephens, Elizabeth H; Takayama, Hiroo; Khalpey, Zain; Ginns, Jonathan; Lee, Sun Hi; Chen, Jonathan

    2013-08-01

    The Mustard procedure is a palliative surgical procedure used to repair complete transposition of the great arteries. Cardiac transplantation remains the only definitive therapy for patients who develop heart failure after a Mustard procedure. However, pulmonary hypertension represents a major hemodynamic contraindication. The use of a ventricular assist device as destination therapy has not yet been established after a Mustard procedure. Here, we present the case of a 41-year-old patient who presented with systemic right ventricular failure following Mustard procedure complicated by pulmonary hypertension. The patient received a HeartMate II (Thoratec, Pleasanton, CA) ventricular assist device as a bridge to decision. Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  18. 室间隔完整型肺动脉闭锁的产前超声诊断价值分析%Diagnostic value of pulmonary atresia with intact ventricular septum by prenatal echocardiography

    Institute of Scientific and Technical Information of China (English)

    杨萍; 葛群; 张玉奇; 王凤蕾; 张志芳; 江丽

    2014-01-01

    Objective To evaluate the diagnostic value of prenatal echocardiography in pulmonary atresia with intact ven‐tricular septum (PA/IVS) ,to analyze the reasons of misdiagnosed and to improve the echocardiographic diagnosis .Meth‐ods A retrospective echocardiographic review was performed on 19 fetus with PA/IVS confirmed by prenatal magnetic resonance imaging (MRI) or postnatal echocardiography .Results More common findings of PA/IVS were tricuspid valve regurgitation in 19 cases (100% ) ,reversed flow through ductus arteriosus by color Doppler flow imaging in 18 cases (94.7% ) ,and right ventricular hypoplasia in 13 cases(68 .4% ) .Among 19 PA/IVS fetus ,16 cases (84 .2% ) were diag‐nosed correctly by echocardiography .In the remaining 3 cases (15 .8% ) ,1 case with pulmonary valve stenosis ,tricuspid valve regurgitation and right ventricular hypoplasia and 1 case with mild tricuspid valve regurgitation were diagnosed by prenatal echocardiography ,1 case with intramyocardial sinusoids was misdiagnosed .Conclusion Combining visualization of PA/IVS in four‐chamber view ,outflow tract view ,and three vessels view ,PA/IVS could be accurately diagnosed by prenatal echocardiography ,but it should be differentiated from critical pulmonary valve stenosis .%目的:评价超声心动图对室间隔完整型肺动脉闭锁伴(PA/IVS )的产前诊断价值,分析超声心动图误诊的原因,旨在提高超声心动图对胎儿PA/IVS诊断的正确性。方法回顾性分析19例经胎儿核磁共振(M RI)或出生后超声心动图诊断为PA/IVS的产前超声资料。结果 PA/IVS最常见的超声征象为三尖瓣反流19例(100%)、动脉导管内逆向血流18例(94.7%)及右心室肥厚伴心腔小13例(68.4%)。19例 PA/IVS 胎儿超声心动图诊断正确16例,占84.2%;漏、误诊3例,占15.8%;误诊2例,其中1例产前超声心动图误诊为肺动脉瓣重度狭窄、三尖瓣重度反流,1

  19. [Successful excision of a left ventricular fibroma in an adult patient; report of a case].

    Science.gov (United States)

    Okada, Shuichi; Kaneko, Tatsuo; Ezure, Masahiko; Hasegawa, Yutaka; Kimura, Chieri; Okonogi, Shuichi; Takihara, Hitomi; Naito, Noritsugu

    2014-07-01

    A 55-year-old man was referred with a diagnosis of a left ventricular thrombus. Echocardiography revealed that he had a thrombus in the free wall of the left ventricle. Under cardiopulmonary bypass, we removed the intramural tumor. After the removal, the defect was repaired by Dor operation. Pathological examination revealed the tumor was a cardiac fibroma. He is doing well without any troubles 3 years after the operation.

  20. Normal left ventricular mechanics by two-dimensional speckle-tracking echocardiography. Reference values in healthy adults.

    Science.gov (United States)

    Kocabay, Gonenc; Muraru, Denisa; Peluso, Diletta; Cucchini, Umberto; Mihaila, Sorina; Padayattil-Jose, Seena; Gentian, Denas; Iliceto, Sabino; Vinereanu, Dragos; Badano, Luigi P

    2014-08-01

    Two-dimensional speckle-tracking echocardiography is a novel tool to assess myocardial function. The purpose of this study was to evaluate left ventricular myocardial strain and rotation parameters by two-dimensional speckle-tracking echocardiography in a large group of healthy adults across a wide age range to establish their reference values and to assess the influence of age, sex, and hemodynamic factors. Transthoracic echocardiograms were acquired in 247 healthy volunteers (139 women, 44 years [standard deviation, 16 years old] (range, 18-80 years). We measured longitudinal, circumferential, and radial peak systolic strain values, and left ventricular rotation and twist. Average values of global longitudinal, radial, and circumferential strain were -21.5% (standard deviation, 2.0%), 40.1% (standard deviation, 11.8%) and -22.2% (standard deviation, 3.4%), respectively. Longitudinal strain was significantly more negative in women, whereas radial and circumferential strain and rotational parameters were similar in both sexes. Accordingly, lower limits of normality for the strain components were -16.9% in men and -18.5% in women for longitudinal strain, and -15.4% for circumferential and 24.6% for radial strain, irrespective of sex. Longitudinal strain values were more negative at the base than at apical segments. Mean rotational values were -6.9° (standard deviation, 3.5°) for the base, 13.0° (standard deviation, 6.5°) for apical rotation, and 20.0° (standard deviation, 7.3°) for net twist. We report the comprehensive assessment of normal myocardial deformation and rotational mechanics in a large cohort of healthy volunteers. We found that women have more negative longitudinal strain, accounting for their higher left ventricular ejection fraction. Availability of reference values for these parameters may foster their implementation in the clinical routine. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  1. Energy Requirement and Food Intake Behaviour in Young Adult Intact Male Cats with and without Predisposition to Overweight

    Directory of Open Access Journals (Sweden)

    Brigitta Wichert

    2012-01-01

    Full Text Available Obesity is a common problem in cats. In the experimental cat family of the institute of animal nutrition besides a “normal” lean phenotype, cats with predisposition to an overweight phenotype are present. To investigate energy requirements and food intake behaviour of intact male cats of different phenotypes, six “normal” lean cats (GL and six cats disposed to overweight (GO were used. At the beginning of the experiment, all cats had an ideal body condition score of 5. To reach this the GO cats had to pass a weight-loss program. Energy requirements of the cats were determined using respiration chambers, whereas the amount and frequency of food intake was measured with a feeding station recording the data automatically. Energy requirement at weight constancy of the GO cats was even on fat-free mass (FFM significantly (P=0.02 lower (162.6 kJ/kg FFM/d than that of the “normal” lean cats (246 kJ/kg FFM/d. The GO cats also showed a higher food intake 34.5±1.5 g dry matter/kg body weight0.67 compared to the GL cats (24.0±2.1 g dry matter/kg body weight0.67(P=0.001. In conclusion quantifiable differences in food intake and behaviour in cats predisposed to overweight compared to “normal” lean cats were found.

  2. Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) presenting with ventricular fibrillation in an adult: a case report

    DEFF Research Database (Denmark)

    Kristensen, Thomas; Kofoed, Klaus Fuglsang; Helqvist, Steffen;

    2008-01-01

    the right coronary artery is sufficient and symptoms may be subtle or even absent. Arrhythmias or sudden cardiac death in adult life may be the first clinical presentation in patients with ALCAPA. We report a case, where a 39-year old woman presented with ventricular fibrillation during phycial exertion...

  3. Dutch survey of congenital coronary artery fistulas in adults: coronary artery-left ventricular multiple micro-fistulas multi-center observational survey in the Netherlands.

    NARCIS (Netherlands)

    Said, S.A.M.; Werf, T. van der

    2006-01-01

    BACKGROUND: Congenital coronary artery-left ventricular multiple micro-fistulas (CA-LVMMFs) in adults are rare anomalies. They may cause angina pectoris and myocardial infarction in association with normal coronary arteries. METHODS AND RESULTS: From the medical databases of a Dutch Survey of corona

  4. Examination of isolated ventricular noncompaction (hypertrabeculation) as a distinct entity in adults.

    Science.gov (United States)

    Roberts, William Clifford; Karia, Sumit Jagdish; Ko, Jong Mi; Grayburn, Paul Arthur; George, Betsy Ann; Hall, Shelley Anne; Kuiper, Johannes Jacob; Meyer, Dan Marshall

    2011-09-01

    Three patients (2 women) 36, 45, and 49 years of age underwent cardiac transplantation for what was diagnosed clinically as nonischemic dilated cardiomyopathy. Examination of the transthoracic echocardiogram and explanted heart in each disclosed marked hypertrabeculation involving the free wall of the very dilated left ventricle, a finding consistent with what has been termed "isolated ventricular noncompaction" (IVNC). Although these 3 cases anatomically fulfilled the echocardiographic definition of IVNC, review of previous publications containing gross photographs of the heart suggests that IVNC is overdiagnosed at least morphologically. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. Measuring ventricular width on cranial computed tomography. Feasibility of dose reduction in a custom-made adult phantom

    Energy Technology Data Exchange (ETDEWEB)

    Daubner, D.; Cerhova, J.; Linn, J. [Dresden Univ. (Germany). Dept. of Neuroradiology; Spieth, S. [Dresden Univ. (Germany). Dept. of Radiology; Kirchhof, K. [Chemnitz Hospital (Germany). Dept. of Diagnostic and Interventional Radiology and Neuradiology

    2016-01-15

    To estimate feasible dose reduction to reliably measure ventricular width in adults with hydrocephalus in follow-up cranial computed tomography (CCT) using a custom-made phantom. A gelatine-filled adult calvarium with embedded central fibers of two carrots representing the lateral ventricles was used as a phantom. The phantom was scanned 11 times with two CT scanners (LightSpeed Ultra, GE and Somatom Sensation, Siemens), using tube currents of 380/400, 350, 300, 250, 200, 150 and 100 mA, and tube voltages of 140, 120, 100 and 80 kV. The width of the carrots was measured at four sites in consensus decision of two principle investigators blinded to the scan parameters. Values measured at 380/400 mA and 140 kV served as a reference for the width of the ventricles. Measurements received 1 point if they did not differ more than 0.5 mm from the reference values. A maximum score of 4 could be achieved. The relationship between the correct width measurement of the carrots (lateral ventricles) and the radiation dose can be described by a quadratic regression function. Pixel noise increases and accuracy of measurements decreases with a lower radiation dose. Starting from a tube current of 380/400 mA and a tube voltage of 140 kV, the dose can be reduced by 76 % for LightSpeed Ultra and by 80 % for Somatom Sensation provided that a margin of error of 37.5 % (score = 2.5) for correct width measurement of the carrots is accepted. Lowering the radiation dose by up to 48 % for LightSpeed Ultra and by 52 % for Somatom Sensation, compared to the standard protocol (120 kV and 400 mA) still allowed reliable measurements of ventricular widths in this model.

  6. Circulação coronária dependente do ventrículo direito na atresia pulmonar com septo interventricular íntegro. Ausência da origem das artérias coronárias da aorta Right ventricle-dependent coronary circulation in pulmonary atresia with intact ventricular septum. Absence of origin of the coronary arteries from the aorta

    Directory of Open Access Journals (Sweden)

    Ivan Romero Rivera

    1998-08-01

    Full Text Available São descritos os aspectos clínicos, ecocardiográficos e angiográficos de um neonato de sexo masculino, com cinco dias de vida e diagnóstico de atresia pulmonar com septo interventricular íntegro. Tanto o ecocardiograma como a aortografia mostraram ausência da origem das artérias coronárias da aorta. O ecocardiograma bidimensional e, posteriormente, a ventriculografia direita identificaram as artérias coronárias, originando-se no ventrículo direito. Não houve contrastação retrógrada da aorta ou do tronco pulmonar quando contrastadas as artérias coronárias. Este é o primeiro caso relatado com diagnóstico ecocardiográfico pré angiografia, e é um exemplo da necessidade de se avaliar as artérias coronárias em pacientes com atresia pulmonar e septo ventricular íntegro.This report describes the clinical, echocardiographic and angiographic aspects of a five-day old boy with pulmonary atresia and intact ventricular septum. Both the echocardiogram and the aortography did not show any coronary arteries arising from the aorta. Two-dimensional echocardiography was able to identify the coronary arteries originating from the right ventricle and so did the right ventricular angiogram. No retrograde flow into the aorta or pulmonary trunk was identified after opacification of the coronary arteries. As far as we know this is the first case diagnosed by echocardiography, and is a vivid example of the necessity of identifying the coronary arteries in patients with pulmonary atresia and intact ventricular septum.

  7. Effects of CB1 receptor agonism and antagonism on behavioral fear and physiological stress responses in adult intact, ovariectomized, and estradiol-replaced female rats.

    Science.gov (United States)

    Simone, J J; Malivoire, B L; McCormick, C M

    2015-10-15

    There is growing interest in the development of cannabis-based therapies for the treatment of fear and anxiety disorders. There are a few studies, but none in females, of the effects of the highly selective cannabinoid receptor type 1 (CB1) agonist, arachidonyl 2'-chlorethylamide (ACEA), on behavioral fear. In experiment 1 involving gonadally-intact females, ACEA (either 0.1 or 0.01 mg/kg) was without effect in the elevated plus maze (EPM), and the lower dose decreased anxiety in the open field test (OFT). AM251 increased anxiety in the EPM and decreased locomotor activity in the OFT. Twenty-four hours after fear conditioning, neither ACEA nor AM251 affected generalized fear or conditioned fear recall. AM251 and 0.1 mg/kg ACEA impaired, and 0.01 mg/kg ACEA enhanced, within-session fear extinction. AM251 increased plasma corticosterone concentrations after the fear extinction session, whereas ACEA was without effect. Based on evidence that estradiol may moderate the effects of CB1 receptor signaling in females, experiment 2 involved ovariectomized (OVX) rats provided with 10-μg 17β-Estradiol and compared with OVX rats without hormone replacement (oil vehicle). Irrespective of hormone treatment, AM251 increased anxiety in the EPM, whereas ACEA (0.01 mg/kg) was without effect. Neither hormone nor drug altered anxiety in the OFT, but estradiol increased and AM251 decreased distance traveled. After fear conditioning, AM251 decreased generalized fear. Neither hormone nor drug had any effect on recall or extinction of conditioned fear, however, ACEA and AM251 increased fear-induced plasma corticosterone concentrations. Further, when results with intact rats were compared with those from OVX rats, gonadal status did not moderate the effects of either AM251 or ACEA, although OVX displayed greater anxiety and fear than did intact rats. Thus, the effects of CB1 receptor antagonism and agonism in adult female rats do not depend on ovarian estradiol.

  8. Impaired right and left ventricular mechanics in adults with pulmonary hypertension and congenital shunts.

    Science.gov (United States)

    Toro, Rocio; Cabeza-Letrán, Maria Luisa; Quezada, Maribel; Rodriguez-Puras, Maria Jose; Mangas, Alipio

    2016-03-01

    To assess left ventricle mechanics in Eisenmenger physiology patients with congenital shunts, and their relationship with the right ventricle, and to consider the clinical usefulness of this information. The study involved 28 patients with pulmonary artery hypertension (PAH) and congenital shunt, matched with 28 healthy participants. Standard echocardiography and pulsed wave tissue Doppler imaging were employed to analyze systolic and diastolic ventricular function, the myocardial performance index (MPI) of ventricles, and the strain and strain rate along the left ventricle lateral wall, septum, and right ventricle free wall. The left ventricle ejection fraction was similar in the two groups. However, despite normal standard left ventricle measures, patients presented parameters of defective myocardial mechanics: mitral peak systolic velocity (S') (cm/s) (8.6 (7.6-10.9) vs. 10.7 (8.6-12.5); P = 0.002) was higher, whereas left ventricle-MPI was lower (0.54 ± 01 vs. 0.32 ± 0.07, P < 0.001). Right ventricle-MPI and right ventricle global strain were correlated significantly with left ventricle-MPI and left ventricle global strain (r = 0.74, P < 0.001; r = 0.442, P < 0.001, respectively). Clinically, the six-minute walking test results were correlated negatively with left ventricle-MPI (r = -0.69, P < 0.001), whereas the functional class was positively correlated (r = 0.36, P < 0.001). In conclusion, left ventricle mechanics and geometry are impaired in Eisenmenger syndrome patients, although conventional evaluation is in the normal range. Our results highlight the significance of ventricular interdependence in PAH and provide a useful tool for improving the clinical management of these patients.

  9. Two-Dimensional Speckle Tracking Echocardiography Detects Subclinical Left Ventricular Systolic Dysfunction among Adult Survivors of Childhood, Adolescent, and Young Adult Cancer

    Directory of Open Access Journals (Sweden)

    Anthony F. Yu

    2016-01-01

    Full Text Available Two-dimensional speckle tracking echocardiography (2DSTE provides a sensitive measure of left ventricular (LV systolic function and may aid in the diagnosis of cardiotoxicity. 2DSTE was performed in a cross-sectional study of 134 patients (mean age: 31.4±8.8 years; 55% male; mean time since diagnosis: 15.4±9.4 years previously treated with anthracyclines (mean cumulative dose: 320±124 mg/m2, with (n=52 or without (n=82 mediastinal radiotherapy. The prevalence of LV systolic dysfunction, defined as fractional shortening < 27%, LV ejection fraction (LVEF < 55%, and global longitudinal strain (GLS ≤ 16%, was 5.2%, 6.0%, and 23.1%, respectively. Abnormal GLS was observed in 24 (18% patients despite a normal LVEF. Indices of LV systolic function were similar regardless of anthracycline dose. However, GLS was worse (18.0 versus 19.0, p=0.003 and prevalence of abnormal GLS was higher (36.5% versus 14.6%, p=0.004 in patients treated with mediastinal radiotherapy. Mediastinal radiotherapy was associated with reduced GLS (p=0.040 after adjusting for sex, age, and cumulative anthracycline dose. In adult survivors of childhood, adolescent, and young adult cancer, 2DSTE frequently detects LV systolic dysfunction despite a normal LVEF and may be useful for the long-term cardiac surveillance of adult cancer survivors.

  10. Experience With a Long-term Pulsatile Ventricular Assist Device as a Bridge to Heart Transplant in Adults.

    Science.gov (United States)

    Gómez Bueno, Manuel; Segovia Cubero, Javier; Serrano Fiz, Santiago; Ugarte Basterrechea, Juan; Hernández Pérez, Francisco José; Goirigolzarri Artaza, Josebe; Castedo Mejuto, Evaristo; Burgos Lázaro, Raúl; García Montero, Carlos; Moñivas Palomero, Vanessa; Mingo Santos, Susana; González Román, Ana Isabel; Álvarez Avelló, José Manuel; Vidal Fernández, Mercedes; Forteza Gil, Alberto; Alonso-Pulpón, Luis

    2017-09-01

    Most long-term ventricular assist devices (VADs) that are currently implanted are intracorporeal continuous-flow devices. Their main limitations include their high cost and inability to provide biventricular support. The aim of this study was to describe the results of using paracorporeal pulsatile-flow VADs as a bridge to transplant (BTT) in adult patients. Retrospective analysis of the characteristics, complications, and outcomes of a single-center case series of consecutive patients treated with the EXCOR VAD as BTT between 2009 and 2015. During the study period, 25 VADs were implanted, 6 of them biventricular. Ventricular assist devices were indicated directly as a BTT in 12 patients and as a bridge to decision in 13 due to the presence of potentially reversible contraindications or chance of heart function recovery. Twenty patients (80%) were successfully bridged to heart transplant after a median of 112 days (range, 8-239). The main complications included infectious (52% of patients), neurological events (32%, half of them fatal), bleeding (28%), and VAD malfunction requiring component replacement (28%). Eighty percent of patients with the EXCOR VAD as BTT achieved the goal after an average of almost 4 months of support. The most frequent complications were infectious, and the most severe were neurological. In our enivonment, the use of these pulsatile-flow VAD as BTT is a feasible strategy that obtains similar outcomes to those of intracorporeal continuous-flow devices. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  11. Vulnerability to ventricular fibrillation

    Science.gov (United States)

    Janse, Michiel J.

    1998-03-01

    One of the factors that favors the development of ventricular fibrillation is an increase in the dispersion of refractoriness. Experiments will be described in which an increase in dispersion in the recovery of excitability was determined during brief episodes of enhanced sympathetic nerve activity, known to increase the risk of fibrillation. Whereas in the normal heart ventricular fibrillation can be induced by a strong electrical shock, a premature stimulus of moderate intensity only induces fibrillation in the presence of regional ischemia, which greatly increases the dispersion of refractoriness. One factor that is of importance for the transition of reentrant ventricular tachycardia to ventricular fibrillation during acute regional ischemia is the subendocardial Purkinje system. After selective destruction of the Purkinje network by lugol, reentrant tachycardias still develop in the ischemic region, but they do not degenerate into fibrillation. Finally, attempts were made to determine the minimal mass of thin ventricular myocardium required to sustain fibrillation induced by burst pacing. This was done by freezing of subendocardial and midmural layers. The rim of surviving epicardial muscle had to be larger than 20 g. Extracellular electrograms during fibrillation in both the intact and the "frozen" left ventricle were indistinguishable, but activation patterns were markedly different. In the intact ventricle epicardial activation was compatible with multiple wavelet reentry, in the "frozen" heart a single, or at most two wandering reentrant waves were seen.

  12. The Adult Ventricular-Subventricular Zone (V-SVZ) and Olfactory Bulb (OB) Neurogenesis.

    Science.gov (United States)

    Lim, Daniel A; Alvarez-Buylla, Arturo

    2016-05-02

    A large population of neural stem/precursor cells (NSCs) persists in the ventricular-subventricular zone (V-SVZ) located in the walls of the lateral brain ventricles. V-SVZ NSCs produce large numbers of neuroblasts that migrate a long distance into the olfactory bulb (OB) where they differentiate into local circuit interneurons. Here, we review a broad range of discoveries that have emerged from studies of postnatal V-SVZ neurogenesis: the identification of NSCs as a subpopulation of astroglial cells, the neurogenic lineage, new mechanisms of neuronal migration, and molecular regulators of precursor cell proliferation and migration. It has also become evident that V-SVZ NSCs are regionally heterogeneous, with NSCs located in different regions of the ventricle wall generating distinct OB interneuron subtypes. Insights into the developmental origins and molecular mechanisms that underlie the regional specification of V-SVZ NSCs have also begun to emerge. Other recent studies have revealed new cell-intrinsic molecular mechanisms that enable lifelong neurogenesis in the V-SVZ. Finally, we discuss intriguing differences between the rodent V-SVZ and the corresponding human brain region. The rapidly expanding cellular and molecular knowledge of V-SVZ NSC biology provides key insights into postnatal neural development, the origin of brain tumors, and may inform the development regenerative therapies from cultured and endogenous human neural precursors.

  13. Anti-diabetic effects of hydroalcohlic juglans regia male flower extract on blood glucose level and on liver enzymes activity in intact and diabetogenized adult male rat

    Directory of Open Access Journals (Sweden)

    Seyyed Ebrahim Hosseini

    2012-08-01

    Full Text Available Background and Aim: Diabetes is a metabolic disorder resulting from defects in insulin secretion or function. Walnut is a nutrient used in traditional medicine to treat diabetes. In the current study, anti-diabetic effects of the Hydroalcoholic extract of walnut male flowers on diabetogenized rats by using Streptozocin were evaluated.   Materials and Methods: Seventy two adult male Wistar rats weighing 200-225 g each were randomly selected and divided into three main groups, i.e. control, diabetic, and non-diabetic(intact The control group included 8 rats (n=8. The diabetic and non-diabetic groups covered 32 rats each. Each of these groups were divided into four 8 rats including the control, diabetic, experimental 1, 2, and 3 which received 2, 4, or 6 g/kg of the extract per day for 15 days ,respectively. The three diabetic groups were each treated with the above doses of the extract, and the fourth group received no treatment. Diabetes was induced in diabetic rats through intraperitoneal injection of 60 mg/kg of Streptozotocin. At the end, blood samples were taken from the experimental and control groups and the serum levels of insulin and glucose were measured.   Results: A significant reduction in blood sugar and increase of insulin in diabetics receiving Hydroalcoholic extract of male flowers walnut was observed compared with non-diabetic ones.   Conclusion: Hydroalcoholic extract of male Walnut flowers, due to increasing insulin, causes reduction of blood sugar.

  14. Quantitative assessment of systolic left ventricular function with speckle-tracking echocardiography in adult patients with repaired aortic coarctation.

    Science.gov (United States)

    Menting, Myrthe E; van Grootel, Roderick W J; van den Bosch, Annemien E; Eindhoven, Jannet A; McGhie, Jackie S; Cuypers, Judith A A E; Witsenburg, Maarten; Helbing, Willem A; Roos-Hesselink, Jolien W

    2016-05-01

    Despite successful aortic coarctation (CoA) repair, systemic hypertension often recurs which may influence left ventricular (LV) function. We aimed to detect early LV dysfunction using LV global longitudinal strain (GLS) in adults with repaired CoA, and to identify associations with patient and echocardiographic characteristics. In this cross-sectional study, patients with repaired CoA and healthy controls were recruited prospectively. All subjects underwent echocardiography, ECG and blood sampling within 1 day. With speckle-tracking echocardiography, we assessed LV GLS on the apical four-, three- and two-chamber views. We included 150 subjects: 75 patients (57 % male, age 33.4 ± 12.8 years, age at repair 2.5 [IQR: 0.1-11.1] years) and 75 healthy controls of similar sex and age. LV GLS was lower in patients than in controls (-17.1 ± 2.3 vs. -20.2 ± 1.6 %, P < 0.001). Eighty percent of the patients had a normal LV ejection fraction, but GLS was still lower than in controls (P < 0.001). In patients, GLS correlated with systolic and diastolic blood pressure (r = 0.32, P = 0.009; r = 0.31, P = 0.009), QRS duration (r = 0.34, P = 0.005), left atrial dimension (r = 0.27, P = 0.029), LV mass (r = 0.30, P = 0.014) and LV ejection fraction (r = -0.48, P < 0.001). Patients with either associated cardiac lesions, multiple cardiac interventions or aortic valve replacement had lower GLS than patients without. Although the majority of adults with repaired CoA seem to have a normal systolic LV function, LV GLS was decreased. Higher blood pressure, associated cardiac lesions, and larger left atrial dimension are related with lower GLS. Therefore, LV GLS may be used as objective criterion for early detection of ventricular dysfunction.

  15. Ventricular synchronicity: observations comparing pulse flow and tissue Doppler assessment in a Chinese healthy adult cohort

    Institute of Scientific and Technical Information of China (English)

    QUAN Xin; ZHU Tian-gang; GUO Shi; MA Jian-xin; WANG Xin; GUO Ji-hong

    2012-01-01

    Background Mechanical asynchrony is an important parameter in predicting the response to cardiac resynchronization therapy,but detailed knowledge about cardiac timing in healthy persons is scarce.Therefore,in the current study,we sought to investigate the physiological status of interventricular synchronicity using pulse wave flow and tissue Doppler imaging in a healthy Chinese population.Methods Eighty-eight healthy volunteers underwent standard flow and tissue Doppler echocardiographic examinations.Ventricular inflow and outflow pulse wave flow Doppler patterns were recorded together with annulus pulse tissue Doppler imaging.Time intervals from the beginning of the QRS complex to the onset,peak and end of each wave were measured.Results The onsets of systole between left and right ventricles were highly synchronized by both imaging modalities.However,the left ventricle reached the peak flow ejection and peak mechanical contraction earlier than the right ventricle,(165.61±26.23) ms vs.(204.3±34.55) ms (P <0.01) and (133.62±26.19) ms vs.(191.25±38.47) ms (P <0.01).Time to peak early diastolic relaxation was earlier in the left ventricle than in the right heart,(500.23±56.52) me vs.(524.94±47.42) ms (P <0.01).Conclusions Left and right ventricles were well synchronized at the onsets of systole and diastole even though interventricular peak systolic and peak early diastolic dyssynchrony was observed in healthy people by pulse wave Doppler imaging.In addition,diastolic timing events were slightly affected by age and gender.

  16. Comparison of cardiac magnetic resonance imaging features of isolated left ventricular non-compaction in adults versus dilated cardiomyopathy in adults

    Energy Technology Data Exchange (ETDEWEB)

    Cheng, H. [Department of Radiology, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037 (China); Zhao, S., E-mail: cjrzhaoshihua2009@163.com [Department of Radiology, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037 (China); Jiang, S.; Lu, M.; Yan, C.; Ling, J.; Zhang, Y.; Liu, Q.; Ma, N.; Yin, G.; Wan, J. [Department of Radiology, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037 (China); Yang, Y. [Department of Cardiology, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037 (China); Li, L. [Department of Pathology, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037 (China); Jerecic, R. [MR Research and Development, Siemens Medical Solutions, Chicago, IL (United States); He, Z. [Department of Nuclear Medicine, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037 (China)

    2011-09-15

    Aim: To compare cardiac magnetic resonance imaging (MRI) features between isolated left ventricular non-compaction (IVNC) and dilated cardiomyopathy (DCM) in adults. Materials and methods: A consecutive series of 50 patients with IVNC from a single institution were reviewed. During the same period, 50 patients with DCM who had prominent trabeculations, who were matched for age, gender, and body surface area, were prospectively included. Left ventricular (LV) morphology and function were assessed using cardiac MRI. Results: Compared with patients with DCM, patients with IVNC had a significantly lower LV sphericity index and end-diastolic volume index (LVEDVI) and a greater LV ejection fraction (LVEF), number of trabeculated segments, and ratio of non-compacted to compacted myocardium (NC/C ratio). There were no significant differences in stroke volume index, cardiac output, and cardiac index between the two patient groups. In patients with IVNC, the number of trabeculated segments and the NC/C ratio correlated positively with LVEDVI (r = 0.626 and r = 0.559, respectively) and negatively with LVEF (r = -0.647 and r = -0.521, respectively, p < 0.001 for all). In patients with DCM, the number of non-compacted segments and the NC/C ratio had no correlation with either the LVEDVI (r = -0.082 and r = -0.135, respectively) or the LVEF (r = 0.097 and r = 0.205, respectively). Conclusion: There are demonstrable morphological and functional differences between IVNC and DCM at LV assessment using cardiac MRI. The occurrence of trabeculated myocardium might be due to a different pathophysiological mechanism.

  17. Evaluation of right ventricular function in adults with congenital heart defects.

    Science.gov (United States)

    Bussadori, Claudio; Di Salvo, Giovanni; Pluchinotta, Francesca R; Piazza, Luciane; Gaio, Giampiero; Russo, Maria Giovanna; Carminati, Mario

    2015-01-01

    The right ventricle (RV) is of lesser importance in acquired heart disease, but its role is of increasing importance in congenital heart disease (CHD). Despite major progress being made, precise measurements of the RV are challenging because of its peculiar anatomical structure that is not adaptable to any planar geometrical assumption. This is particularly true in adult patients with CHD where the RV shape eludes any standardization, it may assume various morphologies, and its modality of contraction depends on previous surgical treatment and/or pathophysiological conditions. However, reliable and repeatable quantification of RV dimensions and function for these patients are essential to provide appropriate timing for intervention to optimize outcomes. In this population, echocardiographic evaluation should not be limited to an observational and subjective functional assessment of the RV but must provide quantitative values repeatable and clinically reliable to help the decision-making process. The aim of this review was to discuss the echocardiographic approach to the RV in adult patients with CHD in general and in specific cases of pressure or volume overload.

  18. Brain ventricular dimensions and relationship to outcome in adult patients with bacterial meningitis

    DEFF Research Database (Denmark)

    Sporrborn, Janni L; Knudsen, Gertrud B; Sølling, Mette;

    2015-01-01

    BACKGROUND: Experimental studies suggest that changes in brain ventricle size are key events in bacterial meningitis. This study investigated the relationship between ventricle size, clinical condition and risk of poor outcome in patients with bacterial meningitis. METHODS: Adult patients diagnosed...... with bacterial meningitis admitted to two departments of infectious diseases from 2003 through 2010 were identified. Clinical and biochemical data as well as cerebral computed tomographic images were collected. The size of the brain ventricles were presented as a Ventricle to Brain Ratio (VBR). Normal range......-day mortality, Mortality Rate Ratio: 6.03 (95 % confidence interval: 1.61-22.64, p = 0.008) for highest versus lowest tertile. A VBR deviating more than 2 standard deviations from the normal range was associated with increased mortality. CONCLUSIONS: Brain ventricles are commonly subject to marked...

  19. Mechanisms of the Frank-Starling phenomena studied in intact hearts.

    Science.gov (United States)

    Burkhoff, D; Stennett, R A; Ogino, K

    1995-01-01

    The impact of ventricular volume on the relationship between intracellular calcium and ventricular pressure under steady-state conditions was determined in intact ferret hearts. The results reveal major quantitative differences and minor qualitative differences between these relations and those previously measured in isolated intact and skinned cardiac muscle. The importance of these differences is discussed within the context of developing a comprehensive mechanistic theory to describe load-dependence of the intact ventricle.

  20. Right ventricular function and N-terminal pro-brain natriuretic peptide levels in adult patients with simple dextro-transposition of the great arteries.

    Science.gov (United States)

    Martínez-Quintana, Efrén; Marrero-Negrín, Natalia; Gopar-Gopar, Silvia; Rodríguez-González, Fayna

    2017-06-01

    Dextro-transposition of the great arteries (d-TGA) patients is at high risk of developing right ventricular dysfunction and tricuspid regurgitation in adulthood. Determining the relation between echocardiographic parameters, N-terminal pro-brain natriuretic peptide (NT-pro-BNP) levels and the New York Heart Association (NYHA) functional class may help determining the best time to operate them. Patients with simple d-TGA operated in infancy with an atrial switch procedure (Mustard or Senning operation) were followed up in our Adult Congenital Heart Disease Unit. Analytical, echocardiographic, and clinical parameters were determined to evaluate the correlation between right echocardiographic ventricular function, NT-pro-BNP levels, and NYHA functional class. Twenty-four patients with d-TGA were operated in infancy of whom 17 alive patients had simple d-TGA. Nine patients had NT-pro-BNP levels lower than 200 pg/mL and eight patients were above 200 pg/mL. Patients with lower hemoglobin concentration, higher right ventricular diameter or under diuretic treatment showed significant higher NT-pro-BNP levels (above 200 pg/dL). The Spearman test showed a positive correlation between basal right ventricular diameter and tricuspid regurgitation with pro NT BNP levels (correlation coefficient of .624; P=.017 and .490; P=.046, respectively) and a negative correlation with the right ventricle fractional area change (-.508, P=.045). No correlation was seen between NT-pro-BNP levels and the rest of echocardiographic parameters or the NYHA functional class. NT-pro-BNP levels showed a positive correlation with basal right ventricular diameter and tricuspid regurgitation but not with NYHA association functional class in d-TGA patients. © 2017, Wiley Periodicals, Inc.

  1. Epidemiology of heart failure: the prevalence of heart failure and ventricular dysfunction in older adults over time. A systematic review.

    Science.gov (United States)

    van Riet, Evelien E S; Hoes, Arno W; Wagenaar, Kim P; Limburg, Alexander; Landman, Marcel A J; Rutten, Frans H

    2016-03-01

    The 'epidemic' of heart failure seems to be changing, but precise prevalence estimates of heart failure and left ventricular dysfunction (LVD) in older adults, based on adequate echocardiographic assessment, are scarce. Systematic reviews including recent studies on the prevalence of heart failure and LVD are lacking. We aimed to assess the trends in the prevalence of LVD, and heart failure with reduced (HFrEF) and preserved ejection fraction (HFpEF) in the older population at large. A systematic electronic search of the databases Medline and Embase was performed. Studies that reported prevalence estimates in community-dwelling people ≥60 years old were included if echocardiography was used to establish the diagnosis. In total, 28 articles from 25 different study populations were included. The median prevalence of systolic and 'isolated' diastolic LVD was 5.5% (range 3.3-9.2%) and 36.0% (range 15.8-52.8%), respectively. A peak in systolic dysfunction prevalence seems to have occurred between 1995 and 2000. 'All type' heart failure had a median prevalence rate of 11.8% (range 4.7-13.3%), with fairly stable rates in the last decade and with HFpEF being more common than HFrEF [median prevalence 4.9% (range 3.8-7.4%) and 3.3% (range 2.4-5.8%), respectively]. Both LVD and heart failure remain common in the older population at large. The prevalence of diastolic dysfunction is on the rise and currently higher than that of systolic dysfunction. The prevalence of the latter seems to have decreased in the 21st century.

  2. Prevalence and determinants of anemia in adults with complex congenital heart disease and ventricular dysfunction (subaortic right ventricle and single ventricle physiology).

    Science.gov (United States)

    Collins, Nicholas; Piran, Sanaz; Harrison, Jeanine; Azevedo, Eduardo; Oechslin, Erwin; Silversides, Candice K

    2008-09-01

    Anemia is well recognized as a marker of poor prognosis in patients with acquired heart disease and heart failure. Adults with complex congenital heart disease and ventricular dysfunction (subaortic right ventricle or single-ventricle physiology) represent a different population, because they are typically much younger and have less co-morbidity compared with patients with acquired forms of heart disease. The purpose of this study was to evaluate the prevalence and determinants of anemia in this population. Baseline hemoglobin levels were recorded at the time of the initial clinic visit, and final hemoglobin levels were those recorded before death or transplantation or at study completion. Anemia was defined as hemoglobin complex congenital heart disease and ventricular dysfunction, in particular those with Fontan physiology.

  3. Treatment of membranous pulmonary atresia with intact ventricular septum by right ventricular decompression and modified Blalock-Taussig shunting%右室减压术伴改良体肺分流术治疗室间隔完整型肺动脉膜性闭锁

    Institute of Scientific and Technical Information of China (English)

    宋海龙; 陶曙光; 杨仕海; 韩剑刚; 温林林; 王建明; 姚洁

    2016-01-01

    组的经皮氧饱和度、三尖瓣Z值、McGoon比值、肺动脉跨瓣压差之间差异具有统计学意义(P<0.01).结论 b组呼吸机辅助时间、CCU住院时间均短于a组,但术后3个月以后随访,a组患儿右心室及肺血管发育优于b组患儿.%Objective To compare the surgical efficacies of membranous pulmonary atresia with intact ventricular septum (PAIVS) by a transannular patch from pulmonary valve after right ventricular outflow-tract cutting with BT shunt under extracorporeal circulation (operation a) and by balloon valvuloplasty via right ventricular pulmonary valve with BT shunt (operation b).Methods A total of 57 patients with PAIVS were treated between July 2003 and July 2014.And 22 patients with membranous PAIVS were selected randomly.The first 11 patients were surgically treated by operation a (group a) while the remainder by operation b (group b).Both groups were compared in mortality,breathing machine auxiliary time and time in cardiac care unit (CCU).The follow up period was up to 6 months.Transcutaneous oxygen saturation,tricuspid Z valve,McGoon ratio pulmonary arterial pressure gradient and pulmonary valve regurgitation (ratio of width of pulmonary artery to diameter of pulmonary valve ring) were monitored and compared at discharging day,1 month,3 and 6 months post-operation.Results Four children died of operation a with a mortality rate of 36.4%.And another 2 died of operation b with a mortality rate of 18.2%.No inter-group statistical difference existed in mortality(P>0.05).After operation a,breathing machine auxiliary average time was (127.09± 46.81) hours and average time in CCU (7.91 ± 2.5) days.After operation b,breathing machine auxiliary average time was (1.55 ± 26.25) hours and average time in CCU (4.82 ± 1.08) days.The time was obviously shorter for operation b than that for operation a.At the day of discharging,pulmonary valve regurgitation was significantly lower in group a than that in group b

  4. Left ventricular hypertrophy and insulin resistance in adults from an urban community in The Gambia: cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Bernard Cudjoe Nkum

    Full Text Available OBJECTIVE: To determine the association between left ventricular hypertrophy and insulin resistance in Gambians. DESIGN: Cross-sectional study. SETTING: Outpatient clinics of Royal Victoria Teaching Hospital and Medical Research Council Laboratories in Banjul. PARTICIPANTS: Three hundred and sixteen consecutive patients were enrolled from outpatient clinics. The data of 275 participants (89 males were included in the analysis with a mean (± standard deviation age of 53.7 (±11.9 years. INTERVENTIONS: A questionnaire was filled and anthropometric measurements were taken. 2-D guided M-mode echocardiography, standard 12-1ead electrocardiogram, fasting insulin and the oral glucose tolerance test were performed. MAIN OUTCOME MEASURES: The Penn formula was used to determine the left ventricular mass index, 125 g/m2 in males and 110 g/m2 in females as the cut-off for left ventricular hypertrophy. Using the fasting insulin and fasting glucose levels, the insulin resistance was estimated by the homeostatic model assessment formula. Logistic regression analysis was used to determine the association between left ventricular hypertrophy and insulin resistance. RESULTS: The mean Penn left ventricular mass index was 119.5 (±54.3 and the prevalence of Penn left ventricular mass index left ventricular hypertrophy was 41%. The mean fasting glucose was 5.6 (±2.5 mmol/l, fasting insulin was 6.39 (±5.49 μU/ml and insulin resistance was 1.58 (±1.45. There was no association between Penn left ventricular mass index left ventricular hypertrophy and log of insulin resistance in univariate (OR = 0.98, 95% CI = 0.80-1.19, p = 0.819 and multivariate logistic regression (OR = 0.93, 95% CI = 0.76-1.15, p = 0.516 analysis. CONCLUSION: No association was found in this study between left ventricular hypertrophy and insulin resistance in Gambians and this does not support the suggestion that insulin is an independent determinant of left ventricular

  5. Relation of fragmented QRS complex to right ventricular fibrosis detected by late gadolinium enhancement cardiac magnetic resonance in adults with repaired tetralogy of fallot.

    Science.gov (United States)

    Park, Seung-Jung; On, Young Keun; Kim, June Soo; Park, Seung Woo; Yang, Ji-Hyuk; Jun, Tae-Gook; Kang, I-Seok; Lee, Heung Jae; Choe, Yeon Hyeon; Huh, June

    2012-01-01

    Fragmented QRS (fQRS) on 12-lead electrocardiography reflects conduction delay caused by myocardial fibrosis and dysfunction. Ventricular fibrosis detected by late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) is reportedly correlated with worse clinical outcomes in adults with repaired tetralogy of Fallot (TOF). The aim of this study was to assess whether the presence of fQRS is associated with right ventricular (RV) fibrosis or dysfunction in this patient group. In 37 consecutive patients (median age 30 years, median age at repair 6.6 years), the number of leads showing fQRS, defined as the presence of >2 notches on the R/S wave in ≥2 contiguous leads, was counted. RV systolic function, dilatation, and LGE score were measured using LGE CMR. Ventricular LGE was observed mainly at the previous surgical sites: the RV outflow tract (33 of 37), ventricular septal defect patch region (15 of 37), and RV anterior wall (11 of 37). Fragmented QRS was found mostly in the right and mid precordial leads. The fQRS group (n = 20) demonstrated higher RV LGE scores (p <0.001) and lower RV ejection fractions (p = 0.02) and a trend toward larger RV end-diastolic and end-systolic volumes (p = 0.12 and p = 0.06, respectively) compared to the non-fQRS group (n = 17). The number of electrocardiographic leads showing fQRS was positively correlated with RV LGE score (r = 0.75, p <0.001). The presence of fQRS remained independently associated with the presence of supramedian RV LGE score, even after adjusting for relevant parameters. In conclusion, fQRS was closely associated with more extensive RV fibrosis and dysfunction in adults with repaired tetralogy of Fallot.

  6. Crisscross heart with dextrocardia and intact interventricular septum

    Directory of Open Access Journals (Sweden)

    P Kader Muneer

    2014-01-01

    Full Text Available Crisscross heart is a rare congenital heart disease characterized by a twisted atrioventricular connection, as a result of rotation of the ventricular mass along its long axis. We report an asymptomatic 48-year-old woman referred to us for evaluation of a cardiac murmur. Further evaluation showed situs solitus, dextrocardia with normal atrioventricular and ventriculoarterial connection, and a crisscross relation of the atrioventricular valves. Unlike the usual case of crisscross heart, our patient had an intact ventricular septum.

  7. Ventricular assist device

    Science.gov (United States)

    VAD; RVAD; LVAD; BVAD; Right ventricular assist device; Left ventricular assist device; Biventricular assist device; Heart pump; Left ventricular assist system; LVAS; Implantable ventricular assist device

  8. Lysophosphatidic acid increases the electrophysiological instability of adult rabbit ventricular myocardium by augmenting L-type calcium current.

    Directory of Open Access Journals (Sweden)

    Yong Wei

    Full Text Available Lysophosphatidic acid (LPA has diverse actions on the cardiovascular system and is widely reported to modulate multiple ion currents in some cell types. However, little is known about its electrophysiological effects on cardiac myocytes. This study investigated whether LPA has electrophysiological effects on isolated rabbit myocardial preparations. The results indicate that LPA prolongs action potential duration at 90% repolarization (APD(90 in a concentration- and frequency-dependent manner in isolated rabbit ventricular myocytes. The application of extracellular LPA significantly increases the coefficient of APD(90 variability. LPA increased L-type calcium current (I(Ca,L density without altering its activation or deactivation properties. In contrast, LPA has no effect on two other ventricular repolarizing currents, the transient outward potassium current (I(to and the delayed rectifier potassium current (I(K. In arterially perfused rabbit left ventricular wedge preparations, the monophasic action potential duration, QT interval, and Tpeak-end are prolonged by LPA. LPA treatment also significantly increases the incidence of ventricular tachycardia induced by S(1S(2 stimulation. Notably, the effects of LPA on action potentials and I(Ca,L are PTX-sensitive, suggesting LPA action requires a G(i-type G protein. In conclusion, LPA prolongs APD and increases electrophysiological instability in isolated rabbit myocardial preparations by increasing I(Ca,L in a G(i protein-dependent manner.

  9. Association of coronary to left ventricular microfistulae (vessels of Wearn) with atrial septal defect in an adult without cyanotic heart disease.

    Science.gov (United States)

    Hussain, Munem; Roberts, Elved Bryn

    2015-07-02

    Vessels of Wearn are rare findings during coronary angiography in adults. They are known to be associated with forms of cyanotic congenital heart disease in infants but we are not aware of any published cases of association with non-cyanotic left to right shunts in adults. We present the case of a 69-year-old man with angiographically evident vessels of Wearn draining from the left and right coronary arteries into the left ventricle associated with an asymptomatic atrial septal defect. We postulate a developmental phase association between atrial septal maturation and closure of perfusing microchannels from the ventricular cavities to the epicardial coronary arteries on the same spectrum as that which leads to more widespread defects in infants. We also highlight a common medication side effect that might have been mistaken as a manifestation of the congenital anomalies.

  10. Unusual cause of exercise-induced ventricular fibrillation in a well-trained adult endurance athlete: a case report

    Directory of Open Access Journals (Sweden)

    Vogt Stefan

    2008-04-01

    Full Text Available Abstract Introduction The diseases responsible for sudden deaths in athletes differ considerably with regard to age. In young athletes, congenital malformations of the heart and/or vascular system cause the majority of deaths and can only be detected noninvasively by complex diagnostics. In contrast, in older athletes who die suddenly, atherosclerotic disease of the coronary arteries is mostly found. Reports of congenital coronary anomalies as a cause of sudden death in older athletes are rare. Case presentation A 48-year-old man who was a well-trained, long-distance runner collapsed at the finish of a half marathon because of a myocardial infarction with ventricular fibrillation. Coronary angiography showed an anomalous origin of the right coronary artery from the left sinus of Valsalva with minimal wall alterations. Multislice computed tomography of the coronary arteries confirmed these findings. Cardiomagnetic resonance imaging demonstrated a mild hypokinesia of the basal right- and left-ventricular posterior wall. An electrophysiological study showed an inducible temporary polymorphic ventricular tachycardia and an inducible ventricular fibrillation. The athlete was subsequently treated by acetylsalicylic acid 100 mg (0-1-0, bisoprolol 2.5 mg (1-0-0 and atorvastatin 10 mg (0-0-1 and was instructed to keep his training intensity under the 'individual anaerobic threshold'. Intense and long-lasting exercise under extreme environmental conditions, particularly heat, should also be avoided. Conclusion This case report presents a coronary anomaly as the most likely reason for an exercise-induced myocardial infarction with ventricular fibrillation in a well-trained 48-year-old endurance athlete. Therefore, coronary anomalies have also to be considered as a possible cause of cardiac problems in older athletes.

  11. A reappraisal of the prevalence and clinical importance of left ventricular false tendons in children and adults.

    OpenAIRE

    1986-01-01

    The prevalence and clinical importance of false tendons were studied in 488 consecutive patients referred for echocardiography. Two hundred and eighty three (58%) patients had acquired heart disease, 91 (19%) had congenital heart disease, and 114 (23%) had normal hearts. Sixty six patients with normal hearts had innocent systolic murmurs and one had recurrent ventricular tachycardia. The overall prevalence of false tendons was 25% compared with 1.6% in a retrospective analysis of 763 cross se...

  12. The value of right ventricular longitudinal strain in the evaluation of adult patients with repaired tetralogy of Fallot: a new tool for a contemporary challenge.

    Science.gov (United States)

    Almeida-Morais, Luís; Pereira-da-Silva, Tiago; Branco, Luísa; Timóteo, Ana T; Agapito, Ana; de Sousa, Lídia; Oliveira, José A; Thomas, Boban; Jalles-Tavares, Nuno; Soares, Rui; Galrinho, Ana; Cruz-Ferreira, Rui

    2017-04-01

    The role of right ventricular longitudinal strain for assessing patients with repaired tetralogy of Fallot is not fully understood. In this study, we aimed to evaluate its relation with other structural and functional parameters in these patients. Patients followed-up in a grown-up CHD unit, assessed by transthoracic echocardiography, cardiac MRI, and treadmill exercise testing, were retrospectively evaluated. Right ventricular size and function and pulmonary regurgitation severity were assessed by echocardiography and MRI. Right ventricular longitudinal strain was evaluated in the four-chamber view using the standard semiautomatic method. In total, 42 patients were included (61% male, 32±8 years). The mean right ventricular longitudinal strain was -16.2±3.7%, and the right ventricular ejection fraction, measured by MRI, was 42.9±7.2%. Longitudinal strain showed linear correlation with tricuspid annular systolic excursion (r=-0.40) and right ventricular ejection fraction (r=-0.45) (all pright ventricular fractional area change (r=0.50), pulmonary regurgitation colour length (r=0.35), right ventricular end-systolic volume (r=-0.60), and left ventricular ejection fraction (r=0.36) (all pright ventricular ejection fraction. The best threshold of longitudinal strain for predicting a right ventricular ejection fraction of Right ventricular longitudinal strain is a powerful method for evaluating patients with tetralogy of Fallot. It correlated with echocardiographic right ventricular function parameters and was independently associated with right ventricular ejection fraction derived by MRI.

  13. Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) presenting with ventricular fibrillation in an adult: a case report

    DEFF Research Database (Denmark)

    Kristensen, T.; Kofoed, Klaus Fuglsang; Helqvist, S.;

    2008-01-01

    Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly. The usual clinical course is severe left sided heart failure and mitral valve insufficiency presenting during the first months of life. However, in some cases collateral blood supply from...... the right coronary artery is sufficient and symptoms may be subtle or even absent. Arrhythmias or sudden cardiac death in adult life may be the first clinical presentation in patients with ALCAPA. We report a case, where a 39-year old woman presented with ventricular fibrillation during phycial exertion....... Coronary angiography and CT-angiography revealed an anomalous origin of the left coronary artery, and an aortic reimplantation of the left coronary artery was performed followed by ICD implantation. A review of the literature on ALCAPA is presented along with CT images before and after surgery...

  14. MRI of intact plants.

    NARCIS (Netherlands)

    As, H. van; Scheenen, T.W.J.; Vergeldt, F.J.

    2009-01-01

    Nuclear magnetic resonance imaging (MRI) is a non-destructive and non-invasive technique that can be used to acquire two- or even three-dimensional images of intact plants. The information within the images can be manipulated and used to study the dynamics of plant water relations and water transpor

  15. MRI of intact plants

    NARCIS (Netherlands)

    As, van H.; Scheenen, T.; Vergeldt, F.J.

    2009-01-01

    Nuclear magnetic resonance imaging (MRI) is a non-destructive and non-invasive technique that can be used to acquire two- or even three-dimensional images of intact plants. The information within the images can be manipulated and used to study the dynamics of plant water relations and water transpor

  16. [Intact cervical pregnancy].

    Science.gov (United States)

    Habek, D; Bobic, M V; Dosen, L

    2003-01-01

    The authors describe a case of intact cervical pregnancy in a 24-year-old secundigravida. The patient was treated successfully with Methotrexate. Conservative treatment is the first choice in the therapy of uncomplicated cervical pregnancy. Conservative and operative therapeutic procedures are discussed.

  17. A Randomized Trial to Measure the Impact of a Community-Based Cognitive Training Intervention on Balance and Gait in Cognitively Intact Black Older Adults

    Science.gov (United States)

    Smith-Ray, Renae L.; Makowski-Woidan, Beth; Hughes, Susan L.

    2014-01-01

    Introduction: Fall prevention is important for maintaining mobility and independence into old age. Approaches for reducing falls include exercise, tai chi, and home modifications; however, causes of falling are multifactorial and include not just physical but cognitive factors. Cognitive decline occurs with age, but older adults with the greatest…

  18. The Role of Calcium-Sensing Receptors in Endothelin-1-Dependent Effects on Adult Rat Ventricular Cardiomyocytes: Possible Contribution to Adaptive Myocardial Hypertrophy.

    Science.gov (United States)

    Dyukova, Elena; Schreckenberg, Rolf; Arens, Christoph; Sitdikova, Guzel; Schlüter, Klaus-Dieter

    2017-09-01

    Nitric oxide (NO)-deficiency as it occurs during endothelial dysfunction activates the endothelin-1 (ET-1) system and increases the expression of receptor activity modifying protein (RAMP)-1 that acts as a chaperon for calcium-sensing receptors (CaR) that have recently been identified to improve cardiac function. Here, we hypothesized that ET-1 increases the cardiac expression of CaR and thereby induces an adaptive type of hypertrophy. Expressions of RAMP-1, endothelin receptors, and CaR were analyzed by RT-PCR in left ventricular tissues of L-NAME-treated rats. Effects of ET-1 on CaR expression and cell function (load free cell shortening) were analyzed in adult rat ventricular cardiomyocytes. siRNA directed against CaR and RAMP-1 was used to investigate a causal relationship. PD142893 and BQ788 were used to dissect the contribution of ETB1 , ETB2 , and ETA receptors. Non-specific NO synthase inhibition with L-Nitro arginine methyl ester (L-NAME) caused a cardiac upregulation of ETB receptors and CaR suggesting a paracrine effect of ET-1 on cardiomyocytes. Indeed, ET-1 induced the expression of CaR in cultured cardiomyocytes. Under these conditions, cardiomyocytes increased cell size (hypertrophy) but maintained normal function. Inhibition of ETA and ETB1 receptors led to ET-1-dependent reduction in cell shortening and attenuated up-regulation of CaR. Down-regulation of RAMP-1 reduced CaR responsiveness. In conclusion, ET-1 causes an adaptive type of hypertrophy by up-regulation of CaR in cardiomyocytes via ETA and/or ETB1 receptors. J. Cell. Physiol. 232: 2508-2518, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  19. Relationship between left ventricular mass and coronary artery disease in young adults: a single-center study using cardiac computed tomography.

    Science.gov (United States)

    Cho, Jae Yong; Sun, Joo Sung; Sur, Young Keun; Park, Jin Sun; Kang, Doo Kyoung

    2015-12-01

    We evaluated the relationship between coronary artery disease (CAD) and left ventricular mass (LVM) as measured by cardiac computed tomography (CT) in young adults ≤40 years of age. We retrospectively enrolled 490 consecutive individuals (383 males; mean age, 35.2 ± 4.4 years) who underwent cardiac CT. CAD was defined by the presence of any plaque detected by coronary CT angiography. Left ventricular (LV) function, including LVM, was automatically measured by a dedicated workstation. LVM and LVM index (LVMi) in patients with CT-detected CAD were compared to those of patients without CT-detected CAD. Logistic regression analysis was used to evaluate the relationship between cardiovascular risk factors and CAD. Fifty-five individuals had CT-detected CAD (11.2 %, 53 males). LVM measured by cardiac CT was 126.9 ± 30.0 g for males and 93.6 ± 20.9 g for females. LVM was higher (117.8 ± 30.8 vs. 133.6 ± 33.1 g, P Obesity, hypertension, smoking, hypercholesterolemia, LVM and LVMi were predictors of CT-detected CAD. Body mass index (r = 0.237, P < 0.001) and systolic blood pressure (r = 0.281, P < 0.001) were positively correlated with LVM. In the multivariate analysis, LVM [odds ratio (OR) = 1.016] and LVMi (OR = 1.026) remained independent predictors of CAD. LVM and LVMi in patients with CT-detected CAD were higher than that of patients without CT-detected CAD. LVM and LVMi measured by cardiac CT were independent predictors of CAD.

  20. Left ventricular pressure-volume relationships during normal growth and development in the adult rat--studies in 8- and 50-week-old male Wistar rats.

    Science.gov (United States)

    Bal, M P; de Vries, W B; van der Leij, F R; van Oosterhout, M F M; Baan, J; van der Wall, E E; van Bel, F; Steendijk, P

    2005-11-01

    Left ventricular (LV) pressure-volume relations provide relatively load-independent indexes of systolic and diastolic LV function, but few data are available on pressure-volume relations during growth and development in the normal adult heart. Furthermore, to quantify intrinsic ventricular function the indexes should be normalized for heart weight. However, in many studies the indexes are reported in absolute terms, or body weight-correction is used as a surrogate for heart weight-correction. We determined pressure-volume relations in young (8-week-old, n = 13) and middle-aged (50-week-old, n = 19) male Wistar rats in relation to their heart and body weights. The animals were anaesthetized and a 2F pressure-conductance catheter was introduced into the LV to measure pressure-volume relations. Heart and body weights were significantly higher in the 50-week-old rats, whereas the heart-to-body weight ratio was significantly lower (2.74 +/- 0.32 vs. 4.41 +/- 0.37 mg g(-1), P pressure-volume relation (E(ES)), the dP/dt(MAX) vs. end-diastolic volume relation (S-dP), and the preload recruitable stroke work relation (PRSW), normalized for heart weight, was slightly decreased in the 50-week-old rats (S-dP: -6%, P pressure-volume indexes showed improved systolic function and significantly depressed diastolic function. Intrinsic systolic function slightly decreases from the juvenile to the middle-aged period in normal male Wistar rats. Furthermore, correction of pressure-volume indexes for body weight is not an adequate surrogate for heart weight-correction in these animals.

  1. Differential effect of elevated blood pressure on left ventricular geometry types in black and white young adults in a community (from the Bogalusa Heart Study).

    Science.gov (United States)

    Wang, Jian; Chen, Wei; Ruan, Litao; Toprak, Ahmet; Srinivasan, Sathanur R; Berenson, Gerald S

    2011-03-01

    Hypertension and left ventricular (LV) hypertrophy are both more common in blacks than in whites. The aim of the present study was to test the hypothesis that blood pressure (BP) has a differential effect on the LV geometry types in black versus white asymptomatic young adults. As a part of the Bogalusa Heart Study, echocardiography and cardiovascular risk factor measurements were performed in 780 white and 343 black subjects (aged 24 to 47 years). Four LV geometry types were identified as normal, concentric remodeling, eccentric, and concentric hypertrophy. Compared to the white subjects, the black subjects had a greater prevalence of eccentric (15.7% vs 9.1%, p <0.001) and concentric (9.3% vs 4.1%, p <0.001) hypertrophy. On multivariate logistic regression analyses, adjusting for age, gender, body mass index, lipids, and glucose, the black subjects showed a significantly stronger association of LV concentric hypertrophy with BP (systolic BP, odds ratio [OR] 3.74, p <0.001; diastolic BP, OR 2.86, p <0.001) than whites (systolic BP, OR 1.50, p = 0.037; and diastolic BP, OR 1.35, p = 0.167), with p values for the race difference of 0.007 for systolic BP and 0.026 for diastolic BP. LV eccentric hypertrophy showed similar trends for the race difference in the ORs; however, the association between eccentric hypertrophy and BP was not significant in the white subjects. With respect to LV concentric remodeling, its association with BP was not significant in either blacks or whites. In conclusion, elevated BP levels have a greater detrimental effect on LV hypertrophy patterns in the black versus white young adults. These findings suggest that blacks might be more susceptible than whites to BP-related adverse cardiac remodeling.

  2. (Photosynthesis in intact plants)

    Energy Technology Data Exchange (ETDEWEB)

    1990-01-01

    Progress in the two years since the last renewal application has been excellent. We have made substantial contributions on both main fronts of the projects, and are particularly happy with the progress of our research on intact plants. The approach of basing our field work on a sound foundation of laboratory studies has enabled is to use methods which provide unambiguous assays of well characterized reactions. We have also made excellent progress in several laboratory studies which will have direct applications in future field work, and have introduced to the laboratory a range of molecular genetics techniques which will allow us to explore new options in the attempt to understand function at the level of molecular structure.

  3. Relation of electrocardiographic left ventricular hypertrophy to blood pressure, body mass index, serum lipids and blood sugar levels in adult Nigerians.

    Science.gov (United States)

    Opadijo, O G; Omotoso, A B O; Akande, A A

    2003-12-01

    Left ventricular hypertrophy (LVH) is considered an independent risk factor even in the absence of systemic hypertension. Electrocardiographic (ECG) LVH with repolarisation changes has been found in some countries to carry more coronary risk than LVH alone. How far this observation is true among adult Nigerians is not known. We therefore decided to study adult Nigerians with ECG-LVH with or without ST-T waves changes and compare them with normal age matched controls (without ECG-LVH) in relation with established modifiable risk factors such as systemic hypertension (BP), body mass index (BMI), fasting blood sugar (FBS) and serum lipids such as total cholesterol (Tc), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and triglyceride (TG). Adult Nigerians who were consecutively referred to the ECG laboratory were randomly recruited. Three hundred patients were studied. Their blood pressures (BP) as well as body mass indices were recorded after recording their resting 12 read ECG using portable Seward 9953 ECG machine. Their waist-hip ratio (WHR) was also recorded. Blood samples were taken to determine their fasting blood sugar and serum lipids. Their ECG tracings were read by the cardiologists involved in the study while the blood samples were analysed by the chemical pathologist also involved in the study. At the end of the ECG reading, the patients were divided into 3 groups according to whether there was no ECG-LVH (control group A), ECG-LVH alone (group B), and ECG-LVH with ST-T waves changes (group C). One hundred and fifty (50%) patients belonged to group A, 100 (33.3%) patients to group B and 50 (16.7%) group C. Group B patients were found to have higher modifiable risk factors in form of systemic BP. Tc, LDL-C, and WHR compared to group A. However, the group C patients had increased load of these coronary risk factors in terms of BP elevation, higher BMI, FBS, and scrum cholesterol compared to group B. In addition

  4. Sex differences in adrenocortical structure and function. XVI. Stereological and karyometric studies on the cortex of the suprarenal gland of intact adult male and female Mongolian gerbils (Meriones unguiculatus).

    Science.gov (United States)

    Malendowicz, L K

    1984-10-01

    The histological structure of intact adult male and female Mongolian gerbil (Meriones unguiculatus) suprarenal cortex has been described, and quantitative stereological and karyometric studies were performed. The weight of the gland relative to body weight was higher in female than in male gerbils, but the volume of the gland was similar in both sexes. The relative volume of the zona reticularis was higher in the female, while no sex difference was observed in the absolute volume of all suprarenal components (expressed in mm3). In all cortical zones, average cell volume was higher in the female; the nuclear volume of the zona glomerulosa and zona reticularis were also higher in the female. In the zona fasciculata, some large cells with large nuclei (greater than 210 micrometers 3) were observed. These are probably polyploid cells and have not been described in other species. The suprarenal cortex of the male gerbil contained more parenchymal cells than that of the female, the difference being dependent upon variation in the number of cells in the zona fasciculata and zona reticularis. Despite these structural differences, gland homogenates from male and female animals secreted similar amounts of cortisol and the plasma levels in the two sexes were the same.

  5. Premature Ventricular Contractions (PVCs)

    Science.gov (United States)

    Diseases and Conditions Premature ventricular contractions (PVCs) By Mayo Clinic Staff Premature ventricular contractions (PVCs) are extra, abnormal heartbeats that begin in one of your heart's two ...

  6. Echocardiographic assessment of subclinical left ventricular eccentric hypertrophy in adult-onset GHD patients by geometric remodeling: an observational case-control study

    Directory of Open Access Journals (Sweden)

    Trimarchi Francesco

    2006-02-01

    Full Text Available Abstract Background Most patients with growth hormone deficiency (GHD show high body mass index. Overweight subjects, but GHD patients, were demonstrated to have high left ventricular mass index (LVMi and abnormal LV geometric remodeling. We sought to study these characteristics in a group of GHD patients, in an attempt to establish the BMI-independent role of GHD. Methods Fifty-four patients, 28 F and 26 M, aged 45.9 ± 13.1, with adult-onset GHD (pituitary adenomas 48.2%, empty sella 27.8%, pituitary inflammation 5.5%, cranio-pharyngioma 3.7%, not identified pathogenesis 14.8% were enrolled. To minimize any possible interferences of BMI on the aim of this study, the control group included 20 age- and weight-matched healthy subjects. The LV geometry was identified by the relationship between LVMi (cut-off 125 g/m2 and relative wall thickness (cut-off 0.45 at echocardiography. Results There was no significant between-group difference in resting cardiac morphology and function, nor when considering age-related discrepancy. The majority of patients had normal-low LVM/LVMi, but about one fourth of them showed higher values. These findings correlated to relatively high circulating IGF-1 and systolic blood pressure at rest. The main LV geometric pattern was eccentric hypertrophy in 22% of GHD population (26% of with severe GHD and in 15% of controls (p = NS. Conclusion Though the lack of significant differences in resting LV morphology and function, about 25% of GHD patients showed high LVMi (consisting of eccentric hypertrophy, not dissimilarly to overweight controls. This finding, which prognostic role is well known in obese and hypertensive patients, is worthy to be investigated in GHD patients through wider controlled trials.

  7. Doppler-derived strain and strain rate imaging assessment of right ventricular systolic function in adults late after tetralogy of Fallot repair: an observational study.

    Science.gov (United States)

    Sadeghpour, Anita; Kyavar, Majid; Madadi, Shabnam; Ebrahimi, Leili; Khajali, Zahra; Sani, Zahra Alizadeh

    2013-09-01

    Tetralogy of Fallot (TOF) is the most common form of cyanotic congenital heart disease. Today, we are faced with an increasing number of patients with residual pulmonary regurgitation (PR) late after TOF repair. The right ventricular (RV) volumes and function are among the most important factors influencing clinical decision-making. Cardiac magnetic resonance (CMR) is the gold standard method for the quantitative assessment of the RV function; it is, however, expensive for routine clinical follow-up and sometimes is contraindicated. We sought to evaluate the RV systolic function via CMR and compare it with Doppler-derived strain(S) and strain rate (SR) imaging in patients with repaired TOF. In an observational cross-sectional study, 70 patients (22 women, mean age=22±4.9 years) late after TOF repair with severe PR were evaluated. Peak systolic strain and SR in the basal, mid, and apical segments of RV free wall (RVFW) were measured and compared with the RV function measured in the short-axis cine MR. Associations between RVEF and S/SR, investigated by ordinal logistic regression models. Significant association was observed between RV function and mean S of all the three segments of the RVFW segments [OR (CI95%): 1.17 (1.05-1.31)]. Association between RV function and mean SR of all the three segments of the RVFW segments was borderline significant [OR (CI95%): 1.7 (0.97-2.93)]. There was a significant correlation between the Doppler-derived mean strain of RVFW and the RV function measured by CMR in adults late after TOF repair. These quantitative methods improved the assessment of the RV function and served as an additional method to follow up patients with contraindications to CMR.

  8. Usefulness of Left Ventricular Mass and Geometry for Determining 10-Year Prediction of Cardiovascular Disease in Adults Aged >65 Years (from the Cardiovascular Health Study).

    Science.gov (United States)

    Desai, Chintan S; Bartz, Traci M; Gottdiener, John S; Lloyd-Jones, Donald M; Gardin, Julius M

    2016-09-01

    Left ventricular (LV) mass and geometry are associated with risk of cardiovascular disease (CVD). We sought to determine whether LV mass and geometry contribute to risk prediction for CVD in adults aged ≥65 years of the Cardiovascular Health Study. We indexed LV mass to body size, denoted as LV mass index (echo-LVMI), and we defined LV geometry as normal, concentric remodeling, and eccentric or concentric LV hypertrophy. We added echo-LVMI and LV geometry to separate 10-year risk prediction models containing traditional risk factors and determined the net reclassification improvement (NRI) for incident coronary heart disease (CHD), CVD (CHD, heart failure [HF], and stroke), and HF alone. Over 10 years of follow-up in 2,577 participants (64% women, 15% black, mean age 72 years) for CHD and CVD, the adjusted hazards ratios for a 1-SD higher echo-LVMI were 1.25 (95% CI 1.14 to 1.37), 1.24 (1.15 to 1.33), and 1.51 (1.40 to 1.62), respectively. Addition of echo-LVMI to the standard model for CHD resulted in an event NRI of -0.011 (95% CI -0.037 to 0.028) and nonevent NRI of 0.034 (95% CI 0.008 to 0.076). Addition of echo-LVMI and LV geometry to the standard model for CVD resulted in an event NRI of 0.013 (95% CI -0.0335 to 0.0311) and a nonevent NRI of 0.043 (95% CI 0.011 to 0.09). The nonevent NRI was also significant with addition of echo-LVMI for HF risk prediction (0.10, 95% CI 0.057 to 0.16). In conclusion, in adults aged ≥65 years, echo-LVMI improved risk prediction for CHD, CVD, and HF, driven primarily by improved reclassification of nonevents.

  9. Ventricular dilation and elevated aqueductal pulsations in a new experimental model of communicating hydrocephalus

    Energy Technology Data Exchange (ETDEWEB)

    Wagshul, M.; Smith, S.; Wagshul, M.; McAllister, J.P.; Rashid, S.; Li, J.; Egnor, M.R.; Walker, M.L.; Yu, M.; Smith, S.D.; Zhang, G.; Chen, J.J.; Beneveniste, H.

    2009-03-01

    In communicating hydrocephalus (CH), explanations for the symptoms and clear-cut effective treatments remain elusive. Pulsatile flow through the cerebral aqueduct is often significantly elevated, but a clear link between abnormal pulsations and ventriculomegaly has yet to be identified. We sought to demonstrate measurement of pulsatile aqueductal flow of CSF in the rat, and to characterize the temporal changes in CSF pulsations in a new model of CH. Hydrocephalus was induced by injection of kaolin into the basal cisterns of adult rats (n = 18). Ventricular volume and aqueductal pulsations were measured on a 9.4 T MRI over a one month period. Half of the animals developed ventricular dilation, with increased ventricular volume and pulsations as early as one day post-induction, and marked chronic elevations compared to intact controls (volume: 130.15 {+-} 83.21 {mu}l vs. 15.52 {+-} 2.00 {mu}l; pulsations: 114.51 nl {+-} 106.29 vs. 0.72 {+-} 0.13 nl). Similar to the clinical presentation, the relationship between ventricular size and pulsations was quite variable. However, the pulsation time-course revealed two distinct sub-types of hydrocephalic animals: those with markedly elevated pulsations which persisted over time, and those with mildly elevated pulsations which returned to near normal levels after one week. These groups were associated with severe and mild ventriculomegaly respectively. Thus, aqueductal flow can be measured in the rat using high-field MRI and basal cistern-induced CH is associated with an immediate change in CSF pulsatility. At the same time, our results highlight the complex nature of aqueductal pulsation and its relationship to ventricular dilation.

  10. Usefulness of right ventricular and right atrial two-dimensional speckle tracking strain to predict late arrhythmic events in adult patients with repaired Tetralogy of Fallot.

    Science.gov (United States)

    Timóteo, Ana T; Branco, Luísa M; Rosa, Sílvia A; Ramos, Ruben; Agapito, Ana F; Sousa, Lídia; Galrinho, Ana; Oliveira, José A; Oliveira, Mário M; Ferreira, Rui C

    2017-01-01

    To determine whether right ventricular and/or atrial speckle tracking strain is associated with previous arrhythmic events in patients with repaired tetralogy of Fallot. We studied right ventricular and atrial strain in 100 consecutive patients with repaired tetralogy of Fallot referred for routine echocardiographic evaluation. Patients were divided into two groups, one with previous documentation of arrhythmias (n=26) and one without arrhythmias, in a median follow-up of 22 years. Patients with arrhythmias were older (pright ventricular strain (-14.7±5.5 vs. -16.9±4.0%, p=0.029) and right atrial strain (19.1±7.7% vs. 25.8±11.4%, p=0.001). Neither right ventricular nor right atrial strain were independent predictors of the presence of a history of documented arrhythmias, which was associated with age at correction and with the presence of residual defects. In a subanalysis after excluding 23 patients who had had more than one corrective surgery, right ventricular strain was an independent predictor of the presence of previous arrhythmic events (OR 1.19, 95% CI 1.02-1.38, p=0.025). Right atrial strain was also an independent predictor after adjustment (OR 0.93, 95% CI 0.87-0.99, p=0.029). The ideal cut-off for right ventricular strain was -15.3% and for right atrial strain 23.0%. Compared with conventional echocardiographic parameters, strain measures of the right heart are associated with the presence of arrhythmic events, and may be useful for risk stratification of patients with repaired tetralogy of Fallot, although a prospective study is required. Copyright © 2016 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Ventricular torsional relation to ventricular fiber arrangement

    CERN Document Server

    Ranjbar, Saeed; Meybodi, Mahmood Emami

    2014-01-01

    Left ventricular torsion from helically oriented myofibers is a key parameter of cardiac performance. Physicians observing heart motion on echocardiograms, during cardiac catheterization, or in the operating room, are impressed by the twisting or rotary motion of the left ventricle during systole. Conceptually, the heart has been treated as a pressure chamber. The rotary or torsional deformation has been poorly understood by basic scientists and has lacked clinical relevance. The aim of this paper attempts to discuss about this question: Is ventricular twisting related to ventricular fiber arrangement? That is dependent to an assumed model of the left ventricular structure.

  12. Atrial – Ventricular Septal Defect

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    T Panagiotopoulos

    2009-05-01

    Full Text Available Atrial and ventricular septal defect constitute the most common congenital heart disease.Aim: Τhe aim of the present retrospective study was to record data and factors that affect atrial and ventricular septal defect.Method and material: The sample study included patients of both sexes who were hospitalized with diagnosis atrial and ventricular septal defect in a Cardiac Surgery hospital of Athens. A specially constructed printed form was used for data collection, where were recorded the demographic and personal variables, the pathological, surgical, cardiology and obstetric history, the habits of adults, as well as the personal characteristics of mothers. Analysis of data was performed by descriptive statistical analysis.Results: The sample study consisted of 101 individuals with diagnosis atrial or ventricular Septal Defect, of which 40% were boys and 60% girls. The 70% of the sample study suffered from atrial Septal Defect and the 30% suffered from ventricular Septal Defect. Regarding age, 12% of the sample study was 0-1 years old, 35% was >1 years old, 8% was >12-18 years old and 45% over than 18 years old. Regarding educational status of the adult participants, 9% was of 0-6 years education, 22%>6 -12 years, 13%>12 years. 14% of the adult paticipants smoked, 4% consumed alcohol and 5% smoked in conjunction with alcohol. In terms of the obstetric history of the sample studied, 32% of the cases had normal birth, 4% had a twin birth and 1% had a triplet one. According to the variables related to mothers, the mean age of the mother was 30 years and 3 months, 10% were smokers at pregnancy and 3% used chemical substance and mainly hair color. Also, the results of the present study showed that individuals of 12-18 and >18 years old did not suffer from ventricular Septal Defect, whereas the infants 0-1 years old did not suffer from Atrial Septal Defect. The mean value of age at the admission in intensive care unit was 7 months (12% for the infants

  13. Ventricular septal defect (image)

    Science.gov (United States)

    Ventricular septal defect is a congenital defect of the heart, that occurs as an abnormal opening in ... wall that separates the right and left ventricles. Ventricular septal defect may also be associated with other ...

  14. Increased susceptibility of aged hearts to ventricular fibrillation during oxidative stress.

    Science.gov (United States)

    Morita, Norishige; Sovari, Ali A; Xie, Yuanfang; Fishbein, Michael C; Mandel, William J; Garfinkel, Alan; Lin, Shien-Fong; Chen, Peng-Sheng; Xie, Lai-Hua; Chen, Fuhua; Qu, Zhilin; Weiss, James N; Karagueuzian, Hrayr S

    2009-11-01

    Oxidative stress with hydrogen peroxide (H(2)O(2)) readily promotes early afterdepolarizations (EADs) and triggered activity (TA) in isolated rat and rabbit ventricular myocytes. Here we examined the effects of H(2)O(2) on arrhythmias in intact Langendorff rat and rabbit hearts using dual-membrane voltage and intracellular calcium optical mapping and glass microelectrode recordings. Young adult rat (3-5 mo, N = 25) and rabbit (3-5 mo, N = 6) hearts exhibited no arrhythmias when perfused with H(2)O(2) (0.1-2 mM) for up to 3 h. However, in 33 out of 35 (94%) aged (24-26 mo) rat hearts, 0.1 mM H(2)O(2) caused EAD-mediated TA, leading to ventricular tachycardia (VT) and fibrillation (VF). Aged rabbits (life span, 8-12 yr) were not available, but 4 of 10 middle-aged rabbits (3-5 yr) developed EADs, TA, VT, and VF. These arrhythmias were suppressed by the reducing agent N-acetylcysteine (2 mM) and CaMKII inhibitor KN-93 (1 microM) but not by its inactive form (KN-92, 1 microM). There were no significant differences between action potential duration (APD) or APD restitution slope before or after H(2)O(2) in aged or young adult rat hearts. In histological sections, however, trichrome staining revealed that aged rat hearts exhibited extensive fibrosis, ranging from 10-90%; middle-aged rabbit hearts had less fibrosis (5-35%), whereas young adult rat and rabbit hearts had ventricular base where fibrosis was intermediate ( approximately 30%). Computer simulations in two-dimensional tissue incorporating variable degrees of fibrosis showed that intermediate (but not mild or severe) fibrosis promoted EADs and TA. We conclude that in aged ventricles exposed to oxidative stress, fibrosis facilitates the ability of cellular EADs to emerge and generate TA, VT, and VF at the tissue level.

  15. The human adult cardiomyocyte phenotype

    NARCIS (Netherlands)

    Bird, SD; Doevendans, PA; van Rooijen, MA; de la Riviere, AB; Hassink, RJ; Passier, R; Mummery, CL

    2003-01-01

    Aim: Determination of the phenotype of adult human atrial and ventricular myocytes based on gene expression and morphology. Methods: Atrial and ventricular cardiomyocytes were obtained from patients undergoing cardiac surgery using a modified isolation procedure. Myocytes were isolated and cultured

  16. Older Adults, "Malignant" Left Ventricular Hypertrophy, and Associated Cardiac-Specific Biomarker Phenotypes to Identify the Differential Risk of New-Onset Reduced Versus Preserved Ejection Fraction Heart Failure: CHS (Cardiovascular Health Study).

    Science.gov (United States)

    Seliger, Stephen L; de Lemos, James; Neeland, Ian J; Christenson, Robert; Gottdiener, John; Drazner, Mark H; Berry, Jarett; Sorkin, John; deFilippi, Christopher

    2015-06-01

    This study hypothesized that biomarkers of subclinical myocardial injury (high-sensitivity cardiac troponin T [hs-cTnT]) and hemodynamic stress (N-terminal pro-B-type natriuretic peptide [NT-proBNP]) would differentiate heart failure (HF) risk among older adults with left ventricular hypertrophy (LVH). The natural history of LVH, an important risk factor for HF, is heterogeneous. NT-proBNP and hs-cTnT were measured at baseline and after 2 to 3 years in older adults without prior HF or myocardial infarction in the CHS (Cardiovascular Health Study). LVH and left ventricular ejection fraction were determined by echocardiography. HF events were adjudicated over a median of 13.1 years and classified as preserved or reduced left ventricular ejection fraction (heart failure with preserved ejection fraction or heart failure with reduced ejection fraction [HFrEF]). Adjusted risk of HF by LVH and biomarker tertiles, and by LVH and longitudinal increase in each biomarker was estimated using Cox regression. Prevalence of LVH was 12.5% among 2,347 participants with complete measures. Adjusted risk of HF (N = 643 events) was approximately 3.8-fold higher among participants with LVH and in the highest biomarker tertile, compared with those with low biomarker levels without LVH (NT-proBNP, hazard ratio [HR]: 3.78; 95% confidence interval [CI]: 2.78 to 5.15 and hs-cTnT, HR: 3.86; 95% CI: 2.84 to 5.26). The adjusted risk of HFrEF was 7.8 times higher among those with the highest tertile of hs-cTnT and LVH (HR: 7.83; 95% CI: 4.43 to 13.83). Those with LVH and longitudinal increases in hs-cTnT or NT-proBNP were approximately 3-fold more likely to develop HF, primarily HFrEF, compared with those without LVH and with stable biomarkers. The combination of LVH with greater hs-cTnT or NT-proBNP levels, and their longitudinal increase, identifies older adults at highest risk for symptomatic HF, especially HFrEF. These biomarkers may characterize sub-phenotypes in the transition from LVH

  17. Relation Between Parameters of Myocardial Mechanics and Ventricular Arterial Coupling: A Three-Dimensional Speckle-Tracking Study in Healthy Adults

    Directory of Open Access Journals (Sweden)

    Esmaeilzadeh

    2015-08-01

    Full Text Available Background Understanding the relation between ventricular-arterial coupling (VAC and myocardial mechanical parameters could offer an adjunctive perspective on left ventricular function. Objectives Our aim was to study the relation between VAC and the parameters of myocardial mechanics using three-dimensional speckle-tracking echocardiography (3DSTE. Patients and Methods We studied 68 normal participants (mean age, 35 ± 12.2 y; 36 [53%] males. VAC was measured by the ratio of arterial elastance (Ea to ventricular elastance (Ees. The peak systolic value of longitudinal strain (LS, circumferential strain (CS, radial strain, three-dimensional global strain (3DGS, apical rotation, torsion, and twist and their time to peak were calculated. Results Almost all deformation indices were higher in the women than in the men. LS (r = -0.41, P < 0.01, twist (r = 0.26, P < 0.03, rotation (r = 0.41, P < 0.01, and 3DGS (r = - 0.39, P < 0.01 were associated with age. Although significant associations were found between VAC and Ea or Ees in the men and women, no relation was found between Ea and Ees in both sexes (r = 0.07 in men and r = 0.08 in women. Indeed, VAC had a stronger association with Ea than with Ees (r = 0.708 vs. r = -0.537. Ees and VAC were related to torsion (r = 0.30 vs. r = -0.37; both P < 0.05; and Ea, Ees, and VAC were also associated with CS (r = 0.64, r = -0.45, and r = 0.79; all P < 0.05 and 3DGS (r = -0.55, r = 0.38, and r = -0.64; all P < 0.01. Conclusions Amongst all myocardial mechanical parameters, VAC was related to CS and 3DGS as well as torsion.

  18. A rare case of isolated non-compaction right ventricular myocardium

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xiao-juan; ZHI Guang; HOU Hai-jun; ZHOU Xiao

    2009-01-01

    Isolated right ventricular noncompaction (IRNC) is a rare congenital cardiomyopathy resulting from an arrest in normal endomyocardial embryogenesis. The clinical syndrome includes systolic and diastolic dysfunction; some cases may have ventricular arrhythmias. We report a case of a female with the diagnosis of right ventricular non-compaction myocardium (RVNC) with normal left ventricular systolic function. To the best of our knowledge, there have been no reports of isolated ventricular non-compaction involving only the right ventricular before 2008, and there have only been described in very few cases of newborns and adult patients.

  19. Right and left ventricular function and myocardial scarring in adult patients with sickle cell disease: a comprehensive magnetic resonance assessment of hepatic and myocardial iron overload.

    Science.gov (United States)

    Junqueira, Flávia P; Fernandes, Juliano L; Cunha, Guilherme M; T A Kubo, Tadeu; M A O Lima, Claudio; B P Lima, Daniel; Uellendhal, Marly; Sales, Sidney R; A S Cunha, Carolina; L R de Pessoa, Viviani; L C Lobo, Clarisse; Marchiori, Edson

    2013-09-19

    Patients with Sickle cell disease (SCD) who receive regular transfusions are at risk for developing cardiac toxicity from iron overload. The aim of this study was to assess right and left cardiac volumes and function, late gadolinium enhancement (LGE) and iron deposits in patients with SCD using CMR, correlating these values with transfusion burden, ferritin and hemoglobin levels. Thirty patients with SCD older than 20 years of age were studied in a 1.5 T scanner and compared to age- and sex-matched normal controls. Patients underwent analysis of biventricular volumes and function, LGE and T2* assessment of the liver and heart. When compared to controls, patients with SCD presented higher left ventricular (LV) volumes with decreased ejection fraction (EF) with an increase in stroke volume (SV) and LV hypertrophy. The right ventricle (RV) also presented with a decreased EF and hypertrophy, with an increased end-systolic volume. Although twenty-six patients had increased liver iron concentrations (median liver iron concentration value was 11.83 ± 9.66 mg/g), only one patient demonstrated an abnormal heart T2* < 20 msec. Only four patients (13%) LGE, with only one patient with an ischemic pattern. Abnormal heart iron levels and myocardial scars are not a common finding in SCD despite increased liver iron overload. The significantly different ventricular function seen in SCD compared to normal suggests the changes in RV and LV function may not be due to the anemia alone. Future studies are necessary to confirm this association.

  20. Operação de Fontan-Kreutzer em anomalias cardíacas complexas outras que não atresia tricúspide lb, ventrículo único e atresia pulmonar com septo ventricular íntegro The operation of Fontan-Kreutzer in complex congenital anomalies other than lb isolated tricuspid atresia, single ventricle and pulmonary atresia with intact septum

    Directory of Open Access Journals (Sweden)

    Miguel Barbero-Marcial

    1988-08-01

    Full Text Available Oitenta e quatro pacientes foram submetidos a operação tipo Fontan, no Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, entre 1979 e 1989; as idades variaram entre 5 meses e 31 anos. Estes pacientes foram colocados em 5 grupos anatômicos: 1 atresia tricúspide la, 3 pacientes (1 óbito, 33,3%; 2 atresia tricúspide lb, 48 pacientes (5 óbitos, 10,4%; 3 ventrículo único: 18 pacientes (2 óbitos, 11,1%; 4 atresia pulmonar com septo interventricular íntegro, 5 pacientes (1 óbito, 20,0%; 5 anomalias complexas, 10 pacientes (zero óbitos. O grupo das anomalias complexas foi dividido em 2 subgrupos: pacientes com situs solitus e pacientes com situs inversus. A maioria destes pacientes foi submetida a procedimentos adicionais: em 5 pacientes, uma das valvas A-V foi fechada; em 1 paciente, foram realizadas valvoplastia mitral e septação do átrio único; em 1 paciente, foi realizada a secção de feixe anômalo (feixe de Kent. A evolução tardia (6 meses a 8 anos revelou que 9 pacientes encontram-se em classe funcional I e 1 na classe funcional II (NYHA. Baseados nos resultados obtidos, concluímos que a operação de Fontan modificada é uma alternativa válida em anomalias cianóticas complexas.Between 1979 and 1989, 84 patients underwent a Fontan operation or one of its modifications; the ages ranged from 5 months to 31 years. Patients were placed into five anatomic groups: 1 tricuspid atresia la (3 cases, 1 death, 33.3%; 2 tricuspid atresia lb (48 cases, 5 deaths, 10.4%; 3 single ventricle (18 cases, 2 deaths, 11.1%; 4 pulmonary atresia, intact ventricular septum (5 cases, 1 death, 20.0%; 5 complex anomalies (10 cases, no deaths. The subgroup of complex anomalies was divided in: with situs inversus and with situs solitus. In the majority of these patients, additional procedures were performed; in 5, one A-V valve was closed; in 2, complex atrial septation was done; in 1, a mitral

  1. Using medical imaging for the detection of adverse events ("incidents") during the utilization of left ventricular assist devices in adult patients with advanced heart failure.

    Science.gov (United States)

    Kaufmann, Friedrich; Krabatsch, Thomas

    2016-05-01

    Ventricular assist devices (VAD) are used for mechanical support of the terminally failing heart. Failure of these life supporting systems can be fatal. Early and reliable detection of any upcoming problems is mandatory and is crucial for the outcome. Medical imaging methods are described within this review, which are not only essential for diagnosis of typically VAD-related complications but also for the detection or verification of technical issues. Within this review the utilization of medical imaging equipment for the diagnosis of technical malfunctions or damages of implanted system components is discussed. A newly developed specialized acoustic imaging method for pump thrombosis detection will also be described along with the most common VAD-related medical complications and their respective imaging methods and the limitations induced by the use of the VAD-system.

  2. A Rare Case of Pulmonary Atresia with Ventricular Septal Defect with a Right Sided Aortic Arch and a Calcified Pulmonary AVM Presenting in an Adult without Cyanosis

    Directory of Open Access Journals (Sweden)

    Devendra V. Kulkarni

    2014-01-01

    Full Text Available Pulmonary atresia with ventricular septal defect (PA-VSD with pulmonary arterial supply arising from the aorta representing large MAPCAs associated with a right sided aortic arch is an uncommon anomaly. Most of the patients succumb to severe respiratory compromise or congestive cardiac failure very early. We report the clinical details and imaging findings of a case of PA-VSD with a right sided aortic arch and a calcified pulmonary arteriovenous malformation (AVM in a 21-year-old postpartum female with no previous episodes of cyanosis who was diagnosed as having a cardiac anomaly on echocardiography when she presented with breathlessness during the 8th month of the pregnancy.

  3. Ventricular hypertrophy--physiological mechanisms.

    Science.gov (United States)

    Vaughan Williams, E M

    1986-01-01

    Adult cardiac myocytes are incapable of mitosis. Dead cells are replaced by connective tissue so that after myocardial infarction (MI), function can only be restored by compensatory hypertrophy of the surviving myocardium. In physiological hypertrophy in response to exercise, high altitude, or mild hypertension, additional myoplasm expands cell diameter in an orderly fashion; Z-lines are in register and the normal ratio of volume densities of contractile elements, mitochondria, and capillaries is conserved. In hypertrophy induced by aortic or pulmonary artery banding or by experimental or congenital hypertension, the borderline between physiological and pathological hypertrophy may be crossed, causing disorganization of fibers and an unfavourable contractile element to capillary ratio. There was, therefore, a need for a graded model of hypertrophy, which involves simulating an altitude of 6,000 m at sea level by supplying rabbits with appropriate nitrogen/oxygen mixtures. In this environment, 50% right ventricular hypertrophy can be achieved without alteration of left ventricular weight or hematocrit. Longer exposures produced 100% right ventricular hypertrophy, with only moderate increases in hematocrit and left ventricular weight. It is well known that adrenergic stimulation causes cardiac hypertrophy, and it has been suggested that release of a trophic factor from sympathetic nerves, either noradrenaline or a protein, might be a necessary stimulus for growth. If so, long-term treatment of post-MI patients with beta-adrenergic blocking agents could inhibit a desirable compensatory hypertrophy of the surviving myocardium. In the above model it has been found, however, that neither beta-blockade nor chemical sympathectomy with guanethidine or 6-hydroxydopamine had any effect on the hypertrophy, nor did treatment with verapamil or nifedipine.(ABSTRACT TRUNCATED AT 250 WORDS)

  4. Augmentation of sarcolemmal Ca by anionic amphiphile: contractile response of three ventricular tissues.

    Science.gov (United States)

    Langer, G A; Rich, T L

    1986-02-01

    The anionic amphiphile dodecyl sulfate was used at the concentration of 100 microM, below the concentration at which membrane permeability is compromised. In rat myocardial tissue culture dodecyl sulfate induced a large increase in Ca uptake in the intact cells, of which 84% was distributed in a rapidly exchangeable (t1/2 less than 18 s) and 16% in a slowly exchangeable (t1/2 = 17 min) compartment. Dodecyl sulfate induced a large increase in Ca bound to isolated sarcolemmal membrane of these cells. This increase in membrane binding and the distribution in whole cells is consistent with insertion of dodecyl sulfate in the sarcolemma (SL) with subsequent Ca binding to its anionic head group. With perfusate extracellular calcium concentration ([Ca]o) equal to 1 mM, dodecyl sulfate produced greater than 60% increase in active force in ventricular tissue from adult rabbit and neonatal rat but virtually no increase in adult rat ventricle. Preperfusion with 0.1 mM [Ca]o or 10(-6) M ryanodine markedly increased the relative response of adult rat ventricle to dodecyl sulfate. After a quiescent period in rabbit ventricle, dodecyl sulfate caused a progressive increase of force of each beat compared with control; i.e., the treppe response was increased at each successive beat. This did not occur in adult rat ventricle. These results further clarify the different quantitative role of SL-bound versus sarcotubular Ca in the hearts of different species.

  5. Ventricular Assist Device Support

    Science.gov (United States)

    Fasseas, Panayotis; Kutalek, Steven P.; Samuels, Fania L.; Holmes, Elena C.; Samuels, Louis E.

    2002-01-01

    We describe herein the cases of 2 patients who had ventricular arrhythmias. In one, a short-term biventricular assist device, the ABIOMED BVS 5000, was placed because the patient had sustained ventricular tachycardia and could not be weaned from cardiopulmonary bypass. Excellent hemodynamic support was maintained for several days while the antiarrhythmic therapy was maximized. Sinus rhythm was restored, and the patient was successfully weaned from the ventricular assist device. However, the substrate for the arrhythmia persisted, and a recurrence, 1 week later, resulted in the patient's death. In the 2nd patient, the use of an implantable left ventricular assist device was successful in temporarily alleviating the ventricular tachycardia associated with ischemic cardiomyopathy. However, after 2 days of device assistance, the patient experienced a recurrence of the tachycardia, which degenerated into ventricular fibrillation with a marked deterioration in the patient's hemodynamics. The arrhythmia persisted despite multiple attempts at external cardioversion, and internal cardioversion and placement of an automatic implantable cardioverter-defibrillator were necessary. This treatment, along with repeated boluses of amiodarone, led to successful suppression of the arrhythmias, and the patient eventually underwent transplantation. The mechanical hemodynamic support of the circulation by ventricular assist devices was effective in supporting these 2 patients who had sustained ventricular arrhythmias. (Tex Heart Inst J 2002;29:33–6) PMID:11995847

  6. Ventricular tachycardia in acromegaly.

    Science.gov (United States)

    Arias, Miguel A; Pachón, Marta; Rodríguez-Padial, Luis

    2011-02-01

    Cases of sudden cardiac death have been reported in patients with acromegaly. Malignant ventricular arrhythmias may play an important role in this fatal complication, but the exact mechanisms are not well understood. We report on an acromegalic patient presenting with documented recurrent syncopal ventricular tachycardia.

  7. Identification of Intrinsic Axon Growth Modulators for Intact CNS Neurons after Injury

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    Kathren L. Fink

    2017-03-01

    Full Text Available Functional deficits persist after spinal cord injury (SCI because axons in the adult mammalian central nervous system (CNS fail to regenerate. However, modest levels of spontaneous functional recovery are typically observed after trauma and are thought to be mediated by the plasticity of intact circuitry. The mechanisms underlying intact circuit plasticity are not delineated. Here, we characterize the in vivo transcriptome of sprouting intact neurons from Ngr1 null mice after partial SCI. We identify the lysophosphatidic acid signaling modulators LPPR1 and LPAR1 as intrinsic axon growth modulators for intact corticospinal motor neurons after adjacent injury. Furthermore, in vivo LPAR1 inhibition or LPPR1 overexpression enhances sprouting of intact corticospinal tract axons and yields greater functional recovery after unilateral brainstem lesion in wild-type mice. Thus, the transcriptional profile of injury-induced sprouting of intact neurons reveals targets for therapeutic enhancement of axon growth initiation and new synapse formation.

  8. Left ventricular diastolic function in patients with advanced cystic fibrosis.

    Science.gov (United States)

    Koelling, Todd M; Dec, G William; Ginns, Leo C; Semigran, Marc J

    2003-05-01

    To assess left ventricular systolic and diastolic function in adult patients with cystic fibrosis using radionuclide ventriculography. Although myocardial fibrosis has been described in autopsy specimens of patients with cystic fibrosis, the possibility that myocardial dysfunction may occur during life in adult patients with cystic fibrosis has not been explored. To assess the possibility of cardiac dysfunction occurring in cystic fibrosis, we studied 40 patients with advanced cystic fibrosis with first-pass radionuclide ventriculography and compared them to 9 patients with advanced bronchiectasis and 18 normal control subjects. Indexes of right ventricular systolic function were similarly impaired in patients with cystic fibrosis and patients with bronchiectasis. Left ventricular ejection fraction of patients with cystic fibrosis, patients with bronchiectasis, and normal control subjects did not differ. Fractional left ventricular filling at 50% of diastole, an index of diastolic function, was significantly lower in patients with cystic fibrosis (54 +/- 13%, mean +/- SD) in comparison to patients with bronchiectasis (66 +/- 4%, p = 0.009) or normal control subjects (69 +/- 14, p = 0.0002). The contribution of atrial systole to total diastolic left ventricular filling was greater in patients with cystic fibrosis (38 +/- 18%) than in patients with bronchiectasis (21 +/- 4%, p = 0.01) or normal control subjects (25 +/- 12%, p = 0.01). Patients with advanced cystic fibrosis demonstrate impaired left ventricular distensibility when compared to normal control subjects and patients with bronchiectasis. Patients with cystic fibrosis may be at risk of heart failure due to right ventricular dysfunction or left ventricular diastolic dysfunction.

  9. Spelling-stress regularity effects are intact in developmental dyslexia.

    Science.gov (United States)

    Mundy, Ian R; Carroll, Julia M

    2013-01-01

    The current experiment investigated conflicting predictions regarding the effects of spelling-stress regularity on the lexical decision performance of skilled adult readers and adults with developmental dyslexia. In both reading groups, lexical decision responses were significantly faster and significantly more accurate when the orthographic structure of a word ending was a reliable as opposed to an unreliable predictor of lexical stress assignment. Furthermore, the magnitude of this spelling-stress regularity effect was found to be equivalent across reading groups. These findings are consistent with intact phoneme-level regularity effects also observed in dyslexia. The paper discusses how findings of intact spelling-sound regularity effects at both prosodic and phonemic levels, as well as other similar results, can be reconciled with the obvious difficulties that people with dyslexia experience in other domains of phonological processing.

  10. Assessment of left ventricular non-compaction in adults: side-by-side comparison of cardiac magnetic resonance imaging with echocardiography.

    Science.gov (United States)

    Thuny, Franck; Jacquier, Alexis; Jop, Bertrand; Giorgi, Roch; Gaubert, Jean-Yves; Bartoli, Jean-Michel; Moulin, Guy; Habib, Gilbert

    2010-03-01

    Two-dimensional echocardiography images obtained at end-diastole and end-systole and cardiac magnetic resonance (CMR) images obtained at end-diastole represent the three imaging methodologies validated for diagnosis of left ventricular non-compaction (LVNC). No study has compared these methodologies in assessing the magnitude of non-compaction. To compare two-dimensional echocardiography with CMR in the evaluation of patients with suspected LVNC. Sixteen patients (48+/-17 years) with LVNC underwent echocardiography and CMR within the same week. Echocardiography images obtained at end-diastole and end-systole were compared in a blinded fashion with those obtained by CMR at end-diastole to assess non-compaction in 17 anatomical segments. All segments could be analysed by CMR, whereas only 238 (87.5%) and 237 (87.1%) could be analysed by echocardiography at end-diastole and end-systole, respectively (p=0.002). Among the analysable segments, a two-layered structure was observed in 54.0% by CMR, 42.9% by echocardiography at end-diastole and 41.4% by echocardiography at end-systole (p=0.006). Similar distribution patterns were observed with the two echocardiographic methodologies. However, compared with echocardiography, CMR identified a higher rate of two-layered structures in the anterior, anterolateral, inferolateral and inferior segments. Echocardiography at end-systole underestimated the NC/C maximum ratio compared with CMR (p=0.04) and echocardiography at end-diastole (p=0.003). No significant difference was observed between CMR and echocardiography at end-diastole (p=0.83). Interobserver reproducibility of the NC/C maximum ratio was similar for the three methodologies. CMR appears superior to standard echocardiography in assessing the extent of non-compaction and provides supplemental morphological information beyond that obtained with conventional echocardiography.

  11. Use of Catheter Ablation in the Treatment of Ventricular Tachycardia Triggered by Premature Ventricular Contraction

    Directory of Open Access Journals (Sweden)

    Isao Kato, MD

    2006-01-01

    Full Text Available A 50-year-old man who had suffered from old myocardial infarction presented with an episode of syncope. DC shock was required for the interruption of frequent pleomorphic ventricular tachycardia (VT. Although the treatment for heart failure decreased the frequency of VT attacks, hemodynamically unstable VT occurred several times. A 12-lead Holter electrocardiogram was used to determine the triggering premature ventricular contraction (PVC and catheter ablation was performed by targeting this PVC. The site of origin of the triggering PVC was considered to be located between damaged cardiac muscle and intact Purkinje's fiber. No episode of PVC and VT was observed after a few days of ablation. An implantable cardioverter defibrillator was implanted but VT did not recur for more than 20 months.

  12. Right ventricular dysfunction affects survival after surgical left ventricular restoration.

    Science.gov (United States)

    Couperus, Lotte E; Delgado, Victoria; Palmen, Meindert; van Vessem, Marieke E; Braun, Jerry; Fiocco, Marta; Tops, Laurens F; Verwey, Harriëtte F; Klautz, Robert J M; Schalij, Martin J; Beeres, Saskia L M A

    2017-04-01

    Several clinical and left ventricular parameters have been associated with prognosis after surgical left ventricular restoration in patients with ischemic heart failure. The aim of this study was to determine the prognostic value of right ventricular function. A total of 139 patients with ischemic heart failure (62 ± 10 years; 79% were male; left ventricular ejection fraction 27% ± 7%) underwent surgical left ventricular restoration. Biventricular function was assessed with echocardiography before surgery. The independent association between all-cause mortality and right ventricular fractional area change, tricuspid annular plane systolic excursion, and right ventricular longitudinal peak systolic strain was assessed. The additive effect of multiple impaired right ventricular parameters on mortality also was assessed. Baseline right ventricular fractional area change was 42% ± 9%, tricuspid annular plane systolic excursion was 18 ± 3 mm, and right ventricular longitudinal peak systolic strain was -24% ± 7%. Within 30 days after surgery, 15 patients died. Right ventricular fractional area change (hazard ratio, 0.93; 95% confidence interval, 0.88-0.98; P right ventricular longitudinal peak systolic strain (hazard ratio, 1.15; 95% confidence interval, 1.05-1.26; P Right ventricular function was impaired in 21%, 20%, and 27% of patients on the basis of right ventricular fractional area change, tricuspid annular plane systolic excursion, and right ventricular longitudinal peak systolic strain, respectively. Any echocardiographic parameter of right ventricular dysfunction was present in 39% of patients. The coexistence of several impaired right ventricular parameters per patient was independently associated with increased 30-day mortality (hazard ratio, 2.83; 95% confidence interval, 1.64-4.87, P right ventricular systolic dysfunction is independently associated with increased mortality in patients with ischemic heart failure undergoing surgical left

  13. Left Ventricular Hypertrophy

    Science.gov (United States)

    ... the chamber itself also increases. The enlarged heart muscle loses elasticity and eventually may fail to pump with as much force as needed. Left ventricular hypertrophy is more common in people who have uncontrolled ...

  14. Intact Transition Epitope Mapping (ITEM)

    Science.gov (United States)

    Yefremova, Yelena; Opuni, Kwabena F. M.; Danquah, Bright D.; Thiesen, Hans-Juergen; Glocker, Michael O.

    2017-08-01

    Intact transition epitope mapping (ITEM) enables rapid and accurate determination of protein antigen-derived epitopes by either epitope extraction or epitope excision. Upon formation of the antigen peptide-containing immune complex in solution, the entire mixture is electrosprayed to translate all constituents as protonated ions into the gas phase. There, ions from antibody-peptide complexes are separated from unbound peptide ions according to their masses, charges, and shapes either by ion mobility drift or by quadrupole ion filtering. Subsequently, immune complexes are dissociated by collision induced fragmentation and the ion signals of the "complex-released peptides," which in effect are the epitope peptides, are recorded in the time-of-flight analyzer of the mass spectrometer. Mixing of an antibody solution with a solution in which antigens or antigen-derived peptides are dissolved is, together with antigen proteolysis, the only required in-solution handling step. Simplicity of sample handling and speed of analysis together with very low sample consumption makes ITEM faster and easier to perform than other experimental epitope mapping methods.

  15. Dynamic changes of left ventricular performance and left atrial volume induced by the mueller maneuver in healthy young adults and implications for obstructive sleep apnea, atrial fibrillation, and heart failure.

    Science.gov (United States)

    Orban, Marek; Bruce, Charles J; Pressman, Gregg S; Leinveber, Pavel; Romero-Corral, Abel; Korinek, Josef; Konecny, Tomas; Villarraga, Hector R; Kara, Tomas; Caples, Sean M; Somers, Virend K

    2008-12-01

    Using the Mueller maneuver (MM) to simulate obstructive sleep apnea (OSA), our aim was to investigate acute changes in left-sided cardiac morphologic characteristics and function which might develop with apneas occurring during sleep. Strong evidence supports a relation between OSA and both atrial fibrillation and heart failure. However, acute effects of airway obstruction on cardiac structure and function have not been well defined. In addition, it is unclear how OSA might contribute to the development of atrial fibrillation and heart failure. Echocardiography was used in healthy young adults to measure various parameters of cardiac structure and function. Subjects were studied at baseline, during, and immediately after performance of the MM and after a 10-minute recovery. Continuous heart rate, blood pressure, and pulse oximetry measurements were made. During the MM, left atrial (LA) volume index markedly decreased. Left ventricular (LV) end-systolic dimension increased in association with a decrease in LV ejection fraction. On release of the maneuver, there was a compensatory increase in blood flow to the left side of the heart, with stroke volume, ejection fraction, and cardiac output exceeding baseline. After 10 minutes of recovery, all parameters returned to baseline. In conclusion, sudden imposition of severe negative intrathoracic pressure led to an abrupt decrease in LA volume and a decrease in LV systolic performance. These changes reflected an increase in LV afterload. Repeated swings in afterload burden and chamber volumes may have implications for the future development of atrial fibrillation and heart failure.

  16. 超声心动图评价不同年龄正常成人左室舒张功能的研究%Echocardiographic evaluation of left ventricular diastolic function in healthy adults in differ-ent ages

    Institute of Scientific and Technical Information of China (English)

    李竹琴; 朱向明; 李国杰; 张霞

    2015-01-01

    Objective:To assess the characteristic changes of left ventricular diastolic function in healthy adults in different ages with Doppler echocardio-graphy for the relationship between age and changes.Methods:Methods:186 healthy adults were allocated to three groups:Adult group (18-40 years,n=32 ses),middle-aged group (41-65 years,n=88),the older group( >65 years,n =66).Evaluation of the left ventricular diastolic function was per-formed in accordance with American Society of Echocardiography,ASE-2010),and the index were measured in left atrial diameter (LAD),left ventricu-lar diameter(LVD),the peak velocity of the early diastolic filling wave (E),the peak velocity of the late diastolic filling wave (A),peak early diastolic mitral annular velocity (e) and E/e.Results:LAD was increased (P<0.05),whereas the ratio of E,E/A and e was decreased with age.A and E/e were also increased with age.In the three groups,the differences between diastolic function parameters (E,A,e,E/e) were statistically significant (P<0.01). E/A in adult group was higher than that of two other groups (P<0.01).LAD,A and E/e ratio was positively correlated with age (r=0.333,0.566, 0.666,respectively,both P<0.05).The ratio of E,E/A,E/A was in negative correlation with age(r=-0.528,-0.383, -0.834;all P <0.05). Conclusion:Left ventricular diastolic function tends to change and to be dysfunctioned with ages .%目的:评价超声心动图检测不同年龄正常成人左心室舒张功能改变特征,并探讨其随年龄变化的关系。方法:选取186例健康成人分为3组:青年组(18~40岁)32例、壮年组(41~65岁)88例、老年组(>65岁)66例。参照美国超声心动图学会( american society of echocardiography,ASE)2010年推荐的超声心动图评估左心功能指南,常规超声测量左心房前后径( LAD)、左心室前后径( LVD)、舒张早期二尖瓣血流峰值流速( E)、舒张晚期二尖瓣血流峰值流速( A)、舒张

  17. Nursing experience of Beta blocker in treating perioperative malignant ventricular arrhythmia in adult rheumatic valves patients%心脏瓣膜病围术期恶性室性心律失常应用β-受体阻滞剂的护理体会

    Institute of Scientific and Technical Information of China (English)

    李坤

    2011-01-01

    Objective To Retrospectively assess the nursing experience of β- receptor blockers in treating perioperative malignant ventricular arrhythmias of adult rheumatic valves patients. Methods The data of 52 adult rheumatic valves patients with malignant ventricular arrhythmias from the first week before surgery to 1 month after the operation was collected. Ventricular arrhythmias were detected by bedside monitor. Once malignant ventricular arrhythmia was found, β - receptor blocker injection was used. Nurses monitored the haemodynamics and electrolyte strictly, paying close attention to effects of pharmaceutical drugs. Results Malignant ventricular arrhythmias were effectively controlled. All 52 patients recovered.%目的 回顾性评估心脏瓣膜病围术期并发恶性室性心律失常,应用β-受体阻滞剂治疗的护理体会.方法 收集本科风湿性心脏瓣膜病术前1周-术后1月出现恶性室性心律失常的患者52例,均用床边心电监测,一旦发现恶性室性心律失常,予β-受体阻滞剂静脉注射,严密监测血流动力学及电解质变化,重视用药护理.结果 恶性室性心律失常得到有效控制,52例患者均治愈.结论 发生室性心律失常的患者使用β受体阻滞剂治疗,配合良好的护理和监测可使药物疗效更加满意.

  18. Volumetric analysis of the African elephant ventricular system.

    Science.gov (United States)

    Maskeo, Busisiwe C; Spocter, Muhammed A; Haagensen, Mark; Manger, Paul R

    2011-08-01

    This study used magnetic resonance imaging (MRI) to determine the volume of the ventricular system in the brain of three adult male African elephants (Loxodonta africana). The ventricular system of the elephant has a volume of ∼240 mL, an order of magnitude larger than that seen in the adult human. Despite this large size, allometric analysis indicates that the volume of the ventricles in the elephant is what one would expect for a mammal with an ∼5 kg brain. Interestingly, our comparison with other mammals revealed that primates appear to have small relative ventricular volumes, and that megachiropterans and microchiropterans follow different scaling rules when comparing ventricular volume to brain mass indicating separate phylogenetic histories. The current study provides context for one aspect of the elephant brain in the broader picture of mammalian brain evolution. Copyright © 2011 Wiley-Liss, Inc.

  19. Oxidative stress decreases microtubule growth and stability in ventricular myocytes

    OpenAIRE

    Drum, BML; Yuan, C.; Li, L; Liu, Q.; Wordeman, L; Santana, LF

    2016-01-01

    © 2016 Elsevier Ltd.Microtubules (MTs) have many roles in ventricular myocytes, including structural stability, morphological integrity, and protein trafficking. However, despite their functional importance, dynamic MTs had never been visualized in living adult myocytes. Using adeno-associated viral vectors expressing the MT-associated protein plus end binding protein 3 (EB3) tagged with EGFP, we were able to perform live imaging and thus capture and quantify MT dynamics in ventricular myocyt...

  20. Sequential Notch activation regulates ventricular chamber development

    OpenAIRE

    D'Amato, Gaetano

    2016-01-01

    Tesis doctoral inédita, leída en la Universidad Autónoma de Madrid, Facultad de Medicina, Departamento de Bioquímica. Fecha de lectura: 15 de enero de 2016 Ventricular chamber morphogenesis is a beautiful example of tissue interactions orchestrating a precise gene regulatory network essential for tissue patterning, cellular proliferation and differentiation that ultimately lead to a fully compacted and functional adult ventricle. The Notch signaling pathway is a crucial regulator ...

  1. TGF-β1, released by myofibroblasts, differentially regulates transcription and function of sodium and potassium channels in adult rat ventricular myocytes.

    Directory of Open Access Journals (Sweden)

    Kuljeet Kaur

    Full Text Available Cardiac injury promotes fibroblasts activation and differentiation into myofibroblasts, which are hypersecretory of multiple cytokines. It is unknown whether any of such cytokines are involved in the electrophysiological remodeling of adult cardiomyocytes. We cultured adult cardiomyocytes for 3 days in cardiac fibroblast conditioned medium (FCM from adult rats. In whole-cell voltage-clamp experiments, FCM-treated myocytes had 41% more peak inward sodium current (I(Na density at -40 mV than myocytes in control medium (p3 fold greater in FCM than control, which suggested that FCM effects could be mediated by TGF-β1. This was confirmed by pre-treatment with TGF-β1 neutralizing antibody, which abolished the FCM-induced changes in both I(Na and I(to. In current-clamp experiments TGF-β1 (10 ng/ml prolonged the action potential duration at 30, 50, and 90 repolarization (p<0.05; at 50 ng/ml it gave rise to early afterdepolarizations. In voltage-clamp experiments, TGF-β1 increased I(Na density in a dose-dependent manner without affecting voltage dependence of activation or inactivation. I(Na density was -36.25±2.8 pA/pF in control, -59.17±6.2 pA/pF at 0.1 ng/ml (p<0.01, and -58.22±6.6 pA/pF at 1 ng/ml (p<0.01. In sharp contrast, I(to density decreased from 22.2±1.2 pA/pF to 12.7±0.98 pA/pF (p<0.001 at 10 ng/ml. At 1 ng/ml TGF-β1 significantly increased SCN5A (Na(V1.5 (+73%; p<0.01, while reducing KCNIP2 (Kchip2; -77%; p<0.01 and KCND2 (K(V4.2; -50% p<0.05 mRNA levels. Further, the TGF-β1-induced increase in I(Na was mediated through activation of the PI3K-AKT pathway via phosphorylation of FOXO1 (a negative regulator of SCN5A. TGF-β1 released by myofibroblasts differentially regulates transcription and function of the main cardiac sodium channel and of the channel responsible for the transient outward current. The results provide new mechanistic insight into the electrical remodeling associated with myocardial injury.

  2. TGF-β1, Released by Myofibroblasts, Differentially Regulates Transcription and Function of Sodium and Potassium Channels in Adult Rat Ventricular Myocytes

    Science.gov (United States)

    Kaur, Kuljeet; Zarzoso, Manuel; Ponce-Balbuena, Daniela; Guerrero-Serna, Guadalupe; Hou, Luqia; Musa, Hassan; Jalife, José

    2013-01-01

    Cardiac injury promotes fibroblasts activation and differentiation into myofibroblasts, which are hypersecretory of multiple cytokines. It is unknown whether any of such cytokines are involved in the electrophysiological remodeling of adult cardiomyocytes. We cultured adult cardiomyocytes for 3 days in cardiac fibroblast conditioned medium (FCM) from adult rats. In whole-cell voltage-clamp experiments, FCM-treated myocytes had 41% more peak inward sodium current (INa) density at −40 mV than myocytes in control medium (p3 fold greater in FCM than control, which suggested that FCM effects could be mediated by TGF-β1. This was confirmed by pre-treatment with TGF-β1 neutralizing antibody, which abolished the FCM-induced changes in both INa and Ito. In current-clamp experiments TGF-β1 (10 ng/ml) prolonged the action potential duration at 30, 50, and 90 repolarization (p<0.05); at 50 ng/ml it gave rise to early afterdepolarizations. In voltage-clamp experiments, TGF-β1 increased INa density in a dose-dependent manner without affecting voltage dependence of activation or inactivation. INa density was −36.25±2.8 pA/pF in control, −59.17±6.2 pA/pF at 0.1 ng/ml (p<0.01), and −58.22±6.6 pA/pF at 1 ng/ml (p<0.01). In sharp contrast, Ito density decreased from 22.2±1.2 pA/pF to 12.7±0.98 pA/pF (p<0.001) at 10 ng/ml. At 1 ng/ml TGF-β1 significantly increased SCN5A (NaV1.5) (+73%; p<0.01), while reducing KCNIP2 (Kchip2; −77%; p<0.01) and KCND2 (KV4.2; −50% p<0.05) mRNA levels. Further, the TGF-β1-induced increase in INa was mediated through activation of the PI3K-AKT pathway via phosphorylation of FOXO1 (a negative regulator of SCN5A). TGF-β1 released by myofibroblasts differentially regulates transcription and function of the main cardiac sodium channel and of the channel responsible for the transient outward current. The results provide new mechanistic insight into the electrical remodeling associated with myocardial injury. PMID:23393573

  3. Left ventricular apical diseases.

    Science.gov (United States)

    Cisneros, Silvia; Duarte, Ricardo; Fernandez-Perez, Gabriel C; Castellon, Daniel; Calatayud, Julia; Lecumberri, Iñigo; Larrazabal, Eneritz; Ruiz, Berta Irene

    2011-08-01

    There are many disorders that may involve the left ventricular (LV) apex; however, they are sometimes difficult to differentiate. In this setting cardiac imaging methods can provide the clue to obtaining the diagnosis. The purpose of this review is to illustrate the spectrum of diseases that most frequently affect the apex of the LV including Tako-Tsubo cardiomyopathy, LV aneurysms and pseudoaneurysms, apical diverticula, apical ventricular remodelling, apical hypertrophic cardiomyopathy, LV non-compaction, arrhythmogenic right ventricular dysplasia with LV involvement and LV false tendons, with an emphasis on the diagnostic criteria and imaging features. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s13244-011-0091-6) contains supplementary material, which is available to authorized users.

  4. Intacting Integrity in coping with health issues

    DEFF Research Database (Denmark)

    Jepsen, Stine Leegaard; Bastrup Jørgensen, Lene; Fridlund, Bengt

    2017-01-01

    The aim of this study was to develop a formal substantive theory (FST) on the multidimensional behavioral process of coping with health issues. Intacting integrity while coping with health issues emerged as the core category of this FST. People facing health issues strive to safeguard and keep...... intact their integrity not only on an individual level but also as members of a group or a system. This intacting process is executed by attunement, continuously minimizing the discrepancy between personal values, personal health, self-expectations and external conditions as health- and cultural...

  5. Totally Tubular: The Mystery behind Function and Origin of the Brain Ventricular System

    OpenAIRE

    Lowery, Laura Anne; Sive, Hazel

    2009-01-01

    A unique feature of the vertebrate brain is the brain ventricular system, a series of connected cavities which are filled with cerebrospinal fluid (CSF) and surrounded by neuroepithelium. While CSF is critical for both adult brain function and embryonic brain development, neither development nor function of the brain ventricular system is fully understood. In this review, we discuss the mystery of why vertebrate brains have ventricles, and whence they originate. The brain ventricular system d...

  6. A double-blind, placebo-controlled, randomized trial of the effects of dark chocolate and cocoa on variables associated with neuropsychological functioning and cardiovascular health: clinical findings from a sample of healthy, cognitively intact older adults.

    Science.gov (United States)

    Crews, W David; Harrison, David W; Wright, James W

    2008-04-01

    In recent years, there has been increased interest in the potential health-related benefits of antioxidant- and phytochemical-rich dark chocolate and cocoa. The objective of the study was to examine the short-term (6 wk) effects of dark chocolate and cocoa on variables associated with neuropsychological functioning and cardiovascular health in healthy older adults. A double-blind, placebo-controlled, fixed-dose, parallel-group clinical trial was used. Participants (n = 101) were randomly assigned to receive a 37-g dark chocolate bar and 8 ounces (237 mL) of an artificially sweetened cocoa beverage or similar placebo products each day for 6 wk. No significant group (dark chocolate and cocoa or placebo)-by-trial (baseline, midpoint, and end-of-treatment assessments) interactions were found for the neuropsychological, hematological, or blood pressure variables examined. In contrast, the midpoint and end-of-treatment mean pulse rate assessments in the dark chocolate and cocoa group were significantly higher than those at baseline and significantly higher than the midpoint and end-of-treatment rates in the control group. Results of a follow-up questionnaire item on the treatment products that participants believed they had consumed during the trial showed that more than half of the participants in both groups correctly identified the products that they had ingested during the experiment. This investigation failed to support the predicted beneficial effects of short-term dark chocolate and cocoa consumption on any of the neuropsychological or cardiovascular health-related variables included in this research. Consumption of dark chocolate and cocoa was, however, associated with significantly higher pulse rates at 3- and 6-wk treatment assessments.

  7. Left ventricular functional parameters and geometric patterns in Korean adults on coronary CT angiography with a 320-detector-row CT scanner

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Eun Ju; Lee, Ki Nam; Cho, Won Jin; Kim, Young Dae [College of Medicine, Dong-A University, Busan (Korea, Republic of); Shin, Kyung Min; Lim, Jae Kwang; Lee, Jong Min [Dept. of Radiology, Kyungpook National University, Daegu (Korea, Republic of)

    2017-08-01

    To assess the normal reference values of left ventricle (LV) functional parameters in Korean adults on coronary CT angiography (CCTA) with a 320-detector-row CT scanner, and to analyze sex-related differences and correlations with various clinical characteristics. This study retrospectively enrolled 172 subjects (107 men and 65 women; age, 58 ± 10.9 years; body surface area [BSA], 1.75 ± 0.2 m{sup 2}) who underwent CCTA without any prior history of cardiac disease. The following parameters were measured by post-processing the CT data: LV volume, LV functional parameters (ejection fraction, stroke volume, cardiac output, etc.), LV myocardial mass, LV inner diameter, and LV myocardial thickness (including septal wall thickness [SWT], posterior wall thickness [PWT], and relative wall thickness [RWT = 2 × PWT / LV inner diameter]). All of the functional or volumetric parameters were normalized using the BSA. The general characteristics and co-morbidities for the enrolled subjects were recorded, and the correlations between these factors and the LV parameters were then evaluated. The LV myocardial thickness (SWT, 1.08 ± 0.18 cm vs. 0.90 ± 0.17 cm, p < 0.001; PWT, 0.91 ± 0.15 cm vs. 0.78 ± 0.10 cm, p < 0.001; RWT, 0.38 ± 0.08 cm vs. 0.33 ± 0.05 cm, p < 0.001), LV volume (LV end-diastolic volume, 112.9 ± 26.1 mL vs. 98.2 ± 21.0 mL, p < 0.001; LV end-systolic volume, 41.7 ± 14.7 mL vs. 33.7 ± 12.2 mL, p = 0.001) and mass (145.0 ± 29.1 g vs. 107.9 ± 20.0 g, p < 0.001) were significantly greater in men than in women. However, these differences were not significant after normalization using BSA, except for the LV mass (LV mass index, 79.6 ± 14.0 g/m{sup 2} vs. 66.2 ± 11.0 g/m{sup 2},p < 0.001). The cardiac output and ejection fraction were not significantly different between the men and women (cardiac output, 4.3 ± 1.0 L/min vs. 4.2 ± 0.9 L/min, p = 0.452; ejection fraction, 63.4 ± 7.7% vs. 66.4 ± 7.6%, p = 0.079). Most of the LV parameters were

  8. Non-invasive diagnosis and follow-up of right ventricular overload

    NARCIS (Netherlands)

    Henkens, Ivo Reinier

    2008-01-01

    Right ventricular overload covers a spectrum ranging from volume overload to pressure overload, and often is a combination of these, compromising cardiac function. Part I focuses on right ventricular volume overload in adults with Fallot’s tetralogy corrected in early childhood. We determined whic

  9. Ventricular Assist Device Support: for Management of Sustained Ventricular Arrhythmias

    OpenAIRE

    2002-01-01

    We describe herein the cases of 2 patients who had ventricular arrhythmias. In one, a short-term biventricular assist device, the ABIOMED BVS 5000, was placed because the patient had sustained ventricular tachycardia and could not be weaned from cardiopulmonary bypass. Excellent hemodynamic support was maintained for several days while the antiarrhythmic therapy was maximized. Sinus rhythm was restored, and the patient was successfully weaned from the ventricular assist device. However, the s...

  10. Incidental Discovery of a Membranous Ventricular Septal Aneurysm in Two Dissimilar Patients

    Directory of Open Access Journals (Sweden)

    Abhishek Naidu

    2012-01-01

    Full Text Available A ventricular septal aneurysm (VSA is a rare cardiac anomaly, and an accurate statistic of its prevalence has not been reported in the literature. True incidence is likely underestimated as most patients are thought to be asymptomatic. As a result, most VSAs are discovered incidentally on echocardiography, during angiography, or at autopsy. Potential complications include rupture, bacterial endocarditis, right ventricular outflow tract obstruction, and thromboembolic disease. It has been proposed that VSAs occur in association with ventricular septal defects (VSDs and other congenital cardiac abnormalities. It is uncommon for a VSA to exist in the absence of a known prior ventricular septal defect. We present two cases, each highlighting an incidental intact aneurysm involving the membranous interventricular septum. We discuss the contrast in the two patients with regard to their age, accompanying cardiac anomalies and cardiovascular fitness. Clinical implications of the condition are reviewed.

  11. Autism Spectrum Disorder and intact executive functioning.

    Science.gov (United States)

    Ferrara, R; Ansermet, F; Massoni, F; Petrone, L; Onofri, E; Ricci, P; Archer, T; Ricci, S

    2016-01-01

    Earliest notions concerning autism (Autism Spectrum Disorders, ASD) describe the disturbance in executive functioning. Despite altered definition, executive functioning, expressed as higher cognitive skills required complex behaviors linked to the prefrontal cortex, are defective in autism. Specific difficulties in children presenting autism or verbal disabilities at executive functioning levels have been identified. Nevertheless, the developmental deficit of executive functioning in autism is highly diversified with huge individual variation and may even be absent. The aim of the present study to examine the current standing of intact executive functioning intact in ASD.

  12. Electrocardiographic criteria for left ventricular hypertrophy in children.

    NARCIS (Netherlands)

    Rijnbeek, P.R.; Herpen, G van; Kapusta, L.; Harkel, AD Ten; Witsenburg, M.; Kors, J.A.

    2008-01-01

    Previous studies to determine the sensitivity of the electrocardiogram (ECG) for left ventricular hypertrophy (LVH) in children had their imperfections: they were not done on an unselected hospital population, several criteria used in adults were not applied to children, and obsolete limits of norma

  13. Sustained Ventricular Tachycardia and Cardiogenic Shock due to Scorpion Envenomation

    Directory of Open Access Journals (Sweden)

    Carlos Henrique Miranda

    2014-01-01

    Full Text Available We describe a case of severe scorpion envenomation in an adult patient, with the presence of very rapid sustained ventricular tachycardia followed by cardiogenic shock, which was reversed by scorpion antivenom administration. Scorpion venom causes cardiac changes that can lead to an environment favoring arrhythmogenesis.

  14. Totally tubular: the mystery behind function and origin of the brain ventricular system.

    Science.gov (United States)

    Lowery, Laura Anne; Sive, Hazel

    2009-04-01

    A unique feature of the vertebrate brain is the ventricular system, a series of connected cavities which are filled with cerebrospinal fluid (CSF) and surrounded by neuroepithelium. While CSF is critical for both adult brain function and embryonic brain development, neither development nor function of the brain ventricular system is fully understood. In this review, we discuss the mystery of why vertebrate brains have ventricles, and whence they originate. The brain ventricular system develops from the lumen of the neural tube, as the neuroepithelium undergoes morphogenesis. The molecular mechanisms underlying this ontogeny are described. We discuss possible functions of both adult and embryonic brain ventricles, as well as major brain defects that are associated with CSF and brain ventricular abnormalities. We conclude that vertebrates have taken advantage of their neural tube to form the essential brain ventricular system.

  15. Ventricular assist device support for management of sustained ventricular arrhythmias.

    Science.gov (United States)

    Fasseas, Panayotis; Kutalek, Steven P; Samuels, Fania L; Holmes, Elena C; Samuels, Louis E

    2002-01-01

    We describe herein the cases of 2 patients who had ventricular arrhythmias. In one, a short-term biventricular assist device, the ABIOMED BVS 5000, was placed because the patient had sustained ventricular tachycardia and could not be weaned from cardiopulmonary bypass. Excellent hemodynamic support was maintained for several days while the antiarrhythmic therapy was maximized. Sinus rhythm was restored, and the patient was successfully weaned from the ventricular assist device. However, the substrate for the arrhythmia persisted, and a recurrence, 1 week later, resulted in the patient's death. In the 2nd patient, the use of an implantable left ventricular assist device was successful in temporarily alleviating the ventricular tachycardia associated with ischemic cardiomyopathy. However, after 2 days of device assistance, the patient experienced a recurrence of the tachycardia, which degenerated into ventricular fibrillation with a marked deterioration in the patient's hemodynamics. The arrhythmia persisted despite multiple attempts at external cardioversion, and internal cardioversion and placement of an automatic implantable cardioverter-defibrillator were necessary. This treatment, along with repeated boluses of amiodarone, led to successful suppression of the arrhythmias, and the patient eventually underwent transplantation. The mechanical hemodynamic support of the circulation by ventricular assist devices was effective in supporting these 2 patients who had sustained ventricular arrhythmias.

  16. Postpartal right ventricular thrombosis.

    Science.gov (United States)

    Velicki, Lazar; Milosavljević, Aleksandar; Majin, Marijan; Vujin, Bojan; Kovacević, Pavle

    2008-11-01

    The discovery of an intracardial mass in patients presents a serious diagnostic dilemma. The differential diagnosis of this condition may seem abundant, but myxomas and intracardial thrombosis are the most frequent diagnoses. A connection between pregnancy and the presence of thrombosis has been documented frequently. Normal pregnancy leads to changes of the coagulative and fibrinolytic status toward a hypercoagulable condition which has its own physiological justification (the risk of blood loss decreases during labor). The case of a patient suffering from postpartal right ventricular thrombosis, which was successfully resolved by surgery as described in this contribution, demonstrates the value of a multidisciplinary approach.

  17. Feasible pickup from intact ossicular chain with floating piezoelectric microphone

    Directory of Open Access Journals (Sweden)

    Kang Hou-Yong

    2012-02-01

    Full Text Available Abstract Objectives Many microphones have been developed to meet with the implantable requirement of totally implantable cochlear implant (TICI. However, a biocompatible one without destroying the intactness of the ossicular chain still remains under investigation. Such an implantable floating piezoelectric microphone (FPM has been manufactured and shows an efficient electroacoustic performance in vitro test at our lab. We examined whether it pick up sensitively from the intact ossicular chain and postulated whether it be an optimal implantable one. Methods Animal controlled experiment: five adult cats (eight ears were sacrificed as the model to test the electroacoustic performance of the FPM. Three groups were studied: (1 the experiment group (on malleus: the FPM glued onto the handle of the malleus of the intact ossicular chains; (2 negative control group (in vivo: the FPM only hung into the tympanic cavity; (3 positive control group (Hy-M30: a HiFi commercial microphone placed close to the site of the experiment ear. The testing speaker played pure tones orderly ranged from 0.25 to 8.0 kHz. The FPM inside the ear and the HiFi microphone simultaneously picked up acoustic vibration which recorded as .wav files to analyze. Results The FPM transformed acoustic vibration sensitively and flatly as did the in vitro test across the frequencies above 2.0 kHz, whereas inefficiently below 1.0 kHz for its overloading mass. Although the HiFi microphone presented more efficiently than the FPM did, there was no significant difference at 3.0 kHz and 8.0 kHz. Conclusions It is feasible to develop such an implantable FPM for future TICIs and TIHAs system on condition that the improvement of Micro Electromechanical System and piezoelectric ceramic material technology would be applied to reduce its weight and minimize its size.

  18. Right ventricular metastasis of leiomyosarcoma

    Directory of Open Access Journals (Sweden)

    Stagmo Martin

    2009-05-01

    Full Text Available Abstract Metastatic presentation of leiomyosarcoma in the heart is very rare. We present transthoracic echocardiography and combined PET/CT images of a case with a large right ventricular metastasis of leiomyosarcoma. The patient was placed on cytostatic drugs for palliative purposes, but passed away one month later because of an untreatable ventricular tackycardia.

  19. Mitochondria and left ventricular hypertrophy

    Institute of Scientific and Technical Information of China (English)

    Haiyan Zhu; Shiwen Wang

    2008-01-01

    @@ Introduction Left ventricular hypertrophy (LVH) is one of the vicious organ damages of essential hypertension.It contributes a lot to high mortality of essential hypertension due to sudden cardiac death,ventricular arrhythmia and heart failure.Many factors involve in the pathogenesis of hypertension-induced LVH including inherited variants as well as environmental factors.

  20. Divertículo ventricular congênito associado à taquicardia ventricular Congenital ventricular diverticulum associated with ventricular tachycardia

    Directory of Open Access Journals (Sweden)

    Ranieli Pitol

    2005-02-01

    Full Text Available Divertículos ventriculares congênitos são raros. Clinicamente, podem ser assintomáticos ou causa de embolização sistêmica, insuficiência cardíaca, insuficiência valvar, ruptura ventricular, arritmia ventricular ou morte súbita. Apresentamos caso de uma mulher de 56 anos com taquicardia ventricular sustentada, na qual, durante a investigação, foi diagnosticada a presença de um divertículo na posição ínfero-basal do ventrículo esquerdo. Comentam-se as características clínicas e o tratamento desta doença infreqüente.Congenital ventricular diverticula are rare. Clinically, they may be asymptomatic or cause systemic embolization, heart failure, valvular regurgitation, ventricular rupture, ventricular arrhythmia, or sudden death. We report the case of a 56-year-old woman with sustained ventricular tachycardia, who, during investigation, was diagnosed with a diverticulum in the inferobasal portion of the left ventricle. The clinical characteristics and treatment of this rare disease are discussed.

  1. Identification of Intrinsic Axon Growth Modulators for Intact CNS Neurons after Injury.

    Science.gov (United States)

    Fink, Kathren L; López-Giráldez, Francesc; Kim, In-Jung; Strittmatter, Stephen M; Cafferty, William B J

    2017-03-14

    Functional deficits persist after spinal cord injury (SCI) because axons in the adult mammalian central nervous system (CNS) fail to regenerate. However, modest levels of spontaneous functional recovery are typically observed after trauma and are thought to be mediated by the plasticity of intact circuitry. The mechanisms underlying intact circuit plasticity are not delineated. Here, we characterize the in vivo transcriptome of sprouting intact neurons from Ngr1 null mice after partial SCI. We identify the lysophosphatidic acid signaling modulators LPPR1 and LPAR1 as intrinsic axon growth modulators for intact corticospinal motor neurons after adjacent injury. Furthermore, in vivo LPAR1 inhibition or LPPR1 overexpression enhances sprouting of intact corticospinal tract axons and yields greater functional recovery after unilateral brainstem lesion in wild-type mice. Thus, the transcriptional profile of injury-induced sprouting of intact neurons reveals targets for therapeutic enhancement of axon growth initiation and new synapse formation. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  2. Hybrid Surgery Options for Complex Clinical Scenarios in Adult Patients with Congenital Heart Disease: Three Case Reports

    Science.gov (United States)

    Rapetto, Filippo; Kenny, Damien; Turner, Mark; Parry, Andrew; Stoica, Serban; Uzun, Orhan; Caputo, Massimo

    2017-01-01

    The strategy for the management of adult patients with congenital heart disease (CHD) often represents a challenge for cardiac surgeons and cardiologists due to complex anatomy, wide range of clinical presentations, and a high-risk profile. However, hybrid approach may represent an attractive solution. We report three cases of adult patients previously operated for CHD and recently treated with a hybrid approach in our institution. Case 1: a 76-year-old woman with permanent atrial fibrillation, lung disease, chronic kidney disease, microcytic anemia, and type II diabetes mellitus, previously operated for atrial septal defect closure and pulmonary valvotomy, presented with severe pulmonary regurgitation and advanced right ventricular failure. In order to minimize the surgical risk, a hybrid approach was used: an extensive right ventricular outflow tract (RVOT) plication was followed by implantation of an Edwards Sapien XT prosthesis in the RVOT through the right ventricular apex, without cardiopulmonary bypass. Case 2: a 64-year-old man with previous atrial septum excision and pericardial baffle for partial anomalous pulmonary venous drainage with intact interatrial septum, presented with worsening dyspnea, right ventricular failure, and pulmonary hypertension caused by baffle stenosis. His comorbidities included coronary artery disease, atrial flutter, and previous left pneumonectomy. After performing a redo longitudinal median sternotomy, a 20-mm stent was implanted in the baffle with access through the superior vena cava. Case 3: a 50-year-old man, with previous atrioventricular septal defect repair, followed by mitral valve replacement with a mechanical prosthesis, subsequently developed a paravalvular leak (PVL) with severe mitral regurgitation and severe left ventricular dysfunction. He underwent a transapical PVL device closure with two Amplatzer Vascular Plugs. In our opinion, hybrid surgery is a promising therapeutic modality that increases the available

  3. Xenopus egg cytoplasm with intact actin.

    Science.gov (United States)

    Field, Christine M; Nguyen, Phuong A; Ishihara, Keisuke; Groen, Aaron C; Mitchison, Timothy J

    2014-01-01

    We report optimized methods for preparing Xenopus egg extracts without cytochalasin D, that we term "actin-intact egg extract." These are undiluted egg cytoplasm that contains abundant organelles, and glycogen which supplies energy, and represents the least perturbed cell-free cytoplasm preparation we know of. We used this system to probe cell cycle regulation of actin and myosin-II dynamics (Field et al., 2011), and to reconstitute the large, interphase asters that organize early Xenopus embryos (Mitchison et al., 2012; Wühr, Tan, Parker, Detrich, & Mitchison, 2010). Actin-intact Xenopus egg extracts are useful for analysis of actin dynamics, and interaction of actin with other cytoplasmic systems, in a cell-free system that closely mimics egg physiology, and more generally for probing the biochemistry and biophysics of the egg, zygote, and early embryo. Detailed protocols are provided along with assays used to check cell cycle state and tips for handling and storing undiluted egg extracts.

  4. True navigation in migrating gulls requires intact olfactory nerves

    DEFF Research Database (Denmark)

    Wikelski, Martin; Arriero, Elena; Gagliardo, Anna;

    2015-01-01

    debated. In this experiment we subjected adult lesser black-backed gulls migrating from their Finnish/Russian breeding grounds (from >60°N) to Africa (to systems required for navigation. We translocated birds westward (1080 km) or eastward (885 km......) to simulate natural navigational challenges. When translocated westwards and outside their migratory corridor birds with olfactory nerve section kept a clear directional preference (southerly) but were unable to compensate for the displacement, while intact birds and gulls with the ophthalmic branch...... of the trigeminal nerve sectioned oriented towards their population-specific migratory corridor. Thus, air-borne olfactory information seems to be important for migrating gulls to navigate successfully in some circumstances....

  5. Complete resolution of chronic pericardial effusion with an intensive course of inhaled iloprost in an adult patient with unrepaired ventricular septal defect, and life-threatening severe pulmonary arterial hypertension.

    Science.gov (United States)

    Alzahrani, Ahmed M; Alqahtani, Abdullah S; Alnajashi, Khalid S; Idrees, Majdy M

    2014-10-01

    A 38-year-old male was diagnosed with unrepaired ventricular septal defect associated with severe pulmonary arterial hypertension, cyanosis, and significant exercise intolerance. His echocardiogram showed right ventricular dysfunction and moderate pericardial effusion with no signs of cardiac tamponade. He was treated with an intensive course of inhaled iloprost and sildenafil. He showed a dramatic clinical response; his saturation went up from 60% on admission to 90% on minimal oxygen with significant improvement in his symptoms and signs of heart failure and total resolution of pericardial effusion. On follow up 3 and 6 weeks later, he was stable and could walk 360 meters in a 6 minutes walk test with disappearance of pericardial effusion. With unavailability of intravenous prostacyclin, we have shown in this case that intensive administration of inhaled iloprost could be used intensively as a rescue therapy in severe cases of pulmonary arterial hypertension with excellent results. 

  6. Symbolic dynamics of ventricular tachycardia and ventricular fibrillation

    Science.gov (United States)

    Wang, Jun; Chen, Jie

    2010-05-01

    In this paper, the symbolic dynamics analysis was used to analyze the complexity of normal heartbeat signal (NSR), Ventricular tachycardia (VT) and ventricular fibrillation (VF) signals. By calculating the information entropy value of symbolic sequences, the complexities were quantified. Based on different information entropy values, NSR, VT and VF signals were distinguished with satisfactory results. The study showed that a sudden drop of symbolic sequence’s entropy value indicated that the patients most likely entered the episode of ventricular tachycardia and this was a crucial episode for the clinical treatment of patients. It had important clinical significance for the automatic diagnosis.

  7. A large ventricular septal defect complicating resuscitation after blunt trauma

    Directory of Open Access Journals (Sweden)

    Henry D I De′Ath

    2012-01-01

    Full Text Available A young adult pedestrian was admitted to hospital after being hit by a car. On arrival to the Accident and Emergency Department, the patient was tachycardic, hypotensive, hypoxic, and acidotic with a Glasgow Coma Scale of 3. Despite initial interventions, the patient remained persistently hypotensive. An echocardiogram demonstrated a traumatic ventricular septal defect (VSD with right ventricular strain and increased pulmonary artery pressure. Following a period of stabilization, open cardiothoracic surgery was performed and revealed an aneurysmal septum with a single large defect. This was repaired with a bovine patch, resulting in normalization of right ventricular function. This case provides a vivid depiction of a large VSD in a patient following blunt chest trauma with hemodynamic compromise. In all thoracic trauma patients, and particularly those poorly responsive to resuscitation, VSDs should be considered. Relevant investigations and management strategies are discussed.

  8. Systolic left ventricular function according to left ventricular concentricity and dilatation in hypertensive patients

    DEFF Research Database (Denmark)

    Bang, Casper; Gerdts, Eva; Aurigemma, Gerard P;

    2013-01-01

    Left ventricular hypertrophy [LVH, high left ventricular mass (LVM)] is traditionally classified as concentric or eccentric based on left ventricular relative wall thickness. We evaluated left ventricular systolic function in a new four-group LVH classification based on left ventricular dilatatio...

  9. Cardiac MRI in a Patient with Coincident Left Ventricular Non-Compaction and Hypertrophic Cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Zahra Alizadeh-Sani

    2011-12-01

    Full Text Available Left ventricular non-compaction cardiomyopathy is a rare congenital cardiomyopathy that affects both children and adults. Since the clinical manifestations are not sufficient to establish diagnosis, echocardiography is the diagnostic tool that makes it possible to document ventricular non-compaction and establish prognostic factors. We report a 47-year-old woman with a history of dilated cardiomyopathy with unknown etiology. Echocardiography showed mild left ventricular enlargement with severe systolic dysfunction (EF = 20-25%. According to cardiac magnetic resonance imaging findings non-compaction left ventricle with hypertrophic cardiomyopathy was considered, and right ventricular septal biopsy was recommended. Right ventricular endomyocardial biopsy showed moderate hypertrophy of cardiac myocytes with foci of myocytolysis and moderate interstitial fibrosis. No evidence of infiltrative deposition was seen.

  10. An Early Requirement for nkx2.5 Ensures First and Second Heart Field Ventricular Identity and Cardiac Function into Adulthood

    Science.gov (United States)

    George, Vanessa; Colombo, Sophie; Targoff, Kimara L.

    2015-01-01

    Temporally controlled mechanisms that define the unique features of ventricular and atrial cardiomyocyte identity are essential for the construction of a coordinated, morphologically intact heart. We have previously demonstrated an important role for nkx genes in maintaining ventricular identity, however, the specific timing of nkx2.5 function in distinct cardiomyocyte populations has yet to be elucidated. Here, we show that heat-shock induction of a novel transgenic line, Tg(hsp70l:nkx2.5-EGFP), during the initial stages of cardiomyocyte differentiation leads to rescue of chamber shape and identity in nkx2.5−/− embryos as chambers emerge. Intriguingly, our findings link an early role of this essential cardiac transcription factor with a later function. Moreover, these data reveal that nkx2.5 is also required in the second heart field as the heart tube forms, reflecting the temporal delay in differentiation of this population. Thus, our results support a model in which nkx genes induce downstream targets that are necessary to maintain chamber-specific identity in both early- and late-differentiating cardiomyocytes at discrete stages in cardiac morphogenesis. Furthermore, we show that overexpression of nkx2.5 during first and second heart field development not only rescues the mutant phenotype, but also is sufficient for proper function of the adult heart. Taken together, these results shed new light on the stage-dependent mechanisms that sculpt chamber-specific cardiomyocytes and, therefore, have the potential to improve in vitro generation of ventricular cells to treat myocardial infarction and congenital heart disease. PMID:25536398

  11. Chronobiology of cardiac ventricular fibrillation development in experimental acute coronary failure.

    Science.gov (United States)

    Blagonravov, M L; Azova, M M; Frolov, V A

    2010-10-01

    Numerous experiments on simulation of acute coronary failure in initially intact rabbits showed that under the same experimental conditions irreversible ventricular fibrillation developed in some animals and did not develop in other. We hypothesize that the probability of fibrillation development was determined by the time of the day, during which acute coronary failure developed. The study was carried out on 2 groups of rabbits in winter in Moscow. In group 1, the failure was induced by ligation of the left descending coronary artery at the interface between its middle and lower thirds at 11.00-18.00 with 30-min intervals. In group 2, the microcirculatory status of the left-ventricular myocardium was studied by light microscopy and morphometry at 12.00 and 18.00. Induction of coronary failure during the period from 15.30 to 18.00 led to irreversible ventricular fibrillation and death in 100% cases. Modeling of the condition from 11.00 to 15.00 caused no ventricular fibrillation in 89% cases, and the animals survived. The area of left-ventricular myocardial capillaries at 12.00 virtually 2-fold surpassed that at 18.00. Presumably, the electrolyte balance and metabolic characteristics of the myocardium switch over to the nocturnal mode of functioning at 15.30 due to changes in blood filling of the myocardium. The appearance of an ischemic focus in the myocardium during this period inevitably leads to the development of irreversible ventricular fibrillation.

  12. How can we conserve intact tropical peatlands?

    Science.gov (United States)

    Lawson, Ian; Roucoux, Katherine

    2017-04-01

    The scientific community has, for more than three decades, been expressing increasing alarm about the fate of peatlands in parts of Indonesia and Malaysia, where extensive land-use conversion and drainage for rice and oil palm have greatly compromised peatland hydrology, ecology, biological richness, and carbon storage. The discourse in the literature on these peatlands is now moving on from attempts to preserve the last remaining fragments of peat-swamp forest, towards discussion of how best to restore damaged ecosystems, and whether it is possible to manage plantations more 'sustainably'. It is becoming increasingly clear, however, that peatlands occur quite widely in other parts of the lowland tropics, including parts of Amazonia and the Congo Basin, and many of these peatlands can reasonably be described as 'intact': although few if any parts of the tropics are totally unaffected by human actions, the hydrology and functional ecology of these systems appear to be close to a 'natural' state. The question then arises as to what should be done with the knowledge of their existence. Here we analyse the arguments in favour of protecting intact peatlands, and the potential conflicts with other priorities such as economic development and social justice. We evaluate alternative mechanisms for protecting intact peatlands, focusing on the particular issues raised by peatlands as opposed to other kinds of tropical ecosystem. We identify ways in which natural science agendas can help to inform these arguments, using our own contributions in palaeoecology and carbon mapping as examples. Finally, we argue for a radical reconsideration of research agendas in tropical peatlands, highlighting the potential contribution of methodologies borrowed from the social sciences and humanities.

  13. Magnetic resonance imaging derived left ventricular global and region function parameters in healthy adults%健康成年人左心室整体及局部功能参数的磁共振研究

    Institute of Scientific and Technical Information of China (English)

    穆莉莎; 蒲艳军; 孙凯; 朱力; 李文玲; 田兴仓

    2014-01-01

    Objective To establish cardiac magnetic resonance imaging (MRI) derived left ventricular (LV) global and region function parameters in normal adults.Methods Twenty normal adults were examined with fast imaging employing steady-state (Fiesta) acquisition sequence of cardiac MRI,LV global function and LV region function were measured at basal,middle,apical level and at 16 LV segments.The regional function parameters among different levels and different segments of the same level were analyzed.Results (1) LV global function: end-diastolic volume (109.17 ± 19.52) ml ; end-systolic volume (37.76 ± 14.16) ml ; ejection fraction (65.93 ± 7.79) % ; wall thickening (83.24 ± 40.82) % ; longitudinal shortening (15.51 ± 3.78)% ; fractional shortening (31.78 ± 9.55)% ; end-diastolic mass (95.20 ± 19.95) g.(2) LV regional function: In each LV level,there was no significant difference in end-systolic wall thickness (P > 0.05).End-diastolic wall thickness and wall thickening were similar between the middle and apical levels,but there were significant differences between middle and apical levels with the basal level (both P <0.05).End-systolic wall thickness of the middle and the apical level was similar,but there were significant differences between middle and apical levels with the basal level (both P < 0.05).At the segments of the same level,end-diastolic wall thickness and the relevant regional function parameters between the segments of anteroseptal and inferoseptal at base and middle level were similar (P > 0.05) ; the end-diastolic wall thickness was the largest and the WT was the minimal at the septal segments of three levels,and the difference were significant between the septal and other segments in the same level (P <0.05).Conclusions Fractional shortening and longitudinal shortening provide new indicators for assessing LV global function by cardiac MRI.There is obvious heterogeneity on LV regional function in normal adults,systolic function is

  14. Genetic heterogeneity of left-ventricular noncompaction cardiomyopathy.

    Science.gov (United States)

    Moric-Janiszewska, Ewa; Markiewicz-Łoskot, Grazyna

    2008-05-01

    Isolated noncompaction of the ventricular myocardium (INVM) sometimes referred to as spongy myocardium is a rare, congenital and also acquired cardiomyopathy. It appears to divide the presentation into neonatal, childhood and adult forms of which spongy myocardium and systolic dysfunction is the commonality. The disorder is characterized by a left ventricular hypertrophy with deep trabeculations, and with diminished systolic function, with or without associated left ventricular dilation. In half or more of the cases, the right ventricle is also affected. The sporadic type, however, in some patients, may be due to chromosomal abnormalities and the occurrence of familial incidence. Isolated noncompaction of the left ventricular myocardium in the majority of adult patients is an autosomal dominant disorder. The familial and X-linked disorders have been described by various authors. We here describe the genetic background of this disorder: some of the most mutated genes that are responsible for the disease are (G4.5 (tafazzin gene): alpha-dystrobrevin gene (DTNA); FKBP-12 gene; lamin A/C gene; Cypher/ZASP (LIM, LDB3) gene); and some genotype-phenotype correlations (Becker muscular dystrophy, Emery-Dreifuss muscular dystrophy or Barth syndrome) based on the literature review.

  15. Ventricular arrhythmias in Chagas disease

    Directory of Open Access Journals (Sweden)

    Marco Paulo Tomaz Barbosa

    2015-02-01

    Full Text Available Sudden death is one of the most characteristic phenomena of Chagas disease, and approximately one-third of infected patients develop life-threatening heart disease, including malignant ventricular arrhythmias. Fibrotic lesions secondary to chronic cardiomyopathy produce arrhythmogenic substrates that lead to the appearance and maintenance of ventricular arrhythmias. The objective of this study is to discuss the main clinical and epidemiological aspects of ventricular arrhythmias in Chagas disease, the specific workups and treatments for these abnormalities, and the breakthroughs needed to determine a more effective approach to these arrhythmias. A literature review was performed via a search of the PubMed database from 1965 to May 31, 2014 for studies of patients with Chagas disease. Clinical management of patients with chronic Chagas disease begins with proper clinical stratification and the identification of individuals at a higher risk of sudden cardiac death. Once a patient develops malignant ventricular arrhythmia, the therapeutic approach aims to prevent the recurrence of arrhythmias and sudden cardiac death by the use of implantable cardioverter defibrillators, antiarrhythmic drugs, or both. In select cases, invasive ablation of the reentrant circuit causing tachycardia may be useful. Ventricular arrhythmias are important manifestations of Chagas cardiomyopathy. This review highlights the absence of high-quality evidence regarding the treatment of ventricular arrhythmias in Chagas disease. Recognizing high-risk patients who require specific therapies, especially invasive procedures such as the implantation of cardioverter defibrillators and ablative approaches, is a major challenge in clinical practice.

  16. Catheter ablation of a monofocal premature ventricular complex triggering idiopathic ventricular fibrillation.

    Science.gov (United States)

    Takatsuki, S; Mitamura, H; Ogawa, S

    2001-07-01

    A 62 year old man was admitted for evaluation of recurrent episodes of syncope. A surface ECG showed frequent repetitive premature ventricular complexes of right ventricular outflow tract origin. Ventricular fibrillation was inducible by programmed electrical stimulation but otherwise cardiac evaluation was unremarkable. A diagnosis of idiopathic ventricular fibrillation was made and an implantable cardioverter-defibrillator (ICD) was installed. However, spontaneous ventricular fibrillation recurred, requiring repeated ICD discharges. The ventricular fibrillation was reproducibly triggered by a single premature ventricular complex with a specific QRS morphology. Radiofrequency catheter ablation was carried out to eradicate this complex. No ventricular fibrillation has developed after this procedure, and the patient does not require drug treatment.

  17. Rupture of Right Ventricular Free Wall Following Ventricular Septal Rupture in Takotsubo Cardiomyopathy with Right Ventricular Involvement.

    Science.gov (United States)

    Sung, June Min; Hong, Sung Jin; Chung, In Hyun; Lee, Hye Young; Lee, Jae Hoon; Kim, Hyun Jung; Byun, Young Sup; Kim, Byung Ok; Rhee, Kun Joo

    2017-01-01

    Most patients diagnosed with takotsubo cardiomyopathies are expected to almost completely recover, and their prognosis is excellent. However, complications can occur in the acute phase. We present a case of a woman with takotsubo cardiomyopathy with right ventricular involvement who developed a rupture of the right ventricular free wall following ventricular septal rupture, as a consequence of an acute increase in right ventricular afterload by left-to-right shunt. Our case report illustrates that takotsubo cardiomyopathy can be life threatening in the acute phase. Ventricular septal rupture in biventricular takotsubo cardiomyopathy may be a harbinger of cardiac tamponade by right ventricular rupture.

  18. Recollections of Parent Characteristics and Attachment Patterns for College Women of Intact vs. Non-Intact Families

    Science.gov (United States)

    Kilmann, Peter R.; Carranza, Laura V.; Vendemia, Jennifer M. C.

    2006-01-01

    This study contrasted offsprings' attachment patterns and recollections of parent characteristics in two college samples: 147 females from intact biological parents and 157 females of parental divorce. Secure females from intact or non-intact families rated parents positively, while insecure females rated parents as absent, distant, and demanding.…

  19. Ventricular fibrillation-induced cardiac arrest in the rat as a model of global cerebral ischemia

    OpenAIRE

    Dave, Kunjan R.; DELLA-MORTE, DAVID; Saul, Isabel; Prado, Ricardo; Perez-Pinzon, Miguel A

    2013-01-01

    Cardiopulmonary arrest remains one of the leading causes of death and disability in Western countries. Although ventricular fibrillation (VF) models in rodents mimic the “square wave” type of insult (rapid loss of pulse and pressure) commonly observed in adult humans at the onset of cardiac arrest (CA), they are not popular because of the complicated animal procedure, poor animal survival and thermal injury. Here we present a modified, simple, reliable, ventricular fibrillation-induced rat mo...

  20. Prognostic impact of isolated right ventricular dysfunction in sepsis and septic shock: an 8-year historical cohort study.

    Science.gov (United States)

    Vallabhajosyula, Saraschandra; Kumar, Mukesh; Pandompatam, Govind; Sakhuja, Ankit; Kashyap, Rahul; Kashani, Kianoush; Gajic, Ognjen; Geske, Jeffrey B; Jentzer, Jacob C

    2017-09-07

    Echocardiographic myocardial dysfunction is reported commonly in sepsis and septic shock, but there are limited data on sepsis-related right ventricular dysfunction. This study sought to evaluate the association of right ventricular dysfunction with clinical outcomes in patients with severe sepsis and septic shock. Historical cohort study of adult patients admitted to all intensive care units at the Mayo Clinic from January 1, 2007 through December 31, 2014 for severe sepsis and septic shock, who had an echocardiogram performed within 72 h of admission. Patients with prior heart failure, cor-pulmonale, pulmonary hypertension and valvular disease were excluded. Right ventricular dysfunction was defined by the American Society of Echocardiography criteria. Outcomes included 1-year survival, in-hospital mortality and length of stay. Right ventricular dysfunction was present in 214 (55%) of 388 patients who met the inclusion criteria-isolated right ventricular dysfunction was seen in 100 (47%) and combined right and left ventricular dysfunction in 114 (53%). The baseline characteristics were similar between cohorts except for the higher mechanical ventilation use in patients with isolated right ventricular dysfunction. Echocardiographic findings demonstrated lower right ventricular and tricuspid valve velocities in patients with right ventricular dysfunction and lower left ventricular ejection fraction and increased mitral E/e' ratios in patients with combined right and left ventricular dysfunction. After adjustment for age, comorbidity, illness severity, septic shock and use of mechanical ventilation, isolated right ventricular dysfunction was independently associated with worse 1-year survival-hazard ratio 1.6 [95% confidence interval 1.2-2.1; p = 0.002) in patients with sepsis and septic shock. Isolated right ventricular dysfunction is seen commonly in sepsis and septic shock and is associated with worse long-term survival.

  1. Pulmonary valve replacement in chronic pulmonary regurgitation in adults with congenital heart disease: impact of preoperative QRS-duration and NT-proBNP levels on postoperative right ventricular function.

    Science.gov (United States)

    Westhoff-Bleck, Mechthild; Girke, Stefan; Breymann, Thomas; Lotz, Joachim; Pertschy, Stefanie; Tutarel, Oktay; Roentgen, Philipp; Bertram, Harald; Wessel, Armin; Schieffer, Bernhard; Meyer, Gerd Peter

    2011-09-15

    Chronic severe pulmonary regurgitation (PR) causes progressive right ventricular (RV) dysfunction and heart failure. Parameters defining the optimal time point for surgery of chronic PR are lacking. The present study prospectively evaluated the impact of preoperative clinical parameters, cardiorespiratory function, QRS duration and NT-proBNP levels on post operative RV function and volumes assessed by cardiac magnetic resonance imaging (CMR) in patients with chronic severe PR undergoing pulmonary valve replacement. CMR was performed pre- and 6 months postoperatively in 27 patients (23.6 ± 2.9 years, 15 women) with severe PR. Postoperatively, RV endsystolic (RVESVI) and enddiastolic volume indices (RVEDVI) decreased significantly (RVESVI pre 78.2 ± 20.4 ml/m² BSA vs. RVESVI post 52.2 ± 16.8 ml/m²BSA, pfunction and volumes. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  2. Genetics Home Reference: arrhythmogenic right ventricular cardiomyopathy

    Science.gov (United States)

    ... Twitter Home Health Conditions ARVC arrhythmogenic right ventricular cardiomyopathy Printable PDF Open All Close All Enable Javascript ... the expand/collapse boxes. Description Arrhythmogenic right ventricular cardiomyopathy ( ARVC ) is a form of heart disease that ...

  3. Oxidative stress decreases microtubule growth and stability in ventricular myocytes.

    Science.gov (United States)

    Drum, Benjamin M L; Yuan, Can; Li, Lei; Liu, Qinghang; Wordeman, Linda; Santana, L Fernando

    2016-04-01

    Microtubules (MTs) have many roles in ventricular myocytes, including structural stability, morphological integrity, and protein trafficking. However, despite their functional importance, dynamic MTs had never been visualized in living adult myocytes. Using adeno-associated viral vectors expressing the MT-associated protein plus end binding protein 3 (EB3) tagged with EGFP, we were able to perform live imaging and thus capture and quantify MT dynamics in ventricular myocytes in real time under physiological conditions. Super-resolution nanoscopy revealed that EB1 associated in puncta along the length of MTs in ventricular myocytes. The vast (~80%) majority of MTs grew perpendicular to T-tubules at a rate of 0.06μm∗s(-1) and growth was preferentially (82%) confined to a single sarcomere. Microtubule catastrophe rate was lower near the Z-line than M-line. Hydrogen peroxide increased the rate of catastrophe of MTs ~7-fold, suggesting that oxidative stress destabilizes these structures in ventricular myocytes. We also quantified MT dynamics after myocardial infarction (MI), a pathological condition associated with increased production of reactive oxygen species (ROS). Our data indicate that the catastrophe rate of MTs increases following MI. This contributed to decreased transient outward K(+) currents by decreasing the surface expression of Kv4.2 and Kv4.3 channels after MI. On the basis of these data, we conclude that, under physiological conditions, MT growth is directionally biased and that increased ROS production during MI disrupts MT dynamics, decreasing K(+) channel trafficking.

  4. Effects of hydrolysed casein, intact casein and intact whey protein on energy expenditure and appetite regulation

    DEFF Research Database (Denmark)

    Bendtsen, Line Quist; Lorenzen, Janne Kunchel; Gomes, Sisse

    2014-01-01

    Casein and whey differ in amino acid composition and in the rate of absorption; however, the absorption rate of casein can be increased to mimic that of whey by exogenous hydrolysis. The objective of the present study was to compare the effects of hydrolysed casein (HC), intact casein (IC......) and intact whey (IW) on energy expenditure (EE) and appetite regulation, and thereby to investigate the influence of amino acid composition and the rate of absorption. In the present randomised cross-over study, twenty-four overweight and moderately obese young men and women consumed three isoenergetic...... dietary treatments that varied in protein source. The study was conducted in a respiration chamber, where EE, substrate oxidation and subjective appetite were measured over 24 h at three independent visits. Moreover, blood and urine samples were collected from the participants. The results showed...

  5. Catheter ablation of a polymorphic ventricular tachycardia inducing monofocal premature ventricular complex.

    Science.gov (United States)

    Uemura, Takashi; Yamabe, Hiroshige; Tanaka, Yasuaki; Morihisa, Kenji; Kawano, Hiroaki; Kaikita, Koichi; Sumida, Hitoshi; Sugiyama, Seigo; Ogawa, Hisao

    2008-01-01

    Ventricular tachycardia originating from the right ventricular outflow tract (RVOT) is considered benign, but sometimes it causes polymorphic ventricular tachycardia and ventricular fibrillation, resulting in sudden cardiac death. A 58-year-old woman without structural heart disease was admitted for evaluation of recurrent episodes of syncope. Surface ECG showed frequent repetitive premature ventricular contraction (PVC) of RVOT origin. Polymorphic ventricular tachycardia triggered by the same PVC was documented by Holter ECG during an episode of syncope. Radiofrequency catheter ablation was performed to eradicate this PVC. No polymorphic ventricular tachycardia has developed after the procedure, and the patient has had no recurrence of syncope.

  6. Comparison of Intact PTH and Bio-Intact PTH Assays Among Non-Dialysis Dependent Chronic Kidney Disease Patients.

    Science.gov (United States)

    Einbinder, Yael; Benchetrit, Sydney; Golan, Eliezer; Zitman-Gal, Tali

    2017-09-01

    The third-generation bio-intact parathyroid hormone (PTH) (1-84) assay was designed to overcome problems associated with the detection of C-terminal fragments by the second-generation intact PTH assay. The two assays have been compared primarily among dialysis populations. The present study evaluated the correlations and differences between these two PTH assays among patients with chronic kidney disease (CKD) stages 3 to 5 not yet on dialysis. Blood samples were collected from 98 patients with CKD stages 3 to 5. PTH concentrations were measured simultaneously by using the second-generation - PTH intact-STAT and third-generation bio-intact 1-84 PTH assays. Other serum biomarkers of bone mineral disorders were also assessed. CKD stage was calculated by using the CKD-Epidemiology Collaboration (EPI) formula. Serum bio-intact PTH concentrations were strongly correlated but significantly lower than the intact PTH concentrations (r=0.963, Pbio-intact PTH) positively correlated with urea (r=0.523, r=0.504; P=0.002, respectively), phosphorus (r=0.532, r=0.521; Pbio-intact PTH assay detected significantly lower PTH concentrations compared with intact PTH assay. Additional studies that correlate the diagnosis and management of CKD mineral and bone disorders with bone histomorphometric findings are needed to determine whether bio-intact PTH assay results are better surrogate markers in these early stages of CKD.

  7. 21 CFR 882.4060 - Ventricular cannula.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ventricular cannula. 882.4060 Section 882.4060...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4060 Ventricular cannula. (a) Identification. A ventricular cannula is a device used to puncture the ventricles of the brain for aspiration...

  8. 21 CFR 882.4100 - Ventricular catheter.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ventricular catheter. 882.4100 Section 882.4100...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4100 Ventricular catheter. (a) Identification. A ventricular catheter is a device used to gain access to the cavities of the brain for...

  9. Measurement of tritiated norepinephrine metabolism in intact rat brain

    Energy Technology Data Exchange (ETDEWEB)

    Levitt, M.; Kowalik, S.; Barkai, A.I. (New York State Psychiatric Inst., New York (USA))

    1983-06-01

    A procedure for the study of NE metabolism in the intact rat brain is described. The method involves ventriculocisternal perfusion of the adult male rat with artificial CSF containing (/sup 3/H)NE. Radioactivity in the perfusate associated with NE and its metabolites 3,4-dihydroxymandelic acid (DOMA), 3,4-dihydroxphenylethyleneglycol (DHPG), 3-methoxy-4-hydroxymandelic acid (VMA), 3-methoxy-4-hydroxyphenylethyleneglycol (MHPG), and normetanephrine (NMN) is separated using high-performance liquid chromatography (HPLC). After 80 min the radioactivity in the perfusate reaches an apparent steady-state. Analysis of the steady-state samples shows higher activity in the fractions corresponding to DHPG and MHPG than in those corresponding to DOMA and VMA, confirming glycol formation as the major pathway of NE metabolism in the rat brain. Pretreatment with an MAO inhibitor (tranylcypromine) results in a marked decrease in the deaminated metabolites DHPG and MHPG and a concurrent increase in NMN. The results indicate this to be a sensitive procedure for the in vivo determination of changes in NE metabolism.

  10. Facts about Ventricular Septal Defect

    Science.gov (United States)

    ... Living With Heart Defects Data & Statistics Tracking & Research Articles & Key Findings Free Materials Multimedia and Tools Links to Other Websites Information For... Media Policy Makers Facts about Ventricular Septal Defect Language: English Español (Spanish) Recommend on Facebook Tweet Share Compartir ...

  11. Vagal control of cardiac electrical activity and wall motion during ventricular fibrillation in large animals.

    Science.gov (United States)

    Naggar, Isaac; Nakase, Ko; Lazar, Jason; Salciccioli, Louis; Selesnick, Ivan; Stewart, Mark

    2014-07-01

    Vagal inputs control pacemaking and conduction systems in the heart. Anatomical evidence suggests a direct ventricular action, but functional evidence that separates direct and indirect (via the conduction system) vagal actions is less well established. We studied vagus nerve stimulation (VNS) during sinus rhythm and ventricular fibrillation (VF) in pigs and sheep to determine: 1) the range of unilateral and bilateral actions (inotropic and chronotropic) and 2) whether VNS alters left ventricular motion and/or electrical activity during VF, a model of abnormal electrical conduction of the left ventricle that excludes sinus and atrioventricular nodal function. Adult pigs (N=8) and sheep (N=10) were anesthetized with urethane and mechanically ventilated. VNS was performed in animals at 1, 2, 5, 10, 20, 50, and 100Hz for 20s. VF was induced with direct current to the ventricles or occlusion of the left anterior descending coronary artery. In 4 pigs and 3 sheep, left ventricular wall motion was assessed from endocardial excursion in epicardial echocardiography. In sheep and pigs, the best frequency among those tested for VNS during sinus rhythm to produce sustained electrical and mechanical ventricular standstill was 50Hz for unilateral or bilateral stimulation. When applied during VF, bilateral VNS increased the variability of the dominant VF frequency, indicating a direct impact on the excitability of ventricular myocytes, and decreased endocardial excursion by more than 50% during VF. We conclude that the vagus nerve directly modulates left ventricular function independently from its effects on the conduction system.

  12. Positive Youth Development, Life Satisfaction and Problem Behaviors of Adolescents in Intact and Non-Intact Families in Hong Kong

    Directory of Open Access Journals (Sweden)

    Daniel Tan Lei Shek

    2013-08-01

    Full Text Available This study investigated whether Chinese adolescents living in intact and non-intact families differed in their positive development, life satisfaction, and risk behavior. A total of 3,328 Secondary 1 students responded to measures of positive youth development (such as resilience and psychosocial competencies, life satisfaction, and risk behavior (substance abuse, delinquency, Internet addiction, consumption of pornographic materials, self-harm, and behavioral intention to engage in problem behavior. Findings revealed that adolescents growing up in intact families reported higher levels of positive developmental outcomes and life satisfaction as compared with adolescents from non-intact families. Adolescents in non-intact families also reported higher levels of risk behaviors than those growing up in intact families.

  13. Electrical heterogeneity of canine right ventricular transient outward potassium currents

    Institute of Scientific and Technical Information of China (English)

    杨新春; 周鹏; 李翠兰

    2004-01-01

    Background Some studies have confirmed that the right ventricular walls of most rodents, such as canines and humans, have evident transient outward potassium current (lto1) heterogeneity, and this heterogeneity is closely related to J point elevation, J wave formation, and some ventricular tachycardias such as ventricular fibrillations caused by Brugada syndrome. This study is designed to investigate transmural electrical heterogeneity of the canine right ventricle during repolarization (phase 1) from the viewpoint of 4-aminopyridine sensitive and calcium-independent lto1.Methods Adult canine single right ventricular epicardial (Epi) cells, mid-myocardial (M) cells, and endocardial (Endo) cells were enzymatically dissociated. Whole cell voltage-clamp recordings were made to compare the lto1 values of the three cell types.Results At 37℃ and using 0.2 Hz and + 70 mV depolarizing test potentials, the average peak lto1 values of Epi cells and M cells averaged (4070±1720) pA and (3540±1840) pA, respectively. The activated and inactivated Epi and M cells kinetic processes were in accordance with the Boltzmann distribution. Compared with lto1 in Epi cells and M cells, the average peak lto1 in Endo cells was very low, averaged (470±130) pA.Conclusions These results suggest that there are evident differences and potent gradients in lto1 between the three cardiac cell types, especially between Epi and Endo cells. These differences are among the prominent manifestations of right ventricular electrical heterogeneity, and may form an important ionic basis and prerequisite for some malignant arrhythmias in the right ventricle, including those arising from Brugada syndrome and other diseases.

  14. Structured prediction for differentiating between normal rhythms, ventricular tachycardia, and ventricular fibrillation in the ECG.

    Science.gov (United States)

    Alwan, Yaqub; Cvetkovic, Zoran; Curtis, Michael

    2015-01-01

    Recent studies have been performed on feature selection for diagnostics between non-ventricular rhythms and ventricular arrhythmias, or between non-ventricular fibrillation and ventricular fibrillation. However they did not assess classification directly between non-ventricular rhythms, ventricular tachycardia and ventricular fibrillation, which is important in both a clinical setting and preclinical drug discovery. In this study it is shown that in a direct multiclass setting, the selected features from these studies are not capable at differentiating between ventricular tachycardia and ventricular fibrillation. A high dimensional feature space, Fourier magnitude spectra, is proposed for classification, in combination with the structured prediction method conditional random fields. An improvement in overall accuracy, and sensitivity of every category under investigation is achieved.

  15. 46 CFR 28.570 - Intact righting energy.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Intact righting energy. 28.570 Section 28.570 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY UNINSPECTED VESSELS REQUIREMENTS FOR COMMERCIAL FISHING INDUSTRY VESSELS Stability § 28.570 Intact righting energy. (a) Except as provided in paragraph (c) of...

  16. X-ray inspection for boreholes in intact trees

    NARCIS (Netherlands)

    Jansen, R.M.C.; Hemming, J.

    2010-01-01

    X-ray systems are commonly used for luggage inspection. The size of these systems is sufficient for inspection of intact trees. The first objective of this study is to determine whether such an X-ray system is able to visualise boreholes in intact trees. The present study is partly based on human in

  17. Atlas-Based Ventricular Shape Analysis for Understanding Congenital Heart Disease.

    Science.gov (United States)

    Farrar, Genevieve; Suinesiaputra, Avan; Gilbert, Kathleen; Perry, James C; Hegde, Sanjeet; Marsden, Alison; Young, Alistair A; Omens, Jeffrey H; McCulloch, Andrew D

    2016-12-01

    Congenital heart disease is associated with abnormal ventricular shape that can affect wall mechanics and may be predictive of long-term adverse outcomes. Atlas-based parametric shape analysis was used to analyze ventricular geometries of eight adolescent or adult single-ventricle CHD patients with tricuspid atresia and Fontans. These patients were compared with an "atlas" of non-congenital asymptomatic volunteers, resulting in a set of z-scores which quantify deviations from the control population distribution on a patient-by-patient basis. We examined the potential of these scores to: (1) quantify abnormalities of ventricular geometry in single ventricle physiologies relative to the normal population; (2) comprehensively quantify wall motion in CHD patients; and (3) identify possible relationships between ventricular shape and wall motion that may reflect underlying functional defects or remodeling in CHD patients. CHD ventricular geometries at end-diastole and end-systole were individually compared with statistical shape properties of an asymptomatic population from the Cardiac Atlas Project. Shape analysis-derived model properties, and myocardial wall motions between end-diastole and end-systole, were compared with physician observations of clinical functional parameters. Relationships between altered shape and altered function were evaluated via correlations between atlas-based shape and wall motion scores. Atlas-based shape analysis identified a diverse set of specific quantifiable abnormalities in ventricular geometry or myocardial wall motion in all subjects. Moreover, this initial cohort displayed significant relationships between specific shape abnormalities such as increased ventricular sphericity and functional defects in myocardial deformation, such as decreased long-axis wall motion. These findings suggest that atlas-based ventricular shape analysis may be a useful new tool in the management of patients with CHD who are at risk of impaired ventricular

  18. Development of spatial database on intact forest landscapes of India

    Science.gov (United States)

    Sudhakar Reddy, C.; Singh, Jyoti; Jha, C. S.; Diwakar, P. G.; Dadhwal, V. K.

    2017-01-01

    There is an increased interest in identifying the status of biodiversity in different spatial and temporal scales. The objective of the current research is to prepare a consistent spatial database of intact forest landscapes of India. The intact forest landscapes are located in the Himalayas, Andaman & Nicobar Islands, Western Ghats and Sunderbans. At national level 237 forest landscapes and 5.4% of the total natural forest remained as intact in India. Current intact forest landscapes of India consists of blocks larger than 10 km2 covering an area of 34,061 km2. Of the total area under intact forest landscapes, Eastern Himalayas represent 76.7% of the area, followed by Western Himalayas (8.8%), Andaman & Nicobar Islands (6.2%) and Western Ghats (5.7%). The largest intact forest landscape block occupies an area of 3342.9 km2 (9.8%) is found in western Arunachal Pradesh. Temperate forest zone represents the highest intactness (56.6%), followed by subtropical zone (19.2%), tropical zone (18.6%) and alpine zone (5.6%). Himalayan moist temperate forests represent the highest area (39.1%) of intact forest landscapes followed by subtropical broad-leaved hill forests, wet evergreen forests, and montane wet temperate forests. It is estimated that 4.4% of the area of intact forest landscapes fall inside the existing 47 protected areas. The results of the analysis best suited as input for the process of identification of new protected areas. The study recommends fine-scale mapping of biodiversity within the intact forest landscapes and to prepare efficient conservation plans.

  19. Vesta Is Not an Intact Protoplanet

    Science.gov (United States)

    Consolmagno, Guy; Turrini, Diego; Golabeck, Gregor; Jutzi, Martin; Sirono, Sin-iti; Svetsov, Vladimir; Tsiganis, Kleomenis

    2014-11-01

    Asteroid 4 Vesta has been identified as the likely source of howardite, eucrite, and diogenite (HED) basaltic achondrite meteorites, whose parent body differentiated and started solidifying within 3 Ma after the condensation of the Ca-Al-rich inclusions (CAIs). The formation of Jupiter and the disk-driven migration of the giant planets also occurred during this period; thus it was expected that Vesta could provide an intact record of large-scale early episodes of planetary migration and bombardment as in the proposed Jovian Early Bombardment and the “Grand Tack” scenarios. However, the results of the Dawn mission detailing Vesta’s mass, volume, density, and surface characteristics provide challenges for modeling the structure and evolution of this asteroid. All proposed models for the generation of the HEDs require the presence of a substantial olivine-rich mantle. But recent work on the depth of excavation of the large basins at the south pole of Vesta suggests that because there is not abundant mantle olivine visible on Vesta or in the Vestoid family asteroids, the crust of Vesta must be at least 80 km thick. Such a thick crust is radically at odds with previous models; should it exist, it ought to manifest itself in other ways such as Vesta’s density structure and bulk chemical composition. However, we find that no Vesta model of iron core, olivine-rich mantle, and HED crust can match the joint constraints of (a) Vesta’s density as derived from the gravity field observed by Dawn; (b) the observed depletion of sodium and potassium and trace element enrichments of the HED meteorites; and (c) the absence of exposed olivine on Vesta’s surface, among Vestoid asteroids, or in our collection of basaltic meteorites. Either Vesta was subjected to a radical change in composition, presumably due to the intense collisional environment where and when it formed, or the asteroid we see today is in fact a reaccretion of material formed elsewhere from now

  20. PREDICTORS OF MORTALITY IN PATIENTS WITH SUSTAINED VENTRICULAR TACHYCARDIAS OR VENTRICULAR-FIBRILLATION AND DEPRESSED LEFT-VENTRICULAR FUNCTION - IMPORTANCE OF BETA-BLOCKADE

    NARCIS (Netherlands)

    SZABO, BM; CRIJNS, HJGM; WIESFELD, ACP; VANVELDHUISEN, DJ; HILLEGE, HL; LIE, KI

    1995-01-01

    To study prognostic factors in patients with sustained ventricular tachycardias (VT) or ventricular fibrillation (VF) complicated by left ventricular dysfunction, we evaluated the predictive value of demographic, clinical, and hemodynamic parameters for cardiac mortality and sudden cardiac death in

  1. Prophylactic implantable defibrillator in patients with arrhythmogenic right ventricular cardiomyopathy/dysplasia and no prior ventricular fibrillation or sustained ventricular tachycardia.

    LENUS (Irish Health Repository)

    Corrado, Domenico

    2010-09-21

    The role of implantable cardioverter-defibrillator (ICD) in patients with arrhythmogenic right ventricular cardiomyopathy\\/dysplasia and no prior ventricular fibrillation (VF) or sustained ventricular tachycardia is an unsolved issue.

  2. Effect of atropine-dobutamine stress test on left ventricular echocardiographic parameters in untrained warmblood horses.

    Science.gov (United States)

    Sandersen, Charlotte F; Detilleux, Johanne; de Moffarts, Brieuc; Van Loon, Gunther; Amory, Hélène

    2006-01-01

    The aim of this study was to investigate the effect of combined atropine low-dose dobutamine stress test on left ventricular parameters in adult warmblood horses, to establish a potential protocol for pharmacological stress echocardiography. Seven healthy untrained warmblood horses aged 9 to 22 years were used. Heart rate (HR) and left ventricular B- and M-mode dimensions were recorded at baseline and during stress testing with 35 microg/kg atropine IV followed by incremental dobutamine infusion of 2 to 6 microg/kg/min. HR increased significantly (P stress test induced significant changes in left ventricular echocardiographic parameters in adult warmblood horses. Additional research should evaluate the value of this stress test in horses suffering from cardiac disease.

  3. Preload recruitable stroke work in the presence of intact cardiovascular reflexes in rats fed a diet high in unsaturated fats.

    Science.gov (United States)

    Trifunovic, B; Woodiwiss, A J; Norton, G R

    1995-01-15

    A decreased inotropic effect of myocardial beta receptor agonists in animals receiving diets high in unsaturated fats (UNSAT) has been demonstrated. The effect of an UNSAT diet on myocardial systolic performance under different loading conditions, in the presence of intact cardiovascular reflexes, has not been examined. We investigated the effect of an UNSAT diet on preload recruitable stroke work (SW) in the anaesthetised, open chest, ventilated rat. A control (CONTROL, 11% by energy), a high saturated fat (SAT, 37% by energy) and a high UNSAT (37% by energy) diet were fed to three groups of rats. At three months, systolic myocardial performance (stroke work: SW) at increasing left ventricular end diastolic pressures (LVEDP) was measured within a physiological preload range. There were no significant differences in either the slope or the intercept of the LVEDP/SW relation were found between the three diet groups. Systemic vascular resistance and heart rate decreased to the same extent in the three diet groups over the range of preloads examined. This occurred as a consequence of intact baroreceptor reflexes. Hence dietary modulation of unsaturated fats does not influence myocardial contraction over a wide range of physiological preloads in the presence of intact baroreceptor reflexes.

  4. Reflectance Spectra Comparison of Orbital Debris, Intact Spacecraft, and Intact Rocket Bodies in the GEO Regime

    Science.gov (United States)

    Albercromby, Kira J.; Abell, Paul; Barker, Ed

    2009-03-01

    A key objective of NASA's Orbital Debris program office at Johnson Space Center (JSC) is to characterize the debris environment by way of assessing the physical properties (type, mass, density, and size) of objects in orbit. Knowledge of the geosynchronous orbit (GEO) debris environment in particular can be used to determine the hazard probability at specific GEO altitudes and aid predictions of the future environment. To calculate an optical size from an intensity measurement of an object in the GEO regime, a 0.175 albedo is assumed currently. However, identification of specific material type or types could improve albedo accuracy and yield a more accurate size estimate for the debris piece. Using spectroscopy, it is possible to determine the surface materials of space objects. The study described herein used the NASA Infrared Telescope Facility (IRTF) to record spectral data in the ~ 0.65 to 2.5 micron regime on eight catalogued space objects. For comparison, all of the objects observed were in GEO or near-GEO. The eight objects consisted of two intact spacecraft, three rocket bodies, and three catalogued debris pieces. Two of the debris pieces stemmed from Titan 3C transtage breakup and the third is from COSMOS 2054. The reflectance spectra of the Titan 3C pieces share similar slopes (increasing with wavelength) and lack any strong absorption features. The COSMOS debris spectrum has a slight slope and has no absorption features. In contrast, the intact spacecraft show classic absorption features due to solar cells with a strong band gap feature near 1 micron. The two spacecraft were spin-stabilized objects and therefore have solar panels surrounding the outer surface. Two of the three rocket bodies are inertial upper stage (IUS) rocket bodies and have similar looking spectra. The slopes flatten out near 1.5 microns with absorption features in the near-infrared that are similar to that of white paint. The third rocket body has a similar flattening of slope but

  5. A unique association of arrhythmogenic right ventricular dysplasia and acute myocarditis, as assessed by cardiac MRI: a case report.

    Science.gov (United States)

    Ponsiglione, Andrea; Puglia, Marta; Morisco, Carmine; Barbuto, Luigi; Rapacciuolo, Antonio; Santoro, Mario; Spinelli, Letizia; Trimarco, Bruno; Cuocolo, Alberto; Imbriaco, Massimo

    2016-11-21

    Arrhythmogenic right ventricular dysplasia (ARVD), is a genetic disorder of the heart, which mainly involves the right ventricle. It is characterized by hypokinetic areas at the free wall of the right ventricle (RV) or both ventricles, where myocardium is replaced by fibrous or fatty tissue. ARVD is an important cause of ventricular arrhythmias in children and young adults. Although the transmission of the disease is based on hereditary, in young adults it may not show any symptoms. The main differential diagnoses with other frequent etiological causes of sudden arrhythmia are: idiopathic outflow tract ventricular tachycardia of the RV, myocarditis, dilated cardiomyopathy and sarcoidosis. We describe an unusual case of a 44-year-old woman who was hospitalized for ventricular tachycardia, deep asthenia and dyspnoea with no previous history of cardiac disease. The patient had a ten-year history of palpitations, which started immediately after her last pregnancy. She was diagnosed with both acute/subacute viral myocarditis and arrhythmogenic right ventricular dysplasia, based on established clinical and cardiac MRI criteria. After the diagnosis the patient received an automatic implantable cardioverter defibrillator. Currently, she is on clinical follow-up with no apparent further complications. Analyzing this rare case, we have shown the link between myocarditis and arrhythmogenic right ventricular dysplasia, and how important is to perform a cardiac MRI, in the context of acute myocarditis and ventricular arrhythmia.

  6. Premature ventricular contractions associated with isotretinoin use.

    Science.gov (United States)

    Alan, Sevil; Ünal, Betül; Yildirim, Aytül

    2016-01-01

    Isotretinoin has been considered a unique drug for acne treatment. However, it is associated with numerous adverse effects. Isotretinoin can trigger premature ventricular contractions. This report describes a 33-year-old-woman who presented with palpitations for 1 week while undergoing 1-month isotretinoin treatment for mild-moderate facial acne. An electrocardiogram and Holter monitoring showed premature ventricular contractions during isotretinoin (Roaccutane, Roche) treatment. Isotretinoin-related premature ventricular contractions were strongly suggested in this case due to the existence of documented premature ventricular contractions on electrocardiograms and the disappearance of these premature ventricular contractions two weeks after termination of the treatment To the authors' knowledge, there has been 1 reported case of premature ventricular contractions linked to isotretinoin use; this report describes a second such case.

  7. Premature ventricular contractions associated with isotretinoin use*

    Science.gov (United States)

    Alan, Sevil; Ünal, Betül; Yildirim, Aytül

    2016-01-01

    Isotretinoin has been considered a unique drug for acne treatment. However, it is associated with numerous adverse effects. Isotretinoin can trigger premature ventricular contractions. This report describes a 33-year-old-woman who presented with palpitations for 1 week while undergoing 1-month isotretinoin treatment for mild-moderate facial acne. An electrocardiogram and Holter monitoring showed premature ventricular contractions during isotretinoin (Roaccutane, Roche) treatment. Isotretinoin-related premature ventricular contractions were strongly suggested in this case due to the existence of documented premature ventricular contractions on electrocardiograms and the disappearance of these premature ventricular contractions two weeks after termination of the treatment To the authors' knowledge, there has been 1 reported case of premature ventricular contractions linked to isotretinoin use; this report describes a second such case. PMID:28099609

  8. Treatment for burn blisters: debride or leave intact?

    Science.gov (United States)

    Murphy, Faye; Amblum, Jeshi

    2014-05-01

    This article presents findings from a systematic literature review of whether blisters arising from minor burns should be de-roofed or left intact. It discusses the risks of infection, healing outcomes, discomfort, choice of dressings and costs associated with each method, and reveals that debriding blisters larger than the patient's little fingernail while leaving smaller ones intact is generally agreed to be the best option. The article also explains external factors that influence the choice of whether to debride or leave blisters intact, reviews policy at the trust where one of the authors works in the context of the research and makes recommendations for practice.

  9. Association between circulating fibroblast growth factor 23, α-Klotho, and the left ventricular ejection fraction and left ventricular mass in cardiology inpatients.

    Directory of Open Access Journals (Sweden)

    Kensaku Shibata

    Full Text Available BACKGROUND: Fibroblast growth factor 23 (FGF23, with its co-receptor Klotho, plays a crucial role in phosphate metabolism. Several recent studies suggested that circulating FGF23 and α-Klotho concentrations might be related to cardiovascular abnormalities in patients with advanced renal failure. PURPOSE: Using data from 100 cardiology inpatients who were not undergoing chronic hemodialysis, the association of circulating levels of FGF23, α-Klotho, and other calcium-phosphate metabolism-related parameters with the left ventricular ejection fraction (LVEF and left ventricular mass (LVM was analyzed. METHODS AND RESULTS: LVEF was measured using the modified Simpson method for apical 4-chamber LV images and the LVM index (LVMI was calculated by dividing the LVM by body surface area. Univariate analysis showed that log transformed FGF23, but not that of α-Klotho, was significantly associated with LVEF and LVMI with a standardized beta of -0.35 (P<0.001 and 0.26 (P<0.05, respectively. After adjusting for age, sex, estimated glomerular filtration rate, and serum concentrations of intact parathyroid hormone, and 25-hydroxyvitamin D as covariates into the statistical model, log-transformed FGF23 was found to be a statistically positive predictor for decreased left ventricular function and left ventricular hypertrophy. CONCLUSIONS: In cardiology department inpatients, circulating FGF23 concentrations were found to be associated with the left ventricular mass and LVEF independent of renal function and other calcium-phosphate metabolism-related parameters. Whether modulation of circulating FGF23 levels would improve cardiac outcome in such a high risk population awaits further investigation.

  10. Right ventricular lipomatous mass and biventricular multifocal fat in a young woman: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Bo Rahm; Park, Jae Hyeong; Ahn, Kye Taek; Kim, Song Soo; Jeong, Jin Ok; Choi, Si Wan; Jin, Seon Ah; Lee, Jae Hwan [Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon (Korea, Republic of)

    2015-04-15

    Cardiac lipoma is a rare neoplasm of encapsulated mature adult adipose tissue. It is usually asymptomatic, but it may be related to hemodynamic obstruction depending on its location. We report a typical case of right ventricular lipomatous mass and multifocal fat infiltration of both ventricles, which were detected incidentally in a young woman.

  11. Hemodynamic effects of chronic prenatal ventricular pacing for the treatment of complete atrioventricular block.

    Science.gov (United States)

    Liddicoat, J R; Klein, J R; Reddy, V M; Klautz, R J; Teitel, D F; Hanley, F L

    1997-08-05

    Increasing the heart rate of the fetus with cardiac failure caused by complete AV block (CAVB) may allow delivery of a full-term, stable neonate with preserved ventricular function. Direct fetal pacing may be a feasible method to achieve this, but the effect of pacing on the structure and function of the rapidly developing fetal heart is unknown. CAVB was created in fetal lambs at 80% gestation by cryoablating the AV node. Epicardial ventricular pacing at 130 bpm was achieved by use of a pacemaker placed under the pectoral muscles. The fetus was returned to the uterus and allowed to continue to term. Ventricular function was assessed 1 week after birth in 7 lambs with CAVB and 10 control lambs. By use of the conductance catheter technique, the end-systolic pressure-volume relationship was determined at different heart rates, pacing conditions, and inotropic states. The contractility was not different between the two groups at their baseline heart rates and rhythms or when they were paced synchronously compared with asynchronously. Also, both groups responded significantly and similarly to inotropic manipulation, indicating preserved contractile reserve. Finally, in both groups, increased heart rates were associated with increased contractility, indicating an intact force-frequency relationship. We conclude that chronic epicardial ventricular pacing is well tolerated by the fetus, can be successfully applied as a treatment for CAVB, and does not adversely affect myocardial function in the rapidly developing, immature heart.

  12. Ventricular arrhythmias in patients of atrial fibrillation treated with Flecainide: A case report

    Directory of Open Access Journals (Sweden)

    Barman M, Djamel B

    2014-07-01

    Full Text Available Purpose: Flecainide is a class 1C antiarrhythmic drug, especially used for the management of supraventricular arrhythmia. Flecainide also has a recognized proarrhythmic effect in all age groups of adult patients treated for ventricular tachycardia. It is used to treat a variety of cardiac arrhythmias including paroxysmal fibrillation, Paroxysmal Supraventricular tachycardia and ventricular tachycardia. Flecainide works by regulating the flow of sodium in the heart, causing prolongation of the cardiac action potential. The proarrhythmic effects however noted are not widely reported. Case report: We report a case of paroxysmal atrial fibrillation with structurally normal heart who was treated with oral Flecainide. Despite subjective improvement and no adverse events [QTc prolongation] a repeat holter detected him to have multiple short non sustained ventricular arrhythmias. Results: Development of ventricular arrhythmias, salvos &non sustained ventricular tachycardia after a month of initiation of oral Flecainide detected by 24 hours ECG holter lead to discontinuation of Flecainide and subsequent early electro physiological studies and successful ablation. Conclusion: Initiation of oral Flecainide in a case of atrial fibrillation with subjective improvement and regular ECG monitoring, no QTc prolongation can still lead to development of dangerous ventricular arrhythmias. A cautious approach and thorough investigations and follow up are recommended.

  13. Correlation of echocardiographic wall stress and left ventricular pressure and function in aortic stenosis.

    Science.gov (United States)

    DePace, N L; Ren, J F; Iskandrian, A S; Kotler, M N; Hakki, A H; Segal, B L

    1983-04-01

    Previous studies have suggested that left ventricular pressure (P) can be predicted in patients with aortic stenosis by the equation P = 235 h/r, where 235 is a constant peak wall stress (sigma), h is end-systolic wall thickness, and r is end-systolic dimension/2; h and r are measured by M-mode echocardiography. In 73 patients with aortic stenosis (valve area less than 0.7 cm2), measured and predicted left ventricular pressure correlated poorly (r = 0.17). The measured wall stress in our patients varied from 120 to 250 mm Hg in patients with normal left ventricular function and from 250 to 550 mm Hg in patients with abnormal function. The correlation between sigma and h was only fair (r = 0.53), because many patients had inappropriate left ventricular hypertrophy. There was a statistically significant correlation between ejection fraction and sigma (r = 0.62) and between ejection fraction and end-systolic dimension (r = -0.70), but there was considerable scatter of ejection fractions for any given end-systolic dimension. We conclude that sigma is not constant in aortic stenosis, and the use of a constant sigma to predict left ventricular pressure is unreliable; inappropriate left ventricular hypertrophy may explain why sigma is not constant. M-mode echocardiography is not reliable in assessing the severity of aortic stenosis in adults; such assessment requires precise measurements of pressure gradients and flow by cardiac catheterization.

  14. Vesta is not an intact protoplanet

    Science.gov (United States)

    Consolmagno, G.; Turrini, D.; Golabek, G.; Svetsov, V.; Sirono, S.; Tsiganis, K.

    2014-07-01

    The Dawn mission was designed to explore ''remnant intact protoplanets from the earliest epoch of solar system formation'' [1]. However, models of Vesta composed of an iron core, olivine mantle, and HED crust in chondritic proportions cannot match the joint constraints from Dawn [1] of Vesta's density, core size, and the extremely limited presence of exposed olivine on its surface. Vesta has a mean density of 3456 kg/m3 and its surface composition is well matched by howardites. The Dawn gravity data suggest a nickel-iron core of radius 110 km and density 7500--7800 kg/m3. The Rheasilvia impact basin, formed within a pre-existing large basin, Veneneia, should have excavated material from a depth of 50 km to 80 km or more below Vesta's surface [2]. If the howardite crust were thinner than 50--80 km, a significant amount of olivine-rich material, derived from depth, would have been exposed within this basin; models suggest that olivine would also be distributed both on Vesta's surface and in space as meteorite-source Vestoids. Such olivine is rare on Vesta, among the Vestoids, or in our meteorite collection. Vesta's density is similar to an L chondrite, but the Na and K abundances in Vesta are strongly depleted compared to chondrites and the average metal content of an L chondrite, 8.4% by mass, would give a core radius less than 90 km. A 110 km radius metallic core, via the Dawn data, represents 15% of Vesta's mass. The Mg/Al ratio in cosmic abundances is about 10:1, but roughly 1:1 within the eucrites; thus if Vesta started with cosmic abundances, the eucrites can only represent 10% of the parent body total mass. Likewise the 10 x chondritic rare earth trace elements (REE) abundance seen in most eucrites demands that, regardless of formation mechanism, these basalts were crystallized from a melt representing 10% of the mass of the source region [3]. Thus the howardite crust of a chondritic HED parent body, mixing all the available eucritic and diogenitic material

  15. Non-intact zona improves development of murine preimplantation ...

    African Journals Online (AJOL)

    ajl5

    2012-09-25

    Sep 25, 2012 ... African Journal of Biotechnology Vol. 11(77), pp. ... Key words: Mouse, non-intact zona embryos, adenovirus vector with green fluorescent protein (pAd-GFP), embryos ..... informational molecule, could be lysised or its function.

  16. Calcium Signaling Regulates Ventricular Hypertrophy During Development Independent of Contraction or Blood Flow

    Science.gov (United States)

    Andersen, Nicholas D.; Ramachandran, Kapil V.; Bao, Michelle M.; Kirby, Margaret L.; Pitt, Geoffrey S.; Hutson, Mary R.

    2014-01-01

    In utero interventions aimed at restoring left ventricular hemodynamic forces in fetuses with prenatally diagnosed hypoplastic left heart syndrome failed to stimulate ventricular myocardial growth during gestation, suggesting chamber growth during development may not rely upon fluid forces. We therefore hypothesized that ventricular hypertrophy during development may depend upon fundamental Ca2+-dependent growth pathways that function independent of hemodynamic forces. To test this hypothesis, zebrafish embryos were treated with inhibitors or activators of Ca2+ signaling in the presence or absence of contraction during the period of chamber development. Abolishment of contractile function alone in the setting of preserved Ca2+ signaling did not impair ventricular hypertrophy. In contrast, inhibition of L-type voltage-gated Ca2+ influx abolished contraction and led to reduced ventricular hypertrophy, whereas increasing L-type voltage-gated Ca2+ influx led to enhanced ventricular hypertrophy in either the presence or absence of contraction. Similarly, inhibition of the downstream Ca2+-sensitive phosphatase calcineurin, a known regulator of adult cardiac hypertrophy, led to reduced ventricular hypertrophy in the presence or absence of contraction, whereas hypertrophy was rescued in the absence of L-type voltage-gated Ca2+ influx and contraction by expression of a constitutively active calcineurin. These data suggest ventricular cardiomyocyte hypertrophy during chamber formation is dependent upon Ca2+ signaling pathways that are unaffected by heart function or hemodynamic forces. Disruption of Ca2+-dependent hypertrophy during heart development may therefore represent one mechanism for impaired chamber formation that is not related to impaired blood flow. PMID:25536179

  17. Applications of magnetic resonance imaging in the assessment of left ventricular dysfunction

    Energy Technology Data Exchange (ETDEWEB)

    Beacock, David John

    2002-07-01

    This thesis has described the use of Magnetic Resonance Imaging (MRI) in the investigation of left ventricular dimensions and systolic function. This has been performed in conditions of left ventricular dysfunction, in congestive cardiac failure and following anterior myocardial infarction. The reproducibility of measurements of left ventricular dimensions using MRI has been presented. Such measurements were shown to be reproducible between different MRI studies of normal volunteers and patients with congestive heart failure. Furthermore, measurements from different MRI studies obtained from two commercially different systems were reproducible for the same subject groups. Ventricular dimensions and systolic function was evaluated in adult normal volunteers of different ages. Although left ventricular volumes and mass remained unchanged, detailed studies of the systolic images revealed significant differences between the two age groups. Differences in left ventricular cavity volumes and mass between patients with congestive heart failure and age-matched normal volunteers were also investigated. Left ventricular volumes and myocardial mass were assessed in a group of patients following anterior myocardial infarction. End-systolic volume was significantly increased compared to age-matched volunteers, but no changes in end-diastolic volume or myocardial mass was observed. Serial re-evaluation of these patients revealed no other changes over the subsequent six months. All these patients were treated with optimal medical therapy (thrombolysis, aspirin, beta-blockade and angiotensin converting enzyme inhibition). Thus, the use of this therapy may attenuate the process of left ventricular remodelling. Regional wall thickness was measured in the post-infarct patients. Wall thickening was significantly reduced both in the infarcted regions and in myocardium remote to the infarction. In contrast to previous echocardiographic studies, no 'hypercontractility' was

  18. The medical physics of ventricular assist devices

    Energy Technology Data Exchange (ETDEWEB)

    Wood, Houston G [Mechanical and Aerospace Engineering Department, Virginia Artificial Heart Institute, 122 Engineers Way, University of Virginia, Charlottesville, VA (United States); Throckmorton, Amy L [Biomedical Engineering Department, Virginia Artificial Heart Institute, University of Virginia, Charlottesville, VA (United States); Untaroiu, Alexandrina [Mechanical and Aerospace Engineering Department, Virginia Artificial Heart Institute, 122 Engineers Way, University of Virginia, Charlottesville, VA (United States); Song Xinwei [Mechanical and Aerospace Engineering Department, Virginia Artificial Heart Institute, 122 Engineers Way, University of Virginia, Charlottesville, VA (United States)

    2005-03-01

    Millions of patients, from infants to adults, are diagnosed with congestive heart failure each year all over the world. A limited number of donor hearts available for these patients results in a tremendous demand for alternative, supplemental circulatory support in the form of artificial heart pumps or ventricular assist devices (VADs). The development procedure for such a device requires careful consideration of biophysical factors, such as biocompatibility, haemolysis, thrombosis, implantability, physiologic control feasibility and pump performance. Conventional pump design equations based on Newton's law and computational fluid dynamics (CFD) are readily used for the initial design of VADs. In particular, CFD can be employed to predict the pressure-flow performance, hydraulic efficiencies, flow profile through the pump, stress levels and biophysical factors, such as possible blood cell damage. These computational flow simulations may involve comprehensive steady and transient flow analyses. The transient simulations involve time-varying boundary conditions and virtual modelling of the impeller rotation in the blood pumps. After prototype manufacture, laser flow measurements with sophisticated optics and mock circulatory flow loop testing assist with validation of pump design and identification of irregular flow patterns for optimization. Additionally, acute and chronic animal implants illustrate the blood pump's ability to support life physiologically. These extensive design techniques, coupled with fundamental principles of physics, ensure a reliable and effective VAD for thousands of heart failure patients each year.

  19. Clinical study on adult dextrocardia with single atrial and ventricular cases%关于成人右位心合并单心房单心室临床病例的探讨

    Institute of Scientific and Technical Information of China (English)

    张志涛; 胡珂

    2016-01-01

    The corbiloculare , a two chambered heart is a rare congenital anomaiy of the heart .It is characterized by a single or common atrium communicating with a single or common ventricle by a single atrioventricular valve. In this article we report an adult case with dextrocardia and cor biloculare who was diagnosed by echocardiography and has survived to 43- year-old of life. It will promote the understanding of disease in cilinic.%单心房合并单心市是极为罕见的一种先天性心脏病,极难成活到成年,单心腔合并右位心更为少见,本文从心脏彩超及心电图方面阐述右位心合并单心腔的情况。

  20. Evolution and development of ventricular septation in the amniote heart.

    Science.gov (United States)

    Poelmann, Robert E; Gittenberger-de Groot, Adriana C; Vicente-Steijn, Rebecca; Wisse, Lambertus J; Bartelings, Margot M; Everts, Sonja; Hoppenbrouwers, Tamara; Kruithof, Boudewijn P T; Jensen, Bjarke; de Bruin, Paul W; Hirasawa, Tatsuya; Kuratani, Shigeru; Vonk, Freek; van de Put, Jeanne M M S; de Bakker, Merijn A; Richardson, Michael K

    2014-01-01

    During cardiogenesis the epicardium, covering the surface of the myocardial tube, has been ascribed several functions essential for normal heart development of vertebrates from lampreys to mammals. We investigated a novel function of the epicardium in ventricular development in species with partial and complete septation. These species include reptiles, birds and mammals. Adult turtles, lizards and snakes have a complex ventricle with three cava, partially separated by the horizontal and vertical septa. The crocodilians, birds and mammals with origins some 100 million years apart, however, have a left and right ventricle that are completely separated, being a clear example of convergent evolution. In specific embryonic stages these species show similarities in development, prompting us to investigate the mechanisms underlying epicardial involvement. The primitive ventricle of early embryos becomes septated by folding and fusion of the anterior ventricular wall, trapping epicardium in its core. This folding septum develops as the horizontal septum in reptiles and the anterior part of the interventricular septum in the other taxa. The mechanism of folding is confirmed using DiI tattoos of the ventricular surface. Trapping of epicardium-derived cells is studied by transplanting embryonic quail pro-epicardial organ into chicken hosts. The effect of decreased epicardium involvement is studied in knock-out mice, and pro-epicardium ablated chicken, resulting in diminished and even absent septum formation. Proper folding followed by diminished ventricular fusion may explain the deep interventricular cleft observed in elephants. The vertical septum, although indistinct in most reptiles except in crocodilians and pythonidsis apparently homologous to the inlet septum. Eventually the various septal components merge to form the completely septated heart. In our attempt to discover homologies between the various septum components we aim to elucidate the evolution and development

  1. Evolution and development of ventricular septation in the amniote heart.

    Directory of Open Access Journals (Sweden)

    Robert E Poelmann

    Full Text Available During cardiogenesis the epicardium, covering the surface of the myocardial tube, has been ascribed several functions essential for normal heart development of vertebrates from lampreys to mammals. We investigated a novel function of the epicardium in ventricular development in species with partial and complete septation. These species include reptiles, birds and mammals. Adult turtles, lizards and snakes have a complex ventricle with three cava, partially separated by the horizontal and vertical septa. The crocodilians, birds and mammals with origins some 100 million years apart, however, have a left and right ventricle that are completely separated, being a clear example of convergent evolution. In specific embryonic stages these species show similarities in development, prompting us to investigate the mechanisms underlying epicardial involvement. The primitive ventricle of early embryos becomes septated by folding and fusion of the anterior ventricular wall, trapping epicardium in its core. This folding septum develops as the horizontal septum in reptiles and the anterior part of the interventricular septum in the other taxa. The mechanism of folding is confirmed using DiI tattoos of the ventricular surface. Trapping of epicardium-derived cells is studied by transplanting embryonic quail pro-epicardial organ into chicken hosts. The effect of decreased epicardium involvement is studied in knock-out mice, and pro-epicardium ablated chicken, resulting in diminished and even absent septum formation. Proper folding followed by diminished ventricular fusion may explain the deep interventricular cleft observed in elephants. The vertical septum, although indistinct in most reptiles except in crocodilians and pythonidsis apparently homologous to the inlet septum. Eventually the various septal components merge to form the completely septated heart. In our attempt to discover homologies between the various septum components we aim to elucidate the

  2. Effect of muscle length on cross-bridge kinetics in intact cardiac trabeculae at body temperature

    Science.gov (United States)

    Milani-Nejad, Nima; Xu, Ying; Davis, Jonathan P.; Campbell, Kenneth S.

    2013-01-01

    Dynamic force generation in cardiac muscle, which determines cardiac pumping activity, depends on both the number of sarcomeric cross-bridges and on their cycling kinetics. The Frank–Starling mechanism dictates that cardiac force development increases with increasing cardiac muscle length (corresponding to increased ventricular volume). It is, however, unclear to what extent this increase in cardiac muscle length affects the rate of cross-bridge cycling. Previous studies using permeabilized cardiac preparations, sub-physiological temperatures, or both have obtained conflicting results. Here, we developed a protocol that allowed us to reliably and reproducibly measure the rate of tension redevelopment (ktr; which depends on the rate of cross-bridge cycling) in intact trabeculae at body temperature. Using K+ contractures to induce a tonic level of force, we showed the ktr was slower in rabbit muscle (which contains predominantly β myosin) than in rat muscle (which contains predominantly α myosin). Analyses of ktr in rat muscle at optimal length (Lopt) and 90% of optimal length (L90) revealed that ktr was significantly slower at Lopt (27.7 ± 3.3 and 27.8 ± 3.0 s−1 in duplicate analyses) than at L90 (45.1 ± 7.6 and 47.5 ± 9.2 s−1). We therefore show that ktr can be measured in intact rat and rabbit cardiac trabeculae, and that the ktr decreases when muscles are stretched to their optimal length under near-physiological conditions, indicating that the Frank–Starling mechanism not only increases force but also affects cross-bridge cycling kinetics. PMID:23277479

  3. Assessment of myocardial adrenergic innervation in patients with sick sinus syndrome: effect of asynchronous ventricular activation from ventricular apical stimulation

    OpenAIRE

    Marketou, M E; Simantirakis, E N; Prassopoulos, V K; Chrysostomakis, S I; Velidaki, A A; Karkavitsas, N S; Vardas, P.E.

    2002-01-01

    Objective: To investigate ventricular sympathetic innervation in patients with sick sinus syndrome and to detect regional deterioration of adrenergic innervation caused by asynchronous ventricular activation from right ventricular pacing.

  4. Impact of the permanent ventricular pacing site on left ventricular function in children: A retrospective multicentre survey

    NARCIS (Netherlands)

    I.E. van Geldorp (Irene); T. Delhaas (Tammo); R.A. Gebauer (Roman); P. Frias (Patrick); M. Tomaske (Maren); M.K. Friedberg (Mark); S. Tisma-Dupanovic (Svjetlana); J. Elders (Jan); A. Früh (Andreas); F. Gabbarini (Fulvio); P. Kubuš (Petr); V. Illikova (Viera); E.C. Tsao (Elisa); A.C. Blank (Andreas Christian); A. Hiippala (Anita); T. Sluysmans (Thierry); P. Karpawich (Peter); S.A. Clur (Sally-Ann); X. Ganame (Xavier); K.K. Collins (Kathryn); G.C. Dann (Greg); J.-B. Thambo (Jean-Benoît); C. Trigo (Conceição); B. Nagel (Bert); J. Papagiannis (John); A. Rackowitz (Annette); J. Marek (Josef); J.-H. Nürnberg (Jan-Hendrik); W.Y. Vanagt (Ward); F.W. Prinzen (Frits); J. Janousek (Jan)

    2011-01-01

    textabstractBackground: Chronic right ventricular (RV) pacing is associated with deleterious effects on cardiac function. Objective In an observational multicentre study in children with isolated atrioventricular (AV) block receiving chronic ventricular pacing, the importance of the ventricular paci

  5. Impact of the permanent ventricular pacing site on left ventricular function in children : a retrospective multicentre survey

    NARCIS (Netherlands)

    van Geldorp, Irene E.; Delhaas, Tammo; Gebauer, Roman A.; Frias, Patrick; Tomaske, Maren; Friedberg, Mark K.; Tisma-Dupanovic, Svjetlana; Elders, Jan; Fruh, Andreas; Gabbarini, Fulvio; Kubus, Petr; Illikova, Viera; Tsao, Sabrina; Blank, Andreas Christian; Hiippala, Anita; Sluysmans, Thierry; Karpawich, Peter; Clur, Sally-Ann; Ganame, Xavier; Collins, Kathryn K.; Dann, Gisela; Thambo, Jean-Benoit; Trigo, Conceicao; Nagel, Bert; Papagiannis, John; Rackowitz, Annette; Marek, Jan; Nuernberg, Jan-Hendrik; Vanagt, Ward Y.; Prinzen, Frits W.; Janousek, Jan

    2011-01-01

    Background Chronic right ventricular (RV) pacing is associated with deleterious effects on cardiac function. Objective In an observational multicentre study in children with isolated atrioventricular (AV) block receiving chronic ventricular pacing, the importance of the ventricular pacing site on le

  6. Thoracic Epidural Anesthesia Reduces Right Ventricular Systolic Function With Maintained Ventricular-Pulmonary Coupling.

    Science.gov (United States)

    Wink, Jeroen; de Wilde, Rob B P; Wouters, Patrick F; van Dorp, Eveline L A; Veering, Bernadette Th; Versteegh, Michel I M; Aarts, Leon P H J; Steendijk, Paul

    2016-10-18

    Blockade of cardiac sympathetic fibers by thoracic epidural anesthesia may affect right ventricular function and interfere with the coupling between right ventricular function and right ventricular afterload. Our main objectives were to study the effects of thoracic epidural anesthesia on right ventricular function and ventricular-pulmonary coupling. In 10 patients scheduled for lung resection, right ventricular function and its response to increased afterload, induced by temporary, unilateral clamping of the pulmonary artery, was tested before and after induction of thoracic epidural anesthesia using combined pressure-conductance catheters. Thoracic epidural anesthesia resulted in a significant decrease in right ventricular contractility (ΔESV25: +25.5 mL, P=0.0003; ΔEes: -0.025 mm Hg/mL, P=0.04). Stroke work, dP/dtMAX, and ejection fraction showed a similar decrease in systolic function (all Pright ventricular contractility increased (ΔESV25: -26.6 mL, P=0.0002; ΔEes: +0.034 mm Hg/mL, P=0.008), but ventricular-pulmonary coupling decreased (Δ(Ees/Ea) = -0.153, Pright ventricular contractility but does not inhibit the native positive inotropic response of the right ventricle to increased afterload. Right ventricular-pulmonary arterial coupling was decreased with increased afterload but not affected by the induction of thoracic epidural anesthesia. URL: http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2844. Unique identifier: NTR2844. © 2016 American Heart Association, Inc.

  7. Ventricular-Fold Dynamics in Human Phonation

    Science.gov (United States)

    Bailly, Lucie; Bernardoni, Nathalie Henrich; Müller, Frank; Rohlfs, Anna-Katharina; Hess, Markus

    2014-01-01

    Purpose: In this study, the authors aimed (a) to provide a classification of the ventricular-fold dynamics during voicing, (b) to study the aerodynamic impact of these motions on vocal-fold vibrations, and (c) to assess whether ventricular-fold oscillations could be sustained by aerodynamic coupling with the vocal folds. Method: A 72-sample…

  8. Ventricular candidiasis in stone curlews (Burhinus oedicnemus).

    Science.gov (United States)

    Caliendo, Valentina; Bull, Andrew

    2011-09-01

    Ventricular candidiasis is consistently one of the most prominent pathologic conditions diagnosed in stone curlews (Burhinus oedicnemus) in the United Arab Emirates, predominately affecting the captive population. Predisposing factors are a humid environment, stress, immunosuppression, inadequate nutrition, and an extended use of oral antibiotics. In this report, we describe the clinical signs, diagnosis, and pathologic result in stone curlews with ventricular candidiasis.

  9. [Ventricular tachyarrhythmias in patients with cardiomyopathy

    DEFF Research Database (Denmark)

    Henningsen, K.; Christensen, A.H.; Svendsen, Jesper Hastrup

    2008-01-01

    of patients discharged with the diagnostic codes ventricular tachycardia, ventricular fibrillation or premature ventricular contractions with cardiomyopathy as the presumed aetiology. Patients discharged during a period of 6 years and 5 months were included in the study. The patients were characterized......INTRODUCTION: The purpose of this study was to determine the number and distribution of cardiomyopathies as the aetiology of ventricular tachyarrhythmias among patients discharged from the Department of Cardiology, Rigshospitalet. MATERIALS AND METHODS: The study was a retrospective review......), 57 (45%) patients had arrhythmogenic right ventricular cardiomyopathy (ARVC) and 13 (10%) had hypertrophic cardiomyopathy (HCM). The average age was 44 years for HCM, 41 years for ARVC and 58 years for DCM. The majority of the patients were male. ICD treatment was used in 95% of the patients...

  10. Giant and thrombosed left ventricular aneurysm

    Institute of Scientific and Technical Information of China (English)

    Jose; Alberto; de; Agustin; Jose; Juan; Gomez; de; Diego; Pedro; Marcos-Alberca; Jose; Luis; Rodrigo; Carlos; Almeria; Patricia; Mahia; Maria; Luaces; Miguel; Angel; Garcia-Fernandez; Carlos; Macaya; Leopoldo; Perez; de; Isla

    2015-01-01

    Left ventricular aneurysms are a frequent complication of acute extensive myocardial infarction and are most commonly located at the ventricular apex. A timely diagnosis is vital due to the serious complications that can occur,including heart failure,thromboembolism,or tachyarrhythmias. We report the case of a 78-yearold male with history of previous anterior myocardial infarction and currently under evaluation by chronic heart failure. Transthoracic echocardiogram revealed a huge thrombosed and calcified anteroapical left ventricular aneurysm. Coronary angiography demonstrated that the left anterior descending artery was chronically occluded,and revealed a big and spherical mass with calcified borders in the left hemithorax. Left ventriculogram confirmed that this spherical mass was a giant calcified left ventricular aneurysm,causing very severe left ventricular systolic dysfunction. The patient underwent cardioverter-defibrillator implantation for primary prevention.

  11. Giant and thrombosed left ventricular aneurysm.

    Science.gov (United States)

    de Agustin, Jose Alberto; de Diego, Jose Juan Gomez; Marcos-Alberca, Pedro; Rodrigo, Jose Luis; Almeria, Carlos; Mahia, Patricia; Luaces, Maria; Garcia-Fernandez, Miguel Angel; Macaya, Carlos; de Isla, Leopoldo Perez

    2015-07-26

    Left ventricular aneurysms are a frequent complication of acute extensive myocardial infarction and are most commonly located at the ventricular apex. A timely diagnosis is vital due to the serious complications that can occur, including heart failure, thromboembolism, or tachyarrhythmias. We report the case of a 78-year-old male with history of previous anterior myocardial infarction and currently under evaluation by chronic heart failure. Transthoracic echocardiogram revealed a huge thrombosed and calcified anteroapical left ventricular aneurysm. Coronary angiography demonstrated that the left anterior descending artery was chronically occluded, and revealed a big and spherical mass with calcified borders in the left hemithorax. Left ventriculogram confirmed that this spherical mass was a giant calcified left ventricular aneurysm, causing very severe left ventricular systolic dysfunction. The patient underwent cardioverter-defibrillator implantation for primary prevention.

  12. Vulnerability of ecosystems to climate change moderated by habitat intactness.

    Science.gov (United States)

    Eigenbrod, Felix; Gonzalez, Patrick; Dash, Jadunandan; Steyl, Ilse

    2015-01-01

    The combined effects of climate change and habitat loss represent a major threat to species and ecosystems around the world. Here, we analyse the vulnerability of ecosystems to climate change based on current levels of habitat intactness and vulnerability to biome shifts, using multiple measures of habitat intactness at two spatial scales. We show that the global extent of refugia depends highly on the definition of habitat intactness and spatial scale of the analysis of intactness. Globally, 28% of terrestrial vegetated area can be considered refugia if all natural vegetated land cover is considered. This, however, drops to 17% if only areas that are at least 50% wilderness at a scale of 48×48 km are considered and to 10% if only areas that are at least 50% wilderness at a scale of 4.8×4.8 km are considered. Our results suggest that, in regions where relatively large, intact wilderness areas remain (e.g. Africa, Australia, boreal regions, South America), conservation of the remaining large-scale refugia is the priority. In human-dominated landscapes, (e.g. most of Europe, much of North America and Southeast Asia), focusing on finer scale refugia is a priority because large-scale wilderness refugia simply no longer exist. Action to conserve such refugia is particularly urgent since only 1 to 2% of global terrestrial vegetated area is classified as refugia and at least 50% covered by the global protected area network. © 2014 John Wiley & Sons Ltd.

  13. In Vivo Optical Imaging of Neurogenesis: Watching New Neurons in the Intact Brain

    Directory of Open Access Journals (Sweden)

    Sebastien Couillard-Despres

    2008-01-01

    Full Text Available Adult neurogenesis is a highly dynamic process modulated by several pathologic and environmental factors, as well as by various compounds. So far, available techniques to study neurogenesis are lengthy and personnel and cost intensive. We developed a new tool based on the doublecortin promoter driving the expression of the luciferase reporter gene (DCX-promo-luciferase in transgenic mice to perform in vivo imaging of neurogenesis. Indeed, the DCX-promo-luciferase mice allowed optical in vivo imaging of the onset of and increase in neurogenesis in developing fetal brains, as well as imaging of neurogenesis in the intact adult mouse central nervous system. Moreover, the capacity to specifically detect a small number of migrating neuronal precursors in vivo after transplantation is for the first time feasible using this DCX-promo-luciferase transgenic tool. The present imaging approach offers several crucial advantages over methods currently available, such as bromodeoxyuridine incorporation or labeling using iron oxide nanoparticles. Hence, it allows longitudinal study of neurogenesis in intact animals without the requirement of cellular prelabeling. Moreover, it guarantees that detection is specific for neuronal precursors and restricted to viable cells. Hence, our DCX-promo-luciferase transgenic model constitutes an effective tool that answers the pressing need for rapid investigation of the impact on neurogenesis of a large number of candidate compounds waiting to be tested.

  14. Transesophageal Echocardiography, 3-Dimensional and Speckle Tracking Together as Sensitive Markers for Early Outcome in Patients With Left Ventricular Dysfunction Undergoing Cardiac Surgery.

    Science.gov (United States)

    Kumar, Alok; Puri, Goverdhan Dutt; Bahl, Ajay

    2017-10-01

    Speckle tracking, when combined with 3-dimensional (3D) left ventricular ejection fraction, might prove to be a more sensitive marker for postoperative ventricular dysfunction. This study investigated early outcomes in a cohort of patients with left ventricular dysfunction undergoing cardiac surgery. Prospective, blinded, observational study. University hospital; single institution. The study comprised 73 adult patients with left ventricular ejection fraction speckle tracking and 3D left ventricular ejection fraction were computed using transesophageal echocardiography. Mean prebypass global longitudinal strain and 3D left ventricle ejection fraction were significantly lower in patients with postoperative low-cardiac-output syndrome compared with patients who did not develop low cardiac output (global longitudinal strain -7.5% v -10.7% and 3D left ventricular ejection fraction 29% v 39%, respectively; p < 0.0001). The cut-off value of global longitudinal strain predicting postoperative low-cardiac-output syndrome was -6%, with 95% sensitivity and 68% specificity; and 3D left ventricular ejection fraction was 19% with 98% sensitivity and 81% specificity. Preoperative left ventricular global longitudinal strain (-6%) and 3D left ventricular ejection fraction (19%) together could act as predictor of postoperative low-cardiac-output states with high sensitivity (99.9%) in patients undergoing cardiac surgery. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Connexin43 contributes to electrotonic conduction across scar tissue in the intact heart

    Science.gov (United States)

    Mahoney, Vanessa M.; Mezzano, Valeria; Mirams, Gary R.; Maass, Karen; Li, Zhen; Cerrone, Marina; Vasquez, Carolina; Bapat, Aneesh; Delmar, Mario; Morley, Gregory E.

    2016-05-01

    Studies have demonstrated non-myocytes, including fibroblasts, can electrically couple to myocytes in culture. However, evidence demonstrating current can passively spread across scar tissue in the intact heart remains elusive. We hypothesize electrotonic conduction occurs across non-myocyte gaps in the heart and is partly mediated by Connexin43 (Cx43). We investigated whether non-myocytes in ventricular scar tissue are electrically connected to surrounding myocardial tissue in wild type and fibroblast-specific protein-1 driven conditional Cx43 knock-out mice (Cx43fsp1KO). Electrical coupling between the scar and uninjured myocardium was demonstrated by injecting current into the myocardium and recording depolarization in the scar through optical mapping. Coupling was significantly reduced in Cx43fsp1KO hearts. Voltage signals were recorded using microelectrodes from control scars but no signals were obtained from Cx43fsp1KO hearts. Recordings showed significantly decreased amplitude, depolarized resting membrane potential, increased duration and reduced upstroke velocity compared to surrounding myocytes, suggesting that the non-excitable cells in the scar closely follow myocyte action potentials. These results were further validated by mathematical simulations. Optical mapping demonstrated that current delivered within the scar could induce activation of the surrounding myocardium. These data demonstrate non-myocytes in the scar are electrically coupled to myocytes, and coupling depends on Cx43 expression.

  16. Protein kinase D selectively targets cardiac troponin I and regulates myofilament Ca2+ sensitivity in ventricular myocytes.

    Science.gov (United States)

    Cuello, Friederike; Bardswell, Sonya C; Haworth, Robert S; Yin, Xiaoke; Lutz, Susanne; Wieland, Thomas; Mayr, Manuel; Kentish, Jonathan C; Avkiran, Metin

    2007-03-30

    Protein kinase D (PKD) is a serine/threonine kinase with emerging myocardial functions; in skinned adult rat ventricular myocytes (ARVMs), recombinant PKD catalytic domain phosphorylates cardiac troponin I at Ser22/Ser23 and reduces myofilament Ca(2+) sensitivity. We used adenoviral gene transfer to determine the effects of full-length PKD on protein phosphorylation, sarcomere shortening and [Ca(2+)](i) transients in intact ARVMs. In myocytes transduced to express wild-type PKD, the heterologously expressed enzyme was activated by endothelin 1 (ET1) (5 nmol/L), as reflected by PKD phosphorylation at Ser744/Ser748 (PKC phosphorylation sites) and Ser916 (autophosphorylation site). The ET1-induced increase in cellular PKD activity was accompanied by increased cardiac troponin I phosphorylation at Ser22/Ser23; this measured approximately 60% of that induced by isoproterenol (10 nmol/L), which activates cAMP-dependent protein kinase (PKA) but not PKD. Phosphorylation of other PKA targets, such as phospholamban at Ser16, phospholemman at Ser68 and cardiac myosin-binding protein C at Ser282, was unaltered. Furthermore, heterologous PKD expression had no effect on isoproterenol-induced phosphorylation of these proteins, or on isoproterenol-induced increases in sarcomere shortening and relaxation rate and [Ca(2+)](i) transient amplitude. In contrast, heterologous PKD expression suppressed the positive inotropic effect of ET1 seen in control cells, without altering ET1-induced increases in relaxation rate and [Ca(2+)](i) transient amplitude. Complementary experiments in "skinned" myocytes confirmed reduced myofilament Ca(2+) sensitivity by ET1-induced activation of heterologously expressed PKD. We conclude that increased myocardial PKD activity induces cardiac troponin I phosphorylation at Ser22/Ser23 and reduces myofilament Ca(2+) sensitivity, suggesting that altered PKD activity in disease may impact on contractile function.

  17. Automated left ventricular capture management.

    Science.gov (United States)

    Crossley, George H; Mead, Hardwin; Kleckner, Karen; Sheldon, Todd; Davenport, Lynn; Harsch, Manya R; Parikh, Purvee; Ramza, Brian; Fishel, Robert; Bailey, J Russell

    2007-10-01

    The stimulation thresholds of left ventricular (LV) leads tend to be less reliable than conventional leads. Cardiac resynchronization therapy (CRT) requires continuous capture of both ventricles. The purpose of this study is to evaluate a novel algorithm for the automatic measurement of the stimulation threshold of LV leads in cardiac resynchronization systems. We enrolled 134 patients from 18 centers who had existing CRT-D systems. Software capable of automatically executing LV threshold measurements was downloaded into the random access memory (RAM) of the device. The threshold was measured by pacing in the left ventricle and analyzing the interventricular conduction sensed in the right ventricle. Automatic LV threshold measurements were collected and compared with manual LV threshold tests at each follow-up visit and using a Holter monitor system that recorded both the surface electrocardiograph (ECG) and continuous telemetry from the device. The proportion of Left Ventricular Capture Management (LVCM) in-office threshold tests within one programming step of the manual threshold test was 99.7% (306/307) with a two-sided 95% confidence interval of (98.2%, 100.0%). The algorithm measured the threshold successfully in 96% and 97% of patients after 1 and 3 months respectively. Holter monitor analysis in a subset of patients revealed accurate performance of the algorithm. This study demonstrated that the LVCM algorithm is safe, accurate, and highly reliable. LVCM worked with different types of leads and different lead locations. LVCM was demonstrated to be clinically equivalent to the manual LV threshold test. LVCM offers automatic measurement, output adaptation, and trends of the LV threshold and should result in improved ability to maintain LV capture without sacrificing device longevity.

  18. Risk of Ventricular Arrhythmia with Citalopram and Escitalopram: A Population-Based Study

    Science.gov (United States)

    Qirjazi, Elena; McArthur, Eric; Nash, Danielle M.; Dixon, Stephanie N.; Weir, Matthew A.; Vasudev, Akshya; Jandoc, Racquel; Gula, Lorne J.; Oliver, Matthew J.; Wald, Ron; Garg, Amit X.

    2016-01-01

    Background The risk of ventricular arrhythmia with citalopram and escitalopram is controversial. In this study we investigated the association between these two drugs and the risk of ventricular arrhythmia. Methods We conducted a population-based retrospective cohort study of older adults (mean age 76 years) from 2002 to 2012 in Ontario, Canada, newly prescribed citalopram (n = 137 701) or escitalopram (n = 38 436), compared to those prescribed referent antidepressants sertraline or paroxetine (n = 96 620). After inverse probability of treatment weighting using a propensity score, the baseline characteristics of the comparison groups were similar. The primary outcome was a hospital encounter with ventricular arrhythmia within 90 days of a new prescription, assessed using hospital diagnostic codes. The secondary outcome was all-cause mortality within 90 days. Results Citalopram was associated with a higher risk of a hospital encounter with ventricular arrhythmia compared with referent antidepressants (0.06% vs. 0.04%, relative risk [RR] 1.53, 95% confidence intervals [CI]1.03 to 2.29), and a higher risk of mortality (3.49% vs. 3.12%, RR 1.12, 95% CI 1.06 to 1.18). Escitalopram was not associated with a higher risk of ventricular arrhythmia compared with the referent antidepressants (0.03% vs. 0.04%, RR 0.84, 95% CI 0.42 to 1.68), but was associated with a higher risk of mortality (2.86% vs. 2.63%, RR 1.09, 95% CI 1.01 to 1.18). Conclusion Among older adults, initiation of citalopram compared to two referent antidepressants was associated with a small but statistically significant increase in the 90-day risk of a hospital encounter for ventricular arrhythmia. PMID:27513855

  19. Remodelado ventricular y cirugía

    Directory of Open Access Journals (Sweden)

    Ignacio Moriones

    2008-01-01

    Se han diseñado anillos mitrales como el de Carpentier- McCarthy-Adams (IMR ETlogix™ para pacientes isquémicos, o el Edwards-Geoform™ en miocardiopatías. La asistencia ventricular puede conseguir en determinados casos recuperación permanente del volumen de la cavidad y función ventricular, particularmente en miocarditis y determinadas miocardiopatías. Paralelamente, se han iniciado experiencias con el sistema de contención CorCap o el sistema Myosplint. Finalmente, la actuación sobre las valvulopatías y la revascularización favorecen la restauración ventricular.

  20. Linearity of the Frank-Starling relationship in the intact heart: the concept of preload recruitable stroke work.

    Science.gov (United States)

    Glower, D D; Spratt, J A; Snow, N D; Kabas, J S; Davis, J W; Olsen, C O; Tyson, G S; Sabiston, D C; Rankin, J S

    1985-05-01

    The Frank-Starling relationship generally has been examined with filling pressure as the index of preload, resulting in a curvilinear function that plateaus at higher filling pressures. To investigate this relationship further in the intact heart, 32 dogs were chronically instrumented with left ventricular and pleural micromanometers and with regional (10 dogs) or global (22 dogs) ultrasonic dimension transducers. Seven days after implantation, left ventricular pressure and regional or global dimensions were recorded in the conscious state. After autonomic blockade, preload was varied by vena caval occlusion. Myocardial function was assessed by calculating regional or global stroke work, and preload was measured as end-diastolic segment length or chamber volume. The relationship between stroke work and either end-diastolic segment length or chamber volume (termed the preload recruitable stroke work relationship) was highly linear in every study (mean r = .97) and could be quantified by a slope (MW) and x-intercept (LW). Previous nonlinear relationships between stroke work and filling pressure seemed to reflect the exponential diastolic pressure-volume curve. Over the physiologic range of systolic arterial pressures produced by infusion of nitroprusside or phenylephrine, no significant change was observed in MW or LW in the normal dog. Calcium infusion increased both regional and global MW by 71 +/- 19% and 65 +/- 9%, respectively (p less than .02), with no significant change in LW. To normalize for ventricular geometry and heart rate, stroke work was computed from circumferential stress-strain data and converted to myocardial power output, which was then plotted against end-diastolic circumferential strain. This relationship also was highly linear, and the slope, Mmp (mW/cm3 of myocardium), is proposed as a potential measure of intrinsic myocardial performance independent of loading, geometry, and heart rate.

  1. Ventricular fibrillation via torsade des pointes of cardiac sarcoidosis with preserved left ventricular ejection fraction.

    Science.gov (United States)

    Sekihara, Takayuki; Nakane, Eisaku; Nakasone, Kazutaka; Inoko, Moriaki

    2016-10-25

    Generally, low left ventricular ejection fraction (LVEF) is a risk for ventricular arrhythmia in patients with cardiac sarcoidosis. We present a case of cardiac sarcoidosis with preserved LVEF that evoked ventricular fibrillation (VF). A 73-year-old woman with VF presented to our emergency department. She had a history of ocular sarcoidosis, with gradual thinning of the basal intraventricular septum. LVEF was 62% on the most recent echocardiography. The electrocardiogram after defibrillation showed complete atrioventricular block (CAVB) with QT segment prolongation and frequent ventricular premature beats. VF via torsade des pointes (TdP) was suspected, and temporary intravenous ventricular pacing and magnesium sulfate infusion suppressed her VF. Cardiac sarcoidosis was diagnosed, and an implantable cardioverter defibrillator was implanted. Patients with cardiac sarcoidosis with CAVB are at risk of evoking VF via TdP regardless of LVEF. If cardiac sarcoidosis is suspected, early diagnosis and risk stratification of ventricular arrhythmia are important. 2016 BMJ Publishing Group Ltd.

  2. Quantification of left ventricular myocardial collagen system in children, young adults, and the elderly Cuantificación del sistema de colágeno del ventrículo izquierdo del miocardio en niños, adultos jóvenes y ancianos

    Directory of Open Access Journals (Sweden)

    Andrea Bogoslavsky Levy Mendes

    2012-06-01

    Full Text Available Studies on the collagen system of the human myocardium are still limited compared to those on small laboratory animals. The aim of this work was to observe the collagen tissue of the myocardium of the human heart as a function of age. The types of collagen, as well as the density of collagen tissue and the diameter of collagen fibrils, were examined. Fragments of the left ventricular wall from 15 hearts, 5 from children, 5 from young adults, and 5 from elderly individuals, were analyzed by using the Picrosirius-polarization method and by transmission electron microscopy (TEM. The results showed the presence of collagen type III and collagen type I, both in the endomysium and perimysium of the 3 groups studied. Measurements of collagen content in myocardial tissue displayed that both endomysial and perimysial collagen increase in number and thickness in the adult and elderly. These histochemical results coincided with the observations obtained with the electron microscope in showing an increase in the number of collagen fibrils with a large diameter in the adult and elderly hearts. The present results on cardiac collagen may be important for assessing the pathogenesis of several cardiopathies in the hearts of children, young adults, and the elderly.Los estudios sobre el colágeno del miocardio humano son aún escasos en comparación con los hechos en pequeños animales de laboratorio. El objetivo de este trabajo fue cuantificar el tejido colágeno del miocardio del corazón humano en función de la edad. Se estudiaron los tipos de colágeno, su densidad y el diámetro de las fibrillas de colágeno. Para esto se utilizaron fragmentos de la pared del ventrículo izquierdo de 15 corazones, cinco de niños, cinco de adultos jóvenes y 5 de personas de edad avanzada. Las muestras se analizaron mediante el método de Picrosirius-polarización y por microscopía electrónica de transmisión (MET. Los resultados mostraron la presencia de colágeno tipo

  3. Unilateral ventricular reflux and asymmetric ventricular distribution of intrathecally introduced contrast medium or tracer

    Energy Technology Data Exchange (ETDEWEB)

    Deisenhammer, E.; Hammer, B.

    Fourteen cases of totally or predominantly unilateral ventricular reflux and stasis of intrathecally injected radioisotope or contrast medium were demonstrated by scintigraphy or computed tomographic cisternography. All showed asymmetric enlargement of the lateral ventricles and nine had ipsilateral brain lesions. Four case reports are presented. The pathophysiologic mechanism of communicating hydrocephalus and possible causes of unilateral ventricular reflux are discussed, as well as indications for ventricular shunt installation.

  4. Ventricular fibrillation induced by a radiofrequency energy delivery for idiopathic premature ventricular contractions arising from the left ventricular anterior papillary muscle.

    Science.gov (United States)

    Yamada, Takumi; McElderry, H Thomas; Allred, James D; Doppalapudi, Harish; Kay, G Neal

    2009-08-01

    A 73-year-old man with idiopathic premature ventricular contractions (PVCs) underwent electrophysiological testing. Left ventricular activation mapping revealed a focal mechanism of the PVCs with the earliest activation on the anterior papillary muscle (APM). Irrigated radiofrequency (RF) current delivered at that site induced a cluster of non-sustained ventricular tachycardia episodes with the same QRS morphology as the PVCs, followed by ventricular fibrillation (VF). The APM might have served as an abnormal automatic trigger and driver for the VF occurrence. Ventricular fibrillation may occur as a complication during RF catheter ablation of papillary muscle ventricular arrhythmias even if the clinical arrhythmia is limited to PVCs.

  5. Serum steroid levels in intact and endocrine ablated BALB/c nude mice and their intact littermates

    DEFF Research Database (Denmark)

    Brünner, N; Svenstrup, B; Spang-Thomsen, M;

    1986-01-01

    An investigation was made of the serum steroid levels found in intact and endocrine ablated nude mice of both sexes and in their intact homozygous littermates. The results showed that nude mice have a normal steroidogenesis, but with decreased levels of circulating steroids compared to those...... of the littermates. The efficacy of the endocrine ablations was confirmed by the reduction in serum oestrone following oophorectomy, and by the reduction in serum testosterone and progesterone following orchiectomy. The normal steroidogenesis in nude mice, and the similarities between mouse and man with regard...

  6. Acute left ventricular dysfunction secondary to right ventricular septal pacing in a woman with initial preserved contractility: a case report

    Directory of Open Access Journals (Sweden)

    Gribaa Rim

    2011-10-01

    Full Text Available Abstract Introduction Right ventricular apical pacing-related heart failure is reported in some patients after long-term pacing. The exact mechanism is not yet clear but may be related to left ventricular dyssynchrony induced by right ventricular apical pacing. Right ventricular septal pacing is thought to deteriorate left ventricular function less frequently because of a more normal left ventricular activation pattern. Case presentation We report the case of a 55-year-old Tunisian woman with preserved ventricular function, implanted with a dual-chamber pacemaker for complete atrioventricular block. Right ventricular septal pacing induced a major ventricular dyssynchrony, severe left ventricular ejection fraction deterioration and symptoms of congestive heart failure. Upgrading to a biventricular device was associated with a decrease in the symptoms and the ventricular dyssynchrony, and an increase of left ventricular ejection fraction. Conclusion Right ventricular septal pacing can induce reversible left ventricular dysfunction and heart failure secondary to left ventricular dyssynchrony. This complication remains an unpredictable complication of right ventricular septal pacing.

  7. Perceived parental control processes, parent-child relational qualities and psychological well-being of Chinese adolescents in intact and non-intact families in Hong Kong.

    Science.gov (United States)

    Shek, Daniel T L; Lee, Tak Yan

    2007-01-01

    This paper examines whether Chinese adolescents' perceptions (N = 3,017) of parental behavioral control (parental knowledge, expectation, monitoring, discipline, and demandingness as well as parental control based on indigenous Chinese concepts), parental psychological control, parent-child relational qualities (perceived parental trust, child's trust of the parents, child's readiness to communicate with the parents, and child's satisfaction with parental control), and adolescent psychological well-being (hopelessness, mastery, life satisfaction and self-esteem) differed in intact and non-intact families. Results showed that relative to non-intact families, parental behavioral control processes were higher and parent-child relational qualities were better in intact families. In contrast, parental psychological control was higher in non-intact families than in intact families. Finally, the psychological well-being of adolescents in non-intact families was poorer than that of adolescents in intact families.

  8. Bioavailability and in vivo metabolism of intact glucosinolates

    DEFF Research Database (Denmark)

    Sørensen, Jens Christian; Frandsen, Heidi Blok; Jensen, Søren Krogh

    2016-01-01

    Health benefits associated with consumption of cruciferous vegetables have received considerable attention with a hitherto focus on the role and bioactivity of glucosinolate degradation products. We investigated the in vivo metabolism of intact glucosinolates by following their fate in digesta an...

  9. Interleukin 6 in intact and injured mouse peripheral nerves.

    Science.gov (United States)

    Reichert, F; Levitzky, R; Rotshenker, S

    1996-03-01

    The multifunctional cytokine interleukin 6 (IL-6) has direct growth, survival and differentiation effects on peripheral and central neurons. Furthermore, it can modulate the production by non-neuronal cells of other cytokines and growth factors, and thereby affect nerve cells indirectly. We have studied IL-6 expression and production in intact and injured peripheral nerves of C57/BL/6NHSD mice, which display the normal rapid progression of Wallerian degeneration. The IL-6 mRNA was detected in nerves degenerating in vitro or in vivo, but not in intact nerves. In vitro- and in vivo-degenerating nerve segments and neuroma nerve segments synthesized and secreted IL-6. The onset of IL-6 production was rapid and prolonged. It was detected as early as 2 h after injury and persisted for the entire period of 21 days tested after the injury. Of the non-neuronal cells that reside in intact and injured nerves, macrophages and fibroblasts were the major contributors to IL-6 production. We also studied IL-6 production in intact and injured nerves of mutant C57BL/6-WLD/OLA/NHSD mice, which display very slow progression of Wallerian degeneration. Injured nerves of C57BL/6-WLD/OLA/NHSD mice produced significantly lower amounts of IL-6 than did rapidly degenerating nerves of C57/BL/6NHSD mice.

  10. Fostering Activities of Daily Living by Intact Nursing Home Residents

    Science.gov (United States)

    Blair, Charles E.; Glaister, Judy; Brown, Alston; Phillips, Carolyn

    2007-01-01

    We assessed effectiveness of four education programs in providing nursing assistants with ability to produce a therapeutic milieu supportive of intact residents' activities of daily living, positive self-esteem and mood: (1) a combination of Orem's Systems of Nursing Care and Skinner's Applied Behavioral Analysis, (2) Applied Behavioral Analysis,…

  11. Cholesteric carbohydrate liquid crystals incorporating an intact glucopyranose moiety

    NARCIS (Netherlands)

    Smits, E; Engberts, J.B.F.N.; Kellogg, R.M; van Doren, H.A.

    1997-01-01

    Recently, the first monosaccharide derivatives containing a fully intact monosaccharide and two vicinal OH-groups which display thermotropic chiral mesophases were synthesized. These liquid crystals have a rigid core, with a trans-decalin-like skeleton incorporating the D-glucopyranose ring, substit

  12. Pharmacokinetics of erythropoietin in intact and anephric dogs

    Energy Technology Data Exchange (ETDEWEB)

    Fu, J.S.; Lertora, J.J.; Brookins, J.; Rice, J.C.; Fisher, J.W.

    1988-06-01

    The present studies were performed to determine the pharmacokinetic parameters of erythropoietin in intact and anephric dogs by use of unlabeled crude native erythropoietin (nEp) and iodine 125-labeled purified recombinant erythropoietin (rEp) given by intravenous infusion for 15 minutes. Sephadex G-75 gel filtration was used to confirm that the 125I-rEp molecule remained iodinated in dog plasma during the 24-hour period of these studies. The plasma disappearance of erythropoietin conformed to a biexponential equation for both nEp and 125I-rEp, with the central compartment being larger than the peripheral compartment. The mean distribution half-life of 75.3 +/- 21.2 minutes for nEp was significantly (p less than 0.05) longer than that of 125I-rEp (23.7 +/- 5.0 minutes) in intact dogs. The intercompartmental clearance (CIic) for nEp (0.018 +/- 0.006 L/kg/hr) was significantly smaller than that of 125I-rEp (0.068 +/- 0.018 L/kg/hr) in intact dogs (p less than 0.05). There were no significant differences in apparent volume of distribution, elimination half-life, and elimination clearance (CIe) for nEp and rEp in intact dogs. The mean elimination half-life for 125I-rEp in intact dogs (9.0 +/- 0.6 hours) and anephric dogs (13.8 +/- 1.4 hours) was significantly different (p less than 0.05). The CIe for 125I-rEp in anephric dogs (0.008 +/- 0.001 L/kg/hr) was significantly (p less than 0.05) smaller than that of 125I-rEp in intact dogs (0.011 +/- 0.001 L/kg/hr). There were no significant differences in apparent volume of distribution, distribution half-life, and CIic for 125I-rEp in intact and anephric dogs.

  13. Premature Ventricular Complexes and Premature Ventricular Complex Induced Cardiomyopathy.

    Science.gov (United States)

    Latchamsetty, Rakesh; Bogun, Frank

    2015-09-01

    Presentation, prognosis, and management of premature ventricular complexes (PVCs) vary significantly among patients and depend on PVC characteristics as well as patient comorbidities. Presentation can range from incidental discovery in an asymptomatic patient to debilitating heart failure. Prognosis depends on, among other factors, the presence or absence of structural heart disease, PVC burden and other factors detailed in this review. Our understanding of the clinical significance of frequent PVCs, particularly as it relates to development of cardiomyopathy, has advanced greatly in the past decade. In this article, we explore the mechanisms governing PVC initiation and discuss prevalence and frequency of PVCs in the general population. We also explore prognostic implications based on PVC frequency as well as the presence or absence of underlying heart disease. We then take a focused look at PVC-induced cardiomyopathy and identify predictors for developing cardiomyopathy. Finally, we discuss clinical evaluation and management of patients presenting with frequent PVCs. Management can include clinical observation, addressing reversible causes, lifestyle modification, pharmacotherapy, or catheter ablation.

  14. Arrhythmogenic right ventricular dysplasia: A case report

    Directory of Open Access Journals (Sweden)

    Tessa Negrín Valdés

    2015-10-01

    Full Text Available Arrhythmogenic right ventricular dysplasia is a heart muscle disease that predominantly affects the right ventricle, bringing about the replacement of normal myocardium with fatty or fibrofatty tissue and causing sudden death in young individuals. Ventricular tachycardia is an important clinical manifestation, although there are reports of right or global heart failure. The diagnosis is confirmed by echocardiography and magnetic resonance imaging. The case of a 65-year-old former smoker, with hypertension and ischemic heart disease, a history of effort syncope symptoms and proven non-sustained ventricular tachycardia, with morphology of left bundle branch block, is reported. Relevant diagnostic studies were performed, and echocardiographic elements which were compatible with arrhythmogenic right ventricular dysplasia were found. Therefore, an implantable cardioverter defibrillator was implanted, after which the patient has had a favorable outcome.

  15. Ventricular repolarization measures for arrhythmic risk stratification

    Institute of Scientific and Technical Information of China (English)

    Francesco Monitillo; Marta Leone; Caterina Rizzo; Andrea Passantino; Massimo Iacoviello

    2016-01-01

    Ventricular repolarization is a complex electrical phenomenon which represents a crucial stage in electrical cardiac activity. It is expressed on the surface electrocardiogram by the interval between the start of the QRS complex and the end of the T wave or U wave(QT). Several physiological, pathological and iatrogenic factors can influence ventricular repolarization. It has been demonstrated that small perturbations in this process can be a potential trigger of malignant arrhythmias, therefore the analysis of ventricular repolarization represents an interesting tool to implement risk stratification of arrhythmic events in different clinical settings. The aim of this review is to critically revise the traditional methods of static analysis of ventricular repolarization as well as those for dynamic evaluation, their prognostic significance and the possible application in daily clinical practice.

  16. Cardiac sarcoidosis mimicking right ventricular dysplasia.

    Science.gov (United States)

    Shiraishi, Jun; Tatsumi, Tetsuya; Shimoo, Kazutoshi; Katsume, Asako; Mani, Hiroki; Kobara, Miyuki; Shirayama, Takeshi; Azuma, Akihiro; Nakagawa, Masao

    2003-02-01

    A 59-year-old woman with skin sarcoidosis was admitted to hospital for assessment of complete atrioventricular block. Cross-sectional echocardiography showed that the apical free wall of the right ventricle was thin and dyskinetic with dilation of the right ventricle. Thallium-201 myocardial imaging revealed a normal distribution. Both gallium-67 and technetium-99m pyrophosphate scintigraphy revealed no abnormal uptake in the myocardium. Right ventriculography showed chamber dilation and dyskinesis of the apical free wall, whereas left ventriculography showed normokinesis, mimicking right ventricular dysplasia. Cardiac sarcoidosis was diagnosed on examination of an endomyocardial biopsy specimen from the right ventricle. A permanent pacemaker was implanted to manage the complete atrioventricular block. After steroid treatment, electrocardiography showed first-degree atrioventricular block and echocardiography revealed an improvement in the right ventricular chamber dilation. Reports of cardiac sarcoidosis mimicking right ventricular dysplasia are extremely rare and as this case shows, right ventricular involvement may be one of its manifestations.

  17. Threats to intact tropical peatlands and opportunities for their conservation.

    Science.gov (United States)

    Roucoux, K H; Lawson, I T; Baker, T R; Del Castillo Torres, D; Draper, F C; Lähteenoja, O; Gilmore, M P; Honorio Coronado, E N; Kelly, T J; Mitchard, E T A; Vriesendorp, C F

    2017-03-08

    Large, intact areas of tropical peatland are highly threatened at a global scale by the expansion of commercial agriculture and other forms of economic development. Conserving peatlands on a landscape scale, with their hydrology intact, is of international conservation importance to preserve their distinctive biodiversity and ecosystem services and maintain their resilience to future environmental change. We explored threats to and opportunities for conserving remaining intact tropical peatlands; thus, we excluded peatlands of Indonesia and Malaysia, where extensive deforestation, drainage, and conversion to plantations means conservation in this region can protect only small fragments of the original ecosystem. We focused on a case study, the Pastaza-Marañón Foreland Basin (PMFB) in Peru, which is among the largest known intact tropical peatland landscapes in the world and is representative of peatland vulnerability. Maintenance of the hydrological conditions critical for carbon storage and ecosystem function of peatlands is, in the PMFB, primarily threatened by expansion of commercial agriculture linked to new transport infrastructure that is facilitating access to remote areas. There remain opportunities in the PMFB and elsewhere to develop alternative, more sustainable land-use practices. Although some of the peatlands in the PMFB fall within existing legally protected areas, this protection does not include the most carbon-dense (domed pole forest) areas. New carbon-based conservation instruments (e.g., REDD+, Green Climate Fund), developing markets for sustainable peatland products, transferring land title to local communities, and expanding protected areas offer pathways to increased protection for intact tropical peatlands in Amazonia and elsewhere, such as those in New Guinea and Central Africa which remain, for the moment, broadly beyond the frontier of commercial development. © 2017 The Authors. Conservation Biology published by Wiley Periodicals, Inc

  18. A case with catecholaminergic polymorphic ventricular tachycardia

    Directory of Open Access Journals (Sweden)

    Ahmet Ünalır

    2011-06-01

    Full Text Available Catecholaminergic polymorphic ventricular tachycardia (CPVT is a rare type of polymorphic ventricular tachycardias in individuals without structural cardiac abnormalities. It typically has been induced by exercise or emotional stres. It generally is seen in childhood and adolescent period but rarely is seen in elderly. It usually ends by spontaneus, but rarely cause hemodynamic collapse. In here, we present a case with CPVT of successful treatment with a beta blocker therapy. J Clin Exp Invest 2011;2(2:232-4

  19. Case series: Congenital left ventricular diverticulum

    Directory of Open Access Journals (Sweden)

    Shah Dharita

    2010-01-01

    Full Text Available Congenital left ventricular diverticulum is a rare cardiac malformation characterized by a localized outpouching from the cardiac chamber. The patient is usually asymptomatic. However, complications like embolism, infective endocarditis, arrhythmia and, rarely, rupture can be the initial presentation. Diagnosis can be established by USG, echocardiography, CT angiography, and MRI. We report here two neonates with congenital left ventricular apical diverticulum associated with epigastric hernia.

  20. Ventricular tachycardia induced by weight loss pills

    DEFF Research Database (Denmark)

    Pareek, Manan; Hansson, Nils Henrik; Grove, Erik Lerkevang

    2013-01-01

    A previously healthy 29-year-old man was admitted with palpitations, dizziness, and near-syncope after he had recently started taking weight loss pills purchased on the internet. The pills contained caffeine and ephedrine. An electrocardiogram and telemetry revealed multiple episodes of non-susta......-sustained monomorphic ventricular tachycardia, which was successfully treated with amiodarone. In conclusion, unauthorized weight loss pills can be harmful. In particular, ephedrine-containing drugs carry a risk of ventricular tachycardia and should be discouraged....

  1. Ventricular Septal Defect from Takotsubo Syndrome

    Science.gov (United States)

    Caplow, Julie; Quatromoni, Neha

    2016-01-01

    Takotsubo Syndrome is a transient condition characterized by left ventricular systolic dysfunction with apical akinesis/dyskinesis and ballooning. Although the prognosis with medical management is excellent in most cases, rare cases of serious complications can occur. We present here a case of a 71-year-old woman presenting with acute decompensated heart failure with initial findings consistent with a myocardial infarction, who was found instead to have an acute ventricular septal defect as a complication of Takotsubo Syndrome. PMID:27563471

  2. Ventricular Septal Defect from Takotsubo Syndrome

    Directory of Open Access Journals (Sweden)

    Daniel Y. Lu

    2016-01-01

    Full Text Available Takotsubo Syndrome is a transient condition characterized by left ventricular systolic dysfunction with apical akinesis/dyskinesis and ballooning. Although the prognosis with medical management is excellent in most cases, rare cases of serious complications can occur. We present here a case of a 71-year-old woman presenting with acute decompensated heart failure with initial findings consistent with a myocardial infarction, who was found instead to have an acute ventricular septal defect as a complication of Takotsubo Syndrome.

  3. Surgical treatment of left ventricular wall rupture, regarded as a consequence of Takotsubo cardiomyopathy

    Science.gov (United States)

    Kudaiberdiev, Taalaibek; Akhmedova, Irina; Imanalieva, Gulzada; Abdildaev, Ildar; Jooshev, Kilichbek; Ashimov, Jamalbek; Mirzabekov, Azamat; Gaybildaev, Janibek

    2017-01-01

    Objective: We present the case of possible reverse type of TCM in a female patient presented with progressive left ventricular dysfunction and its rupture in pericardium. Methods: The detailed history, physical examination, laboratory tests, electrocardiography, serial echocardiography, coronary angiography with left ventriculography were performed to diagnose possible Takotsubo cardiomyopathy in 63-year old woman admitted to our center with complaints of dyspnea, lightheadedness, weakness and signs of hypotension and history of inferior myocardial infarction, acute left ventricular aneurysm, and effusive pericarditis and pleuritis, developed after emotional stress 5 months ago. Results: Clinical evaluation revealed unremarkable laboratory tests, normal troponin values, signs of old inferior myocardial infarction on electrocardiogram, and left ventricular (LV) dilatation and dysfunction, akinesia of LV infero-lateral wall with thinning and its rupture and blood shunting in pericardium. Her coronary angiography revealed normal coronary arteries. The diagnosis of pheochromocytoma was excluded. The patient underwent surgery under cardiopulmonary bypass with removal of LV pseudoaneurysm. The patient was discharged from hospital with improvement in NYHA class and LV function. Conclusion: Thus, in female postmenopausal patients presenting with acute myocardial infarction signs complicated by pericarditis, intact coronary arteries and LV dysfunction with emotional stress as triggering factor, reverse type of TCM should be considered and proper management applied to prevent development of life-threatening complications like LV rupture. PMID:28228965

  4. Surgical treatment of left ventricular wall rupture, regarded as a consequence of Takotsubo cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Taalaibek Kudaiberdiev

    2017-01-01

    Full Text Available Objective: We present the case of possible reverse type of TCM in a female patient presented with progressive left ventricular dysfunction and its rupture in pericardium. Methods: The detailed history, physical examination, laboratory tests, electrocardiography, serial echocardiography, coronary angiography with left ventriculography were performed to diagnose possible Takotsubo cardiomyopathy in 63-year old woman admitted to our center with complaints of dyspnea, lightheadedness, weakness and signs of hypotension and history of inferior myocardial infarction, acute left ventricular aneurysm, and effusive pericarditis and pleuritis, developed after emotional stress 5 months ago. Results: Clinical evaluation revealed unremarkable laboratory tests, normal troponin values, signs of old inferior myocardial infarction on electrocardiogram, and left ventricular (LV dilatation and dysfunction, akinesia of LV infero-lateral wall with thinning and its rupture and blood shunting in pericardium. Her coronary angiography revealed normal coronary arteries. The diagnosis of pheochromocytoma was excluded. The patient underwent surgery under cardiopulmonary bypass with removal of LV pseudoaneurysm. The patient was discharged from hospital with improvement in NYHA class and LV function. Conclusion: Thus, in female postmenopausal patients presenting with acute myocardial infarction signs complicated by pericarditis, intact coronary arteries and LV dysfunction with emotional stress as triggering factor, reverse type of TCM should be considered and proper management applied to prevent development of life-threatening complications like LV rupture.

  5. Right ventricular mass estimation by angioechocardiography.

    Science.gov (United States)

    Arcilla, R A; Mathew, R; Sodt, P; Lester, L; Cahill, N; Thilenius, O G

    1976-01-01

    A combined angiocardiographic-echocardiographic method for estimating right ventricular wall mass is described. Biplane cineangiocardiograms are analyzed for ventricular volume in end-diastole, and wall thickness is determined from echocardiograms obtained with a high frequency transducer and strip chart recorder, The intracavitary and the external surface volumes of the ventricle are derived, and the difference multiplied by 1.050, the specific gravity of myocardium. Excellent correlation was observed between right ventricular wall mass and body surface area in normal children (r = 0.93). The mean right ventricular mass was 44.5 g/M2 as compared to 78.1 g/M2 for the left ventricle, corresponding mass/EDV values were 0.48 g/cm3 and 1.26 g/cm3, respectively. In isolated right ventricular pressure overload, the increase in right ventricular mass is chiefly due to the increase in wall thickness; in volume overload, it is due mostly to the increase in chamber volume,

  6. Selective left ventricular sensing lead implantation to overcome undersensing of ventricular fibrillation during implantable cardioverter defibrillator implantation.

    Science.gov (United States)

    Steinberg, Christian; Philippon, François; O'Hara, Gilles; Molin, Franck

    2013-06-01

    Accurate sensing of malignant arrhythmia is critical for the appropriate delivery of therapy from implantable cardioverter defibrillators, and undersensing of ventricular tachyarrhythmias can have catastrophic consequences. Here, we present an unusual case of ventricular fibrillation undersensing from the right ventricular lead at multiple different implantation sites because of very low amplitude voltage signals during induced ventricular fibrillation. A left ventricular sensing electrode was implanted to allow correct sensing and therapy delivery.

  7. The Multilevel Mixed Intact Group Analysis: A Mixed Method to Seek, Detect, Describe, and Explain Differences Among Intact Groups

    Science.gov (United States)

    Schoonenboom, Judith

    2016-01-01

    Educational innovations often involve intact subgroups, such as school classes or university departments. In small-scale educational evaluation research, typically involving 1 to 20 subgroups, differences among these subgroups are often neglected. This article presents a mixed method from a qualitative perspective, in which differences among…

  8. Effects of right atrial and ventricular DDD pacing on cardiac function and ventricular contraction synchrony

    Institute of Scientific and Technical Information of China (English)

    支力大; 华伟; 张澍; 史蓉芳; 王方正; 陈新

    2004-01-01

    Background Right ventricular apical pacing has been reported to reduce cardiac performance. But there are few reports on the effects of dual chamber (DDD) pacing on cardiac function compared to sinus rhythm. In this study, we evaluated the effects of right atrial and ventricular DDD pacing on cardiac function and ventricular contraction synchrony using equilibrium radionuclide angiography.Methods Ten patients implanted with a right atrial and ventricular DDD pacemaker underwent equilibrium radionuclide angiography. The scintigraphic data were obtained during sinus rhythm and pacing rhythm. Cardiac function parameters were obtained semimanually. Phase analysis was used to study the ventricular activation sequence and ventricular synchrony.Results The left ventricular 1/3 ejection fraction decreased significantly during pacing compared with that during sinus rhythm[(23.4 ±6.1)% vs(27.7 ±4.5)%, P =0.01]. Regional ejection fraction also decreased during pacing, although the difference was not statistically significant. Phase analysis showed that the right ventricle was activated earlier than the left ventricle during pacing, and that the phase shift was significantly greater during pacing than that during sinus rhythm[64.13°±16.80° vs 52.88°± 9.26°, P =0.007]. The activation of both ventricles occurred simultaneously during sinus rhythm, with the activation sequence from proximal septum or base of left ventricle to apex. The earliest activation during pacing occurred at the right ventricular apex, and subsequently spread to the base and left ventricle.Conclusion Right atrial and ventricular DDD pacing impairs left ventricular systolic function and ventricular synchrony.

  9. Electrohydraulic ventricular assist device development.

    Science.gov (United States)

    Diegel, P D; Mussivand, T; Holfert, J W; Juretich, J T; Miller, J A; Maclean, G K; Szurmak, Z; Santerre, J P; Rajagopalan, K; Dew, P A

    1992-01-01

    An electrohydraulic ventricular assist device has been developed. An axial flow pump driven by a brushless DC motor provides actuation. Energy is supplied by internal Ni/Cd batteries and by external Ag/Zn batteries, both rechargeable. Electromagnetic induction is used to pass energy through the skin with a transcutaneous energy transfer (TET) system. Physiologic control, battery management, motor commutation, and communication functions are performed by a surface mount internal controller. An infrared data link within the TET coils provides bidirectional communication between the external and internal controllers. A computer model was developed to predict system performance. The dimensions are 180 mm x 116 mm x 40 mm. An in vitro system pumped 5.7 L/min at 10 mmHg inflow and 100 mmHg outflow pressure. The internal battery can provide the projected energy requirements for 40 min after 540 charge/discharge cycles, and the external battery is capable of 4 hr of operation after 150 cycles. The TET system can deliver 60 W of power and exceeds 80% efficiency between 15 and 30 W. The device configuration is based on human cadaver and intraoperative fit trials. The device is being modified for calf implantation by redirecting the blood ports, increasing the output, and incorporating the internal controller in the unified device base.

  10. Arrhythmogenic right ventricular cardiomyopathy/dysplasia

    Directory of Open Access Journals (Sweden)

    Basso Cristina

    2007-11-01

    Full Text Available Abstract Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D is a heart muscle disease clinically characterized by life-threatening ventricular arrhythmias. Its prevalence has been estimated to vary from 1:2,500 to 1:5,000. ARVC/D is a major cause of sudden death in the young and athletes. The pathology consists of a genetically determined dystrophy of the right ventricular myocardium with fibro-fatty replacement to such an extent that it leads to right ventricular aneurysms. The clinical picture may include: a subclinical phase without symptoms and with ventricular fibrillation being the first presentation; an electrical disorder with palpitations and syncope, due to tachyarrhythmias of right ventricular origin; right ventricular or biventricular pump failure, so severe as to require transplantation. The causative genes encode proteins of mechanical cell junctions (plakoglobin, plakophilin, desmoglein, desmocollin, desmoplakin and account for intercalated disk remodeling. Familiar occurrence with an autosomal dominant pattern of inheritance and variable penetrance has been proven. Recessive variants associated with palmoplantar keratoderma and woolly hair have been also reported. Clinical diagnosis may be achieved by demonstrating functional and structural alterations of the right ventricle, depolarization and repolarization abnormalities, arrhythmias with the left bundle branch block morphology and fibro-fatty replacement through endomyocardial biopsy. Two dimensional echo, angiography and magnetic resonance are the imaging tools for visualizing structural-functional abnormalities. Electroanatomic mapping is able to detect areas of low voltage corresponding to myocardial atrophy with fibro-fatty replacement. The main differential diagnoses are idiopathic right ventricular outflow tract tachycardia, myocarditis, dialted cardiomyopathy and sarcoidosis. Only palliative therapy is available and consists of antiarrhythmic drugs

  11. [Study of ventricular function by means of echocardiographic quantification of the thickness/radius (h/r) ratio of the left ventricle in healthy subjects].

    Science.gov (United States)

    Guadalajara, J F; Martínez, C; Gutiérrez, E; Zamora, C; Huerta, D

    1989-01-01

    We studied 72 healthy subjects; 31 of them were adults and 41 children. By means of two-dimensional echocardiography we obtained a short axis view at the papillary muscle level of the ratio of the thickness (h) of the ventricular wall and the radius (r) of the cavity. We analysed ventricular performance determinants (pre-load, after-load and contractility). This non-invasive method gives information similar to pressure-volume curves. Thus, we propose it for the study of left ventricular overloads.

  12. Fluorescent-protein stabilization and high-resolution imaging of cleared, intact mouse brains.

    Directory of Open Access Journals (Sweden)

    Martin K Schwarz

    Full Text Available In order to observe and quantify long-range neuronal connections in intact mouse brain by light microscopy, it is first necessary to clear the brain, thus suppressing refractive-index variations. Here we describe a method that clears the brain and preserves the signal from proteinaceous fluorophores using a pH-adjusted non-aqueous index-matching medium. Successful clearing is enabled through the use of either 1-propanol or tert-butanol during dehydration whilst maintaining a basic pH. We show that high-resolution fluorescence imaging of entire, structurally intact juvenile and adult mouse brains is possible at subcellular resolution, even following many months in clearing solution. We also show that axonal long-range projections that are EGFP-labelled by modified Rabies virus can be imaged throughout the brain using a purpose-built light-sheet fluorescence microscope. To demonstrate the viability of the technique, we determined a detailed map of the monosynaptic projections onto a target cell population in the lateral entorhinal cortex. This example demonstrates that our method permits the quantification of whole-brain connectivity patterns at the subcellular level in the uncut brain.

  13. An effective manual deboning method to prepare intact mouse nasal tissue with preserved anatomical organization.

    Science.gov (United States)

    Dunston, David; Ashby, Sarah; Krosnowski, Kurt; Ogura, Tatsuya; Lin, Weihong

    2013-08-10

    The mammalian nose is a multi-functional organ with intricate internal structures. The nasal cavity is lined with various epithelia such as olfactory, respiratory, and squamous epithelia which differ markedly in anatomical locations, morphology, and functions. In adult mice, the nose is covered with various skull bones, limiting experimental access to internal structures, especially those in the posterior such as the main olfactory epithelium (MOE). Here we describe an effective method for obtaining almost the entire and intact nasal tissues with preserved anatomical organization. Using surgical tools under a dissecting microscope, we sequentially remove the skull bones surrounding the nasal tissue. This procedure can be performed on both paraformaldehyde-fixed and freshly dissected, skinned mouse heads. The entire deboning procedure takes about 20-30 min, which is significantly shorter than the experimental time required for conventional chemical-based decalcification. In addition, we present an easy method to remove air bubbles trapped between turbinates, which is critical for obtaining intact thin horizontal or coronal or sagittal sections from the nasal tissue preparation. Nasal tissue prepared using our method can be used for whole mount observation of the entire epithelia, as well as morphological, immunocytochemical, RNA in situ hybridization, and physiological studies, especially in studies where region-specific examination and comparison are of interest.

  14. Effect of right ventricular pacing on ventricular rhythm during atrial fibrillation

    NARCIS (Netherlands)

    Wittkampf, F.H.M.; Jongste, M.J.L. de; Lie, H.I.; Meijler, F.L.

    1988-01-01

    In 13 patients with atrial fibrillation, the effect of right ventricular pacing at various rates on spontaneous RR intervals was studied. Five hundred consecutive RR intervals were recorded and measured before and during varying right ventricular pacing rates. As anticipated, all RR intervals longer

  15. Radiofrequency ablation therapy of intractable ventricular tachycardia present with a left ventricular assist device

    DEFF Research Database (Denmark)

    Nielsen, Jan Møller; Kristiansen, Steen Buus; Gerdes, Christian;

    2015-01-01

    Ventricular tachycardia (VT) occurs in up to 59% of patients with left ventricular assist devices (LVAD). In some of these patients, the VT cannot be managed medically or by implantable cardioverter-defibrillator. In this case, a 66-year-old male was successfully treated with radiofrequency...

  16. Right ventricular failure after implantation of a continuous-flow left ventricular assist device

    DEFF Research Database (Denmark)

    Cordtz, Johan Joakim; Nilsson, Jens C; Hansen, Peter B;

    2014-01-01

    Right ventricular failure (RVF) is a significant complication after implantation of a left ventricular assist device. We aimed to identify haemodynamic changes in the early postoperative phase that predicted subsequent development of RVF in a cohort of HeartMate II (HMII) implanted patients....

  17. Outpatient evaluation and management of patients with ventricular premature beats or non-sustained ventricular tachycardia

    DEFF Research Database (Denmark)

    Svendsen, Jesper Hastrup; Goette, Andreas; Dobreanu, Dan

    2012-01-01

    In this survey, European physicians who deal with arrhythmia patients gave their opinions about diagnostic work up when they see patients with ventricular premature beats (VPBs) or non-sustained ventricular tachycardia (NSVT). In general, similar work-up regimens were used for these two arrhythmias...

  18. Giant left ventricular fibroma presenting as ventricular tachycardia in a child.

    Science.gov (United States)

    Khan, Muhammad Arif; Saeedi, Abdul Raoof Al; Tayeab, Hyfeah Al; Momenah, Tarek

    2014-06-01

    We present a rare case of giant left ventricular apical fibroma presenting as recurrent ventricular tachycardia in a 14-month-old girl. The diagnosis was made by echocardiography and chest computed tomography, and confirmed by histopathology. The fibroma was resected surgically, and the patient followed up for 4 years.

  19. Resection of left ventricular fibroma with subacute papillary muscle rupture.

    Science.gov (United States)

    Leja, Monika J; Perryman, Lynda; Reardon, Michael J

    2011-01-01

    Cardiac fibroma is a rare, benign tumor that occurs chiefly in children and rarely in adults. Most fibromas occur in the ventricles and may reach a very large size that complicates surgical removal. Herein, we report the case of a 38-year-old woman who presented with shortness of breath, fatigue, and lightheadedness and was found to have a 6 × 8-cm fibroma of the left ventricle. Surgical resection was successful, but 7 days later she developed sudden-onset severe mitral regurgitation due to partial disruption of the posterolateral papillary muscle. Mitral valve replacement with a 27-mm mechanical valve was performed. Five years later, the patient remained well, without evident tumor recurrence or cardiac dysfunction.Mitral valve dysfunction with regurgitation has been reported to occur before, immediately after, and late after the resection of left ventricular fibromas. To our knowledge, this is the 1st report of subacute papillary muscle rupture after the resection of a left ventricular fibroma. This case highlights the need to evaluate mitral valve function by carefully inspecting the resection margins after surgery and interpreting the echocardiographic results during the acute, subacute, and late time frames.

  20. Maternal Nutrient Restriction Predisposes Ventricular Remodeling in Adult Sheep Offspring

    OpenAIRE

    Ge, Wei; Hu, Nan; George, Lindsey A; Ford, Stephen P.; Peter W Nathanielsz; Wang, Xiaoming; Ren, Jun

    2013-01-01

    Maternal nutrient restriction during pregnancy is associated with the development of a “thrifty phenotype” in offspring, conferring increased prevalence of metabolic diseases in adulthood. To explore the possible mechanisms behind heart diseases in adulthood following maternal nutrient restriction, dams were fed a nutrient restricted (NR: 50%) or control (100%) diet from 28 to 78 d of gestation. Both groups were then fed 100% of requirements to lambing. At 6 yrs of age, female offspring of NR...

  1. Postoperative normalization of left ventricular noncompaction and new echocardiographic signs in aorta to left ventricular tunnel.

    Science.gov (United States)

    Malakan Rad, Elaheh; Zeinaloo, Ali Akbar

    2013-04-01

    We report postoperative normalization of left ventricular noncompaction in a neonate undergoing successful neonatal surgery for type II aorta to left ventricular tunnel (ALVT) associated with a large patent ductus arteriosus, floppy and extremely redundant anterior mitral leaflet, right coronary artery arising directly from the tunnel, and severe left ventricular noncompaction. We also described 2 novel echocardiographic findings in ALVT including "triple wavy line sign" on M-mode echocardiography which disappeared 1 month after operation and "abnormally increased left ventricular posterior wall motion" on M-mode of standard parasternal long-axis view on color tissue Doppler imaging (TDI) that also normalized postoperatively. We showed that proper definition of endocardial border is extremely important in strain and strain rate imaging in the context of left ventricular noncompaction. Preoperative longitudinal strain and strain rate were significantly decreased in comparison to radial strain and strain rate. Circumferential strain and strain rate were normal. © 2013, Wiley Periodicals, Inc.

  2. Structural determination of intact proteins using mass spectrometry

    Science.gov (United States)

    Kruppa, Gary; Schoeniger, Joseph S.; Young, Malin M.

    2008-05-06

    The present invention relates to novel methods of determining the sequence and structure of proteins. Specifically, the present invention allows for the analysis of intact proteins within a mass spectrometer. Therefore, preparatory separations need not be performed prior to introducing a protein sample into the mass spectrometer. Also disclosed herein are new instrumental developments for enhancing the signal from the desired modified proteins, methods for producing controlled protein fragments in the mass spectrometer, eliminating complex microseparations, and protein preparatory chemical steps necessary for cross-linking based protein structure determination.Additionally, the preferred method of the present invention involves the determination of protein structures utilizing a top-down analysis of protein structures to search for covalent modifications. In the preferred method, intact proteins are ionized and fragmented within the mass spectrometer.

  3. Differential Expression Levels of Integrin α6 Enable the Selective Identification and Isolation of Atrial and Ventricular Cardiomyocytes.

    Directory of Open Access Journals (Sweden)

    Anne Maria Wiencierz

    Full Text Available Central questions such as cardiomyocyte subtype emergence during cardiogenesis or the availability of cardiomyocyte subtypes for cell replacement therapy require selective identification and purification of atrial and ventricular cardiomyocytes. However, current methodologies do not allow for a transgene-free selective isolation of atrial or ventricular cardiomyocytes due to the lack of subtype specific cell surface markers.In order to develop cell surface marker-based isolation procedures for cardiomyocyte subtypes, we performed an antibody-based screening on embryonic mouse hearts. Our data indicate that atrial and ventricular cardiomyocytes are characterized by differential expression of integrin α6 (ITGA6 throughout development and in the adult heart. We discovered that the expression level of this surface marker correlates with the intracellular subtype-specific expression of MLC-2a and MLC-2v on the single cell level and thereby enables the discrimination of cardiomyocyte subtypes by flow cytometry. Based on the differential expression of ITGA6 in atria and ventricles during cardiogenesis, we developed purification protocols for atrial and ventricular cardiomyocytes from mouse hearts. Atrial and ventricular identities of sorted cells were confirmed by expression profiling and patch clamp analysis.Here, we introduce a non-genetic, antibody-based approach to specifically isolate highly pure and viable atrial and ventricular cardiomyocytes from mouse hearts of various developmental stages. This will facilitate in-depth characterization of the individual cellular subsets and support translational research applications.

  4. Binding of Clostridium botulinum C3 exoenzyme to intact cells.

    Science.gov (United States)

    Rohrbeck, Astrid; von Elsner, Leonie; Hagemann, Sandra; Just, Ingo

    2014-06-01

    C3 from Clostridium botulinum (C3) specifically modifies Rho GTPases RhoA, RhoB, and RhoC by mono-ADP-ribosylation. The confined substrate profile of C3 is the basis for its use as pharmacological tool in cell biology to study cellular functions of Rho GTPases. Although C3 exoenzyme does not possess a cell-binding/-translocation domain, C3 is taken up by intact cells via an unknown mechanism. In the present work, binding of C3 to the hippocampus-derived HT22 cells and J774A.1 macrophages was characterized. C3 bound concentration-dependent to HT22 and J774A.1 cells. Pronase treatment of intact cells significantly reduced both C3 binding and C3 cell entry. Removal of sugar residues by glycosidase F treatment resulted in an increased binding of C3, but a reduced cell entry. To explore the involvement of phosphorylation in the binding process of C3, intact HT22 and J774A.1 cells were pre-treated with vanadate prior to incubation with C3. Inhibition of de-phosphorylation by vanadate resulted in an increased binding of C3. To differentiate between intracellular and extracellular phosphorylation, intact cells were treated with CIP (calf intestine phosphatase) to remove extracellular phosphate residues. The removal of phosphate residues resulted in a strong reduction in binding of C3 to cells. In sum, the C3 membranous binding partner is proteinaceous, and the glycosylation as well as the phosphorylation state is critical for efficient binding of C3.

  5. The intact urokinase receptor is required for efficient vitronectin binding

    DEFF Research Database (Denmark)

    Høyer-Hansen, G; Behrendt, N; Ploug, M;

    1997-01-01

    The urokinase receptor (uPAR) is a receptor for both urokinase plasminogen activator (uPA) and the adhesion protein vitronectin. There are two forms of cell surface-bound uPAR; intact uPAR and a cleaved form, uPAR(2+3), which is formed by uPA-catalyzed cleavage of uPAR. In ligand-blotting experim...

  6. Pancreatic exocrine studies in intact animals: historic and current methods.

    Science.gov (United States)

    Niebergall-Roth, E; Teyssen, S; Singer, M V

    1997-12-01

    This report presents a review of the historic and current methods for performing pancreatic exocrine studies in intact animals. Special emphasis is given to the various surgical procedures--pancreatic fistulas, duodenal pouches, and duodenal fistulas--and practice of collecting pancreatic secretion in dogs. Procedures in other animal species--rat, cat, pig, rabbit, cattle, sheep, and horse--also are specified. The advantages and disadvantages, as well as the indications and limitations of the distinct methods, are discussed.

  7. Asymptomatic fistula from a giant aneurysmatic left anterior descending artery to the right ventricular outflow tract.

    Science.gov (United States)

    Mustelier, Juan Valiente; Rego, Julio Oscar Cabrera; Aquiles, Eddy W Olivares; Llerena, Luis Roberto

    2010-12-01

    Coronary artery fistulas are unusual congenital or acquired coronary artery abnormalities in which blood is shunted into a cardiac chamber, great vessel or other structure, bypassing the myocardial capillary network (Jung et al. in Cardiovasc Ultrasound 5:10, 2007). We present a young adult patient with an asymptomatic fistula from a giant aneurysmatic left anterior descending artery to the right ventricular outflow tract, first diagnosed by echocardiography examination and further confirmed by 128-slice computed tomography coronary angiography.

  8. Ryanodine prolongs Ca-currents while suppressing contraction in rat ventricular muscle cells.

    OpenAIRE

    Mitchell, M. R.; Powell, T; Terrar, D. A.; Twist, V. W.

    1984-01-01

    Ryanodine (1 microM) suppressed or abolished contraction in response to step depolarization in voltage-clamped cells isolated from adult rat ventricular myocardium. The step depolarizations evoked the second inward current, which is carried largely by Ca ions under these conditions, and there was little or no change in the amplitude of this current when contraction was reduced or abolished by ryanodine. The effects of ryanodine on contraction were, however, accompanied by a prolongation of th...

  9. Form follows function: developmental and physiological view on ventricular myocardial architecture.

    Science.gov (United States)

    Sedmera, David

    2005-10-01

    The arrangement of myocytes within the ventricle is critical for its contractile performance, as evidenced by significant functional impairment seen in cardiomyopathies associated with myofiber disarray or post-infarction remodeling. A review on this topic by Anderson and associates provides anatomical insight gained from a multitude of approaches, and concludes that the best concept is that of syncytial continuum with supporting collagenous matrix. The overall arrangement is in the form of several intertwined helices, and the authors find no support for a recently suggested ventricular myocardial band hypothesis. This commentary aims at providing a developmental and physiological perspective on this purely anatomical concept. Unlike some other organ systems, the developing heart has to function since very early stages to support the oxygen and nutrition demands of the growing embryo, thus putting some constraints on heart development. The ventricular myocardial architecture transforms from a single-layered tube through trabeculated stages into a mature form that relies on a multi-layered compact zone. The first evidence of helical patterns is found in trabeculated hearts during ventricular contraction, and layers with different helix pitch develop during later fetal stages as the compact zone thickens. The second major point determining ventricular contraction is the sequence of its electrical activation. The ventricular activation sequence changes concomitantly with its morphology, from slow peristaltoid through base-to-apex pattern found in looped trabeculated hearts, to mature apex-to-base direction. Thus, adult ventricular myocardial architecture is best understood when one also considers the way it developed together with its electrical activation sequence and contraction pattern.

  10. Effects of Perindopril on Left Ventricular Remodeling and Osteopontin Expression in Rats With Myocardial Infarction

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    To observe the effects of perindopril on left ventricular remodeling and myocardial osteopontin expression in rats with myocardial infarction. Methods In this study male adult SD rats were randomly divided into 3groups: sham-operation group, MI-saline group and MI-perindopril group. Left anterior descending artery was ligated to generate myocardial infarction. Perindopril (2 mg/kg body weight/day) was administered from the next day of MI.Four weeks later, left ventricular diameter (LVEDD and LVESD) and left ventricular ejection fraction was estimated with echocardiography, LVSP, LVEDP and ± dp/dtmax was detected with hemodynamic measurement, cardiomyocyte diameter and interstitial fibrosis infiltration were evaluated with histological methods, and myocardium osteopontin protein expression level was detected with western blot. Results ①Compared with the sham-operation group, all rats with MI developed significant systolic and diastolic dysfunction, as was indicated by decreased LVEF, LVSP and ± dp/dtmax, as well as increased LVEDP. ②Rats with MI showed significantly dilated left ventricles and higher ventricular weight / body weight ratio, significantly increased cardiomyocyte diameter and marked interstitial fibrosis in the non-infarction area. ③Perindopril treatment partly prevented cardiac dysfunction and left ventricular remodeling as indicated by the parameters mentioned above. ④No osteopontin protein was detected in myocardium of sham-operation rats. In rats with MI, high level osteopontin protein expression was significantly inhibited by perindopril treatment. Conclusions In rats with MI, perindopril treatment significantly prevented left ventricular remodeling and myocardium osteopontin protein expression.

  11. Left ventricular wall stress compendium.

    Science.gov (United States)

    Zhong, L; Ghista, D N; Tan, R S

    2012-01-01

    Left ventricular (LV) wall stress has intrigued scientists and cardiologists since the time of Lame and Laplace in 1800s. The left ventricle is an intriguing organ structure, whose intrinsic design enables it to fill and contract. The development of wall stress is intriguing to cardiologists and biomedical engineers. The role of left ventricle wall stress in cardiac perfusion and pumping as well as in cardiac pathophysiology is a relatively unexplored phenomenon. But even for us to assess this role, we first need accurate determination of in vivo wall stress. However, at this point, 150 years after Lame estimated left ventricle wall stress using the elasticity theory, we are still in the exploratory stage of (i) developing left ventricle models that properly represent left ventricle anatomy and physiology and (ii) obtaining data on left ventricle dynamics. In this paper, we are responding to the need for a comprehensive survey of left ventricle wall stress models, their mechanics, stress computation and results. We have provided herein a compendium of major type of wall stress models: thin-wall models based on the Laplace law, thick-wall shell models, elasticity theory model, thick-wall large deformation models and finite element models. We have compared the mean stress values of these models as well as the variation of stress across the wall. All of the thin-wall and thick-wall shell models are based on idealised ellipsoidal and spherical geometries. However, the elasticity model's shape can vary through the cycle, to simulate the more ellipsoidal shape of the left ventricle in the systolic phase. The finite element models have more representative geometries, but are generally based on animal data, which limits their medical relevance. This paper can enable readers to obtain a comprehensive perspective of left ventricle wall stress models, of how to employ them to determine wall stresses, and be cognizant of the assumptions involved in the use of specific models.

  12. Comparison of the stability of split and intact gabapentin tablets.

    Science.gov (United States)

    Volpe, Donna A; Gupta, Abhay; Ciavarella, Anthony B; Faustino, Patrick J; Sayeed, Vilayat A; Khan, Mansoor A

    2008-02-28

    The purpose of this study was to determine the stability differences between split and intact gabapentin tablets. Gabapentin tablets from three different manufacturers (G1, G2 and G3) were tested for a period of 9 weeks under long-term (25 degrees C/60% RH) and intermediate stability (30 degrees C/60% RH) storage conditions after storage in closed amber pharmacy dispensing containers. Samples were analyzed for dissolution and potency using validated HPLC methods. Potency test also included the quantitation of gabapentin's main degradation product. Tablets from all manufacturers and at all time points had potency >90%. At 9 weeks, a statistically significant decrease (psplit G2 and G3 tablets under the intermediate storage conditions. At the end of 9 weeks, all samples also showed slightly higher levels of degradation product which was statistically significant (psplit and intact tablets. No difference was observed between the potency and dissolution of the intact and the split tablets from the same manufacturer and the three products tested remained stable throughout the study period. The results suggest that splitting of gabapentin tablets did not affect the stability of these particular drug products tested as part of this study when stored under normal storage conditions for a period of up to 9 weeks. However, the results should not be extrapolated to other gabapentin drug products and to other tablet dosage forms.

  13. Does human leukocyte elastase degrade intact skin elastin?

    Science.gov (United States)

    Schmelzer, Christian E H; Jung, Michael C; Wohlrab, Johannes; Neubert, Reinhard H H; Heinz, Andrea

    2012-11-01

    This study aimed to investigate the susceptibility of intact fibrillar human elastin to human leukocyte elastase and cathepsin G. Elastin is a vital protein of the extracellular matrix of vertebrates, and provides exceptional properties including elasticity and tensile strength to many tissues and organs, including the aorta, lung, cartilage, elastic ligaments and skin, and is thus critical for their long-term function. Mature elastin is an insoluble and extremely durable protein that undergoes very little turnover, but sustained exposure to proteases may lead to irreversible and severe damage, and thus to functional loss of the elastic fiber network. Hence, it is a key issue to understand which enzymes actually initiate elastolysis under certain pathological conditions or during intrinsic aging. In this paper, we provide a complete workflow for isolation of pure and intact elastin from very small tissue samples to test enzymes for their elastolytic potential. This workflow was applied to skin samples from variously aged individuals, and it was found that strong differences exist in the degradability of the elastins investigated. In summary, human leukocyte elastase was unable to degrade intact elastin fibers but hydrolyzed elastin derived from the skin of old people. However, cathepsin G cleaved all elastin samples, even those derived from younger individuals. These results indicate that human leukocyte elastase is not a driving force for elastolysis, but may nevertheless promote further breakdown of elastic fibers after the action of other enzymes such as cathepsin G. © 2012 The Authors Journal compilation © 2012 FEBS.

  14. Facial lesions in piglets with intact or grinded teeth

    Directory of Open Access Journals (Sweden)

    Hansson Monica

    2012-04-01

    Full Text Available Abstract Background Piglets are born with eight sharp teeth that during nursing can cause facial lesions on littermates and teat lesions on the sow. Teeth grinding in piglets is therefore often practiced to reduce these lesions. The aim of this study was to assess the consequences of grinding piglet teeth in regard to the occurrence of lesions. In this study the piglets' teeth were grinded in 28 litters, and in 36 litters the piglets' teeth were kept intact. Twice, one time during the first week and one time during the second week after birth facial lesions of the piglets were scored and the teats of the sows were examined for lesions. The facial lesion score accounted for the amount and severity of lesions. The individual observations on piglets in the litter were synthesized in a litter facial lesion score. Findings 69.8% and 43.5% of the piglets had facial lesions in week 1 and week 2 respectively. The effect of treatment was not significant on litter facial lesion score. The litter facial lesion score was higher in week 1 than in week 2 (p p = 0.003 than in small litters. Mortality between week 1 and week 2 was higher in litters with intact teeth (p = 0.02. Sow teat lesions only occurred if litters had intact teeth. Conclusions According to our results teeth grinding is only justifiable in large litters.

  15. Modified Madigan Prostatectomy: A Procedure Preserved Prostatic Urethra Intact

    Institute of Scientific and Technical Information of China (English)

    LU Jun; YE Zhangqun; HU Weilie

    2005-01-01

    Summary: A total of 92 patients with benign prostatic hyperplasia (BPH) were subjected to modified Madigan prostatectomy (MPC) for a much satisfactory effect in open prostatectomy surgery. Exposing anterior prostatic urethra near the bladder neck and conjunct cystotomy modified the MPC procedure. This modified procedure preserved prostatic urethra intact and could also deal with intracystic lesions at the same time. The intact of prostatic urethra was kept completely or largely in 86 cases. The amount of blood loss during modified procedure was less. The mean operative time was 105 min. Seventy patients had been followed up for 3-24 months. The postoperative average Qmax was 19.2 ml/s. The cystourethrography revealed that the urethra and bladder neck were intact in 10 patients postoperatively. Furthermore, the prostatic urethra was obviously wider after modified MPC. The modified MPC can reduce the occurrence of urethra injury and enlarge the MPC indications. The modified technique is easy to perform with less complications and much satisfactory clinical result.

  16. Serum uric acid is associated with left ventricular hypertrophy independent of serum parathyroid hormone in male cardiac patients.

    Directory of Open Access Journals (Sweden)

    Shu-ichi Fujita

    Full Text Available BACKGROUND: Several studies have shown that serum uric acid (UA is associated with left ventricular (LV hypertrophy. Serum levels of parathyroid hormone (PTH, which has bbe shown to be correlated with UA, is also known to be associated with cardiac hypertrophy; however, whether the association between UA and cardiac hypertrophy is independent of PTH remains unknown. PURPOSE: We investigated whether the relationship between serum uric acid (UA and LV hypertrophy is independent of intact PTH and other calcium-phosphate metabolism-related factors in cardiac patients. METHODS AND RESULTS: In a retrospective study, the association between UA and left ventricular mass index was assessed among 116 male cardiac patients (mean age 65 ± 12 years who were not taking UA lowering drugs. The median UA value was 5.9 mg/dL. Neither age nor body mass index differed significantly among the UA quartile groups. Patients with higher UA levels were more likely to be taking loop diuretics. UA showed a significant correlation with intact PTH (R = 0.34, P<0.001 but not with other calcium-phosphate metabolism-related factors. Linear regression analysis showed that log-transformed UA showed a significant association with left ventricular mass index, and this relationship was found to be significant exclusively in patients who were not taking loop and/or thiazide diuretics. Multivariate logistic regression analysis showed that log-transformed UA was independently associated with LV hypertrophy with an odds ratio of 2.79 (95% confidence interval 1.48-5.28, P = 0.002 per one standard deviation increase. CONCLUSIONS: Among cardiac patients, serum UA was associated with LV hypertrophy, and this relationship was, at least in part, independent of intact PTH levels, which showed a significant correlation with UA in the same population.

  17. Imaging of the intact mouse cochlea by spectral domain optical coherence tomography

    Science.gov (United States)

    Gao, Simon S.; Yuan, Tao; Xia, Anping; Raphael, Patrick; Shelton, Ryan L.; Applegate, Brian E.; Oghalai, John S.

    2011-03-01

    Current medical imaging modalities, such as MRI and CT, do not provide high enough resolution to detect many changes within the cochlea that cause hearing loss. We sought to develop the technique of optical coherence tomography (OCT) to image the cochlea noninvasively and within its native environment. We used spectral domain OCT with 950 nm as the center wavelength and a bandwidth of ~100 nm to image freshly excised normal mouse cochlea at different developmental ages. The OCT system has an axial resolution of ~4 μm (in air) and a lateral resolution of ~10 μm. When we imaged normal adult mouse cochleae through the round window membrane, Reissner's membrane, the basilar membrane, the tectorial membrane, the spiral ligament, the spiral limbus, and the modiolus could be clearly identified. When we imaged intact adult cochleae, we were able to image through ~130 μm of bone and tissue to see up to a depth of ~600 μm, and all of the previously identified structures were still visible. Imaging of early postnatal mice during the timeline of cochlear development permitted visualization of the expected structural differences from adult cochleae. Therefore, we conclude that spectral domain OCT is an effective technique for noninvasive imaging of the murine cochlea.

  18. [Clinical experience of mechanical ventricular support with centrifugal pump for severe ventricular failure after open heart surgery].

    Science.gov (United States)

    Matsuwaka, R; Matsuda, H; Kaneko, M; Masai, T; Fudemoto, Y; Kobayashi, T; Imagawa, H; Miyamoto, K; Morisaki, H; Kawashima, Y

    1990-09-01

    Five adult patients (pts) with age 15-67 (mean 43) received mechanical circulatory support with centrifugal pump (Biomedicus, BP-80, Sarns centrifugal pump) for postcardiotomy profound shock. Three pts underwent left ventricular support (LVS) alone, and the other 2 required biventricular support (BVS). Duration of the LVS ranged from 33 to 240 hours (mean 126 hours) and the right ventricular support 92, 120 hrs. Pump flow rate was 1.1 to 2.5 (mean 1.9) L/min/m2. Sixteen pumps were used and the pump exchange was performed 9 times in five pts and an average perfusion time per pump was 57 hrs. Two of 3 pts with LVS alone survived and one died of multiorgan failure associated with right heart dysfunction. In two pts with BVS, one survived and the other died of persistent low cardiac output early after pump removal. As the complication during mechanical support, bleeding was seen in 3 pts and cerebral infarction in one. Although centrifugal pump has potential limitation in antithrombogenicity and durability, this device provides a simple and effective mechanical circulatory support.

  19. Treatment of asymptomatic catecholaminergic polymorphic ventricular tachycardia.

    Science.gov (United States)

    Obeyesekere, Manoj N; Sy, Raymond W; Leong-Sit, Peter; Gula, Lorne J; Yee, Raymond; Skanes, Allan C; Klein, George J; Krahn, Andrew D

    2012-05-01

    Catecholaminergic polymorphic ventricular tachycardia is a rare genetic disorder caused by mutations in genes involved in the intracellular calcium homeostasis of cardiac cells. Affected patients typically present with life-threatening ventricular arrhythmias precipitated by emotional/physical stress. The diagnosis is based on the demonstration of polymorphic or bidirectional ventricular tachycardia associated with adrenergic stress. Genetic testing can be confirmatory in some patients. Treatment for catecholaminergic polymorphic ventricular tachycardia includes medical and surgical efforts to suppress the effects of epinephrine at the myocardial level and/or modulation of calcium homeostasis. Mortality is high when untreated and sudden cardiac death may be the first manifestation of the disease. First-degree relatives of a proband should be offered genetic testing if the causal mutation is known. If the family mutation is not known, relatives should be clinically evaluated with provocative testing. In the absence of rigorous trials, prophylactic treatment of the asymptomatic catecholaminergic polymorphic ventricular tachycardia patient appears to reduce morbidity and mortality.

  20. Surgical Treatment of Left Ventricular Pseudoaneurysm

    Science.gov (United States)

    Mujanovic, Emir; Bergsland, Jacob; Avdic, Sevleta; Stanimirovic-Mujanovic, Sanja; Kovacevic-Preradovic, Tamara; Kabil, Emir

    2014-01-01

    Introduction: Left ventricular pseudoaneurysm is a rare condition because in most instances ventricular free-wall rupture leads to fatal pericardial tamponade. Rupture of the free wall of the left ventricle is a cata­strophic complication of myocardial infarction, occurring in approximately 4% of pa­tients with infarcts, resulting in immediate collapse of the patient and electromechanical dissociation. In rare cases the rupture is contained by pericardial and fibrous tissue, and the result is a pseudoaneurysm. The left ventricular pseudoaneurysm contains only pericardial and fibrous elements in its wall-no myocardial tissue. Because such aneurysms have a strong tendency to rupture, this disorder may lead to death if it is left surgically untreated. Case report: In this case report, we present a patient who underwent successful repair of a left ventricular pseudoaneurysm, which followed a myocardial infarction that was caused by occlusion of the left circumflex coronary artery. Although repair of left ventricular pseudoaneurysm is still a surgical challenge, it can be performed with acceptable results in most patients. PMID:25568538

  1. A pig model of acute right ventricular afterload increase by hypoxic pulmonary vasoconstriction.

    Science.gov (United States)

    Knai, Kathrine; Skjaervold, Nils Kristian

    2017-01-03

    The aim of this study was to construct a non-invasive model for acute right ventricular afterload increase by hypoxic pulmonary vasoconstriction. Intact animal models are vital to improving our understanding of the pathophysiology of acute right ventricular failure. Acute right ventricular failure is caused by increased afterload of the right ventricle by chronic or acute pulmonary hypertension combined with regionally or globally reduced right ventricular contractile capacity. Previous models are hampered by their invasiveness; this is unfortunate as the pulmonary circulation is a low-pressure system that needs to be studied in closed chest animals. Hypoxic pulmonary vasoconstriction is a mechanism that causes vasoconstriction in alveolar vessels in response to alveolar hypoxia. In this study we explored the use of hypoxic pulmonary vasoconstriction as a means to increase the pressure load on the right ventricle. Pulmonary hypertension was induced by lowering the FiO2 to levels below the physiological range in eight anesthetized and mechanically ventilated pigs. The pigs were monitored with blood pressure measurements and blood gases. The mean pulmonary artery pressures (mPAP) of the animals increased from 18.3 (4.2) to 28.4 (4.6) mmHg and the pulmonary vascular resistance (PVR) from 254 (76) dyns/cm(5) to 504 (191) dyns/cm(5), with a lowering of FiO2 from 0.30 to 0.15 (0.024). The animals' individual baseline mPAPs varied substantially as did their response to hypoxia. The reduced FiO2 level yielded an overall lowering in oxygen offer, but the global oxygen consumption was unaltered. We showed in this study that the mPAP and the PVR could be raised by approximately 100% in the study animals by lowering the FiO2 from 0.30 to 0.15 (0.024). We therefore present a novel method for minimally invasive (closed chest) right ventricular afterload manipulations intended for future studies of acute right ventricular failure. The method should in theory be reversible

  2. The studies on neurogenesis indufced by brain injury in adult ring dove

    Institute of Scientific and Technical Information of China (English)

    ZUOMINGXUE

    1998-01-01

    It was the first time demonstrated by us that the number of newborn neurons was increased after making lesion in forebrain of adult ring dove(Streptopelia risoria) by means of autoradiography and imunohistochemistry,Neurogensis in the adult avian is restricted to the telencephalon.In doves with bilateral electrolytic lesion of nucleus ectostriatum(E),the mean mumber of proliferating cells in the lateral ventricular zone(LVZ) and newborn neurons in the forebrain increased by 1.95 times and 2.38 times respectively as compared with that in intact doves.The most remarkable incresase of neurogenesis induced by nucleus ectostriatum lesions was found at the anteriorposterior level 3(L3),where the lesion site was located.These results showed that the electrolytic brain lesion al tered the distribution pattern of proliferating cells in the LVZ and resulted in increase of the number of newborn neureons in the non-VZ areas of forebrain.The changes in number and distribution pattern of proliferating cells in LVZ and newbon neurons in forebrain may be dependent on site of lesion.Studies on the relationship between proliferating cells in LVZ and newly generated neurons in non-VZ aresa may help to understand the mechanism of brain plasticity and development.

  3. Staurosporine Inhibits Frequency-Dependent Myofilament Desensitization in Intact Rabbit Cardiac Trabeculae

    Directory of Open Access Journals (Sweden)

    Kenneth D. Varian

    2012-01-01

    Full Text Available Myofilament calcium sensitivity decreases with frequency in intact healthy rabbit trabeculae and associates with Troponin I and Myosin light chain-2 phosphorylation. We here tested whether serine-threonine kinase activity is primarily responsible for this frequency-dependent modulations of myofilament calcium sensitivity. Right ventricular trabeculae were isolated from New Zealand White rabbit hearts and iontophoretically loaded with bis-fura-2. Twitch force-calcium relationships and steady state force-calcium relationships were measured at frequencies of 1 and 4 Hz at 37 °C. Staurosporine (100 nM, a nonspecific serine-threonine kinase inhibitor, or vehicle (DMSO was included in the superfusion solution before and during the contractures. Staurosporine had no frequency-dependent effect on force development, kinetics, calcium transient amplitude, or rate of calcium transient decline. The shift in the pCa50 of the force-calcium relationship was significant from 6.05±0.04 at 1 Hz versus 5.88±0.06 at 4 Hz under control conditions (vehicle, P<0.001 but not in presence of staurosporine (5.89±0.08 at 1 Hz versus 5.94±0.07 at 4 Hz, P=NS. Phosphoprotein analysis (Pro-Q Diamond stain confirmed that staurosporine significantly blunted the frequency-dependent phosphorylation at Troponin I and Myosin light chain-2. We conclude that frequency-dependent modulation of calcium sensitivity is mediated through a kinase-specific effect involving phosphorylation of myofilament proteins.

  4. A Bayesian Model to Predict Right Ventricular Failure Following Left Ventricular Assist Device Therapy.

    Science.gov (United States)

    Loghmanpour, Natasha A; Kormos, Robert L; Kanwar, Manreet K; Teuteberg, Jeffrey J; Murali, Srinivas; Antaki, James F

    2016-09-01

    This study investigates the use of a Bayesian statistical model to address the limited predictive capacity of existing risk scores derived from multivariate analyses. This is based on the hypothesis that it is necessary to consider the interrelationships and conditional probabilities among independent variables to achieve sufficient statistical accuracy. Right ventricular failure (RVF) continues to be a major adverse event following left ventricular assist device (LVAD) implantation. Data used for this study were derived from 10,909 adult patients from the Inter-Agency Registry for Mechanically Assisted Circulatory Support (INTERMACS) who had a primary LVAD implanted between December 2006 and March 2014. An initial set of 176 pre-implantation variables were considered. RVF post-implant was categorized as acute (14 days) in onset. For each of these endpoints, a separate tree-augmented naïve Bayes model was constructed using the most predictive variables employing an open source Bayesian inference engine. The acute RVF model consisted of 33 variables including systolic pulmonary artery pressure (PAP), white blood cell count, left ventricular ejection fraction, cardiac index, sodium levels, and lymphocyte percentage. The early RVF model consisted of 34 variables, including systolic PAP, pre-albumin, lactate dehydrogenase level, INTERMACS profile, right ventricular ejection fraction, pro-B-type natriuretic peptide, age, heart rate, tricuspid regurgitation, and body mass index. The late RVF model included 33 variables and was predicted mostly by peripheral vascular resistance, model for end-stage liver disease score, albumin level, lymphocyte percentage, and mean and diastolic PAP. The accuracy of all Bayesian models was between 91% and 97%, with an area under the receiver operator characteristics curve between 0.83 and 0.90, sensitivity of 90%, and specificity between 98% and 99%, significantly outperforming previously published risk scores. A Bayesian prognostic

  5. Relationship between Fibrosis and Ventricular Arrhythmias in Chagas Heart Disease Without Ventricular Dysfunction

    Energy Technology Data Exchange (ETDEWEB)

    Tassi, Eduardo Marinho, E-mail: etassi@ibest.com.br [Instituto de Cardiologia Edson Saad - Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil); Continentino, Marcelo Abramoff [Hospital Frei Galvão, Guaratinguetá, SP (Brazil); Nascimento, Emília Matos do; Pereira, Basílio de Bragança [Instituto de Cardiologia Edson Saad - Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil); Coppe - Instituto Alberto Luiz Coimbra de Pós-Graduação e Pesquisa de Engenharia - UFRJ, Rio de Janeiro, RJ (Brazil); Pedrosa, Roberto Coury [Instituto de Cardiologia Edson Saad - Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil)

    2014-05-15

    Patients with Chagas disease and segmental wall motion abnormality (SWMA) have worse prognosis independent of left ventricular ejection fraction (LVEF). Cardiac magnetic resonance (CMR) is currently the best method to detect SWMA and to assess fibrosis. To quantify fibrosis by using late gadolinium enhancement CMR in patients with Chagas disease and preserved or minimally impaired ventricular function (> 45%), and to detect patterns of dependence between fibrosis, SWMA and LVEF in the presence of ventricular arrhythmia. Electrocardiogram, treadmill exercise test, Holter and CMR were carried out in 61 patients, who were divided into three groups as follows: (1) normal electrocardiogram and CMR without SWMA; (2) abnormal electrocardiogram and CMR without SWMA; (3) CMR with SWMA independently of electrocardiogram. The number of patients with ventricular arrhythmia in relation to the total of patients, the percentage of fibrosis, and the LVEF were, respectively: Group 1, 4/26, 0.74% and 74.34%; Group 2, 4/16, 3.96% and 68.5%; and Group 3, 11/19, 14.07% and 55.59%. Ventricular arrhythmia was found in 31.1% of the patients. Those with and without ventricular arrhythmia had mean LVEF of 59.87% and 70.18%, respectively, and fibrosis percentage of 11.03% and 3.01%, respectively. Of the variables SWMA, groups, age, LVEF and fibrosis, only the latter was significant for the presence of ventricular arrhythmia, with a cutoff point of 11.78% for fibrosis mass (p < 0.001). Even in patients with Chagas disease and preserved or minimally impaired ventricular function, electrical instability can be present. Regarding the presence of ventricular arrhythmia, fibrosis is the most important variable, its amount being proportional to the complexity of the groups.

  6. MRI assessment of right ventricular dysplasia

    Energy Technology Data Exchange (ETDEWEB)

    Di Cesare, Ernesto [Department of Radiology, University of L' Aquila, via Vetoio 1, 67100, L' Aquila (Italy)

    2003-06-01

    Right ventricular dysplasia is a new entity of unknown origin in the classification of cardiomyopathies. Also known as arrhythmogenic right ventricular cardiomyopathy (ARVC) or arrhythmogenic right ventricular dysplasia, it is a disease of the heart muscle characterised by fibroadipose atrophy mainly involving the right ventricle and responsible for severe ventricular arrhythmias and sudden death also in young people. Magnetic resonance imaging provides evidence of ventricular dilatation at the outflow tract, thinning and thickening of the wall, diastolic bulging areas (especially located at the level of the right ventricle outflow tract) and fatty substitution of the myocardium mainly at the level of the right ventricle. Many radiologists erroneously consider the previously described fatty substitution as the main sign of ARVC, even though an evaluation of fat substitution alone may be a source of error for two reasons: firstly, because isolated areas of fatty replacement are not synonymous with ARVC since small non-transmural focal fatty areas of fat are also present in the normal patients; and secondly, because the MRI detection of fat may be overestimated due to partial-volume artefacts with normal subepicardial fat. Cardiac MRI can also be employed for the diagnosis of idiopathic right ventricular outflow tract tachycardia. Considering the evolutive nature of the disease, the non-invasiveness of MRI allows the follow-up of these patients and may be considered an excellent screening modality for the diagnosis of ARVC in family members. Finally, MRI can be employed in electrophysiological studies to locate the arrhythmogenic focus and reduce sampling errors. (orig.)

  7. Evaluation of right ventricular volumes measured by magnetic resonance imaging

    DEFF Research Database (Denmark)

    Møgelvang, J; Stubgaard, M; Thomsen, C

    1988-01-01

    Right ventricular volumes were determined in 12 patients with different levels of right and left ventricular function by magnetic resonance imaging (MRI) using an ECG gated multisection technique in planes perpendicular to the diastolic position of the interventricular septum. Right ventricular...... stroke volume was calculated as the difference between end-diastolic and end-systolic volume and compared to left ventricular stroke volume and to stroke volume determined simultaneously by a classical indicator dilution technique. There was good agreement between right ventricular stroke volume...... determined by MRI and by the indicator dilution method and between right and left ventricular stroke volume determined by MRI. Thus, MRI gives reliable values not only for left ventricular volumes, but also for right ventricular volumes. By MRI it is possible to obtain volumes from both ventricles...

  8. Endoventriculoplasty using autologous endocardium for anterior left ventricular aneurysms

    NARCIS (Netherlands)

    Grandjean, JG; Mariani, MA; D'Alfonso, A; Musazzi, A; Boonstra, PW

    Background: There is currently consensus that endoventriculoplasty is the treatment of choice for an anterior left ventricular aneurysm. We describe here a new technique of endoventriculoplasty using autologous endocardium for left ventricular anterior aneurysm. Method: From 1990 until 2003, 49

  9. Disruption of cardiac cholinergic neurons enhances susceptibility to ventricular arrhythmias

    Science.gov (United States)

    Jungen, Christiane; Scherschel, Katharina; Eickholt, Christian; Kuklik, Pawel; Klatt, Niklas; Bork, Nadja; Salzbrunn, Tim; Alken, Fares; Angendohr, Stephan; Klene, Christiane; Mester, Janos; Klöcker, Nikolaj; Veldkamp, Marieke W.; Schumacher, Udo; Willems, Stephan; Nikolaev, Viacheslav O.; Meyer, Christian

    2017-01-01

    The parasympathetic nervous system plays an important role in the pathophysiology of atrial fibrillation. Catheter ablation, a minimally invasive procedure deactivating abnormal firing cardiac tissue, is increasingly becoming the therapy of choice for atrial fibrillation. This is inevitably associated with the obliteration of cardiac cholinergic neurons. However, the impact on ventricular electrophysiology is unclear. Here we show that cardiac cholinergic neurons modulate ventricular electrophysiology. Mechanical disruption or pharmacological blockade of parasympathetic innervation shortens ventricular refractory periods, increases the incidence of ventricular arrhythmia and decreases ventricular cAMP levels in murine hearts. Immunohistochemistry confirmed ventricular cholinergic innervation, revealing parasympathetic fibres running from the atria to the ventricles parallel to sympathetic fibres. In humans, catheter ablation of atrial fibrillation, which is accompanied by accidental parasympathetic and concomitant sympathetic denervation, raises the burden of premature ventricular complexes. In summary, our results demonstrate an influence of cardiac cholinergic neurons on the regulation of ventricular function and arrhythmogenesis. PMID:28128201

  10. New ECG Criteria in Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy

    NARCIS (Netherlands)

    M.G.P.J. Cox; J.J. van der Smagt; A.A.M. Wilde; A.C.P. Wiesfeld; D.E. Atsma; M.R. Nelen; L.M. Rodriguez; P. Loh; M.J. Cramer; P.A. Doevendans; J.P. van Tintelen; J.M.T. de Bakker; R.N.W. Hauer

    2009-01-01

    Background-Desmosomal changes, electric uncoupling, and surviving myocardial bundles in fibrofatty tissue characterize arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C). Resultant activation delay is pivotal for reentry and thereby ventricular tachycardia (VT). Current task force cr

  11. Ventricular Tachycardia Induced by Weight Loss Pills

    Directory of Open Access Journals (Sweden)

    Manan Pareek

    2013-01-01

    Full Text Available A previously healthy 29-year-old man was admitted with palpitations, dizziness, and near-syncope after he had recently started taking weight loss pills purchased on the internet. The pills contained caffeine and ephedrine. An electrocardiogram and telemetry revealed multiple episodes of non-sustained monomorphic ventricular tachycardia, which was successfully treated with amiodarone. In conclusion, unauthorized weight loss pills can be harmful. In particular, ephedrine-containing drugs carry a risk of ventricular tachycardia and should be discouraged.

  12. Ventricular arrhythmias. Clinical recognition and management.

    Science.gov (United States)

    Nestico, P F; DePace, N L; Morganroth, J

    1984-05-01

    The recognition that patients at high risk for sudden cardiac death can be identified raises our enthusiasm to eliminate some of these risk factors and thus our hope to prevent sudden cardiac death. Although this effect is yet to be shown in cooperative, well-controlled clinical trials, data exist to suggest that this result will be achieved. Thus, the use of antiarrhythmic agents in chronic ventricular ectopy, particularly in patients with left ventricular dysfunction, seems to be warranted, and new and more potent agents to be used for this end will be available in the future.

  13. Catecholaminergic polymorphic ventricular tachycardia in 2012

    Directory of Open Access Journals (Sweden)

    Christian van der Werf

    2011-12-01

    Full Text Available Catecholaminergic polymorphic ventricular tachycardia (CPVT is a rare, potentially lethal inherited arrhythmia syndrome characterized by stress or emotion-induced ventricular arrhythmias. CPVT was first described in 1960, while the genetic basis underlying this syndrome was discovered in 2001. The past decade has seen substantial advances in understanding the pathophysiology of CPVT. In addition, significant advances have been made in elucidating clinical characteristics of CPVT patients and new treatment options have become available. Here, we review current literature on CPVT to present state-of-the-art knowledge on the subject of the genetic basis, pathophysiology, clinical presentation, diagnosis, treatment and prognosis.

  14. Right ventricular cardiomyopathy meeting the arrhythmogenic right ventricular dysplasia revised criteria? Do not forget sarcoidosis

    Energy Technology Data Exchange (ETDEWEB)

    Vasaturo, Sabina; Ploeg, David E.; Zeppenfeld, Katja; Veselic-Charvat, Maud [Leiden University Medical Center, Leiden (Netherlands); Buitrago, Guadalupe [Dept. of Radiology, Hospital General Universitario Gregorio Maranon, Madrid (Spain)

    2015-06-15

    A 53-year-old woman was referred for ventricular fibrillation with resuscitation. A CT-angiography showed signs of a right ventricular enlargement without obvious cause. A cardiac MRI demonstrated a dilated and hypokinetic right ventricle with extensive late gadolinium enhancement. Arrhythmogenic right ventricular dysplasia (ARVD) was suspected according to the {sup r}evised ARVD task force criteria{sup .} An endomyocardial biopsy was inconclusive. The patient developed purulent pericarditis after epicardial ablation therapy and died of toxic shock syndrome. The post-mortem pathologic examination demonstrated sarcoidosis involving the heart, lungs, and thyroid gland.

  15. Left ventricular cardiac fibroma in a child presenting with ventricular tachycardia.

    Science.gov (United States)

    Stratemann, Stacy; Dzurik, Yvette; Fish, Frank; Parra, David

    2008-01-01

    Cardiac tumors in children are rare. Although most are histologically benign, they can be associated with life-threatening arrhythmias and sudden death. We report a 7-year-old boy, with a first episode of symptomatic tachycardia, who was found to have a left ventricular (LV) fibroma. He had a normal echocardiogram prior to an electrophysiology study, which revealed a sustained monomorphic ventricular tachycardia and a radio-opacity near the LV apex. These findings prompted a cardiac MRI, which demonstrated a discrete mass on his LV apex and free wall. Our case emphasizes that structural heart disease should be aggressively pursued in children presenting with ventricular tachycardia.

  16. Hypertrophic cardiomyopathy with mid-ventricular obstruction and apical aneurysm

    Directory of Open Access Journals (Sweden)

    N.D. Oryshchyn

    2016-11-01

    Full Text Available A case report of apical left ventricular aneurysm in patient with hypertrophic cardiomyopathy with mid-ventricular obstruction (diagnosis and surgical treatment is presented. We revealed apical aneurysm and mid-ventricular obstruction during echocardiography and specified anatomical characteristics of aneurysm during computer tomography. There was no evidence of obstructive coronary artery disease during coronary angiography. Taking into consideration multiple cerebral infarcts, aneurysm resection and left ventricular plastics was performed. Electronic microscopy of myocardium confirmed the diagnosis of hypertrophic cardiomyopathy.

  17. A case of mixed transcortical aphasia with intact naming.

    Science.gov (United States)

    Heilman, K M; Tucker, D M; Valenstein, E

    1976-09-01

    Altholgh Lichtheim recognized that Wernicke's 'reflex arch' (primary auditory area, to Wernicke's area, to Broca's area, to primary motor area) was important for repetition, he recognized that other areas of the brain (for example, area of concepts or semantic area) must be important in comprehension and voluntary speech. He suggested that Wernicke's area (phonemic area) not only projected to Broca's area (as Wernicke suggested) but that it also projected to the area of concepts. A lesion of this latter pathway or in the area of concepts would produce a syndrome where repetition was intact but comprehension was impaired (e.g. transcortical sensory aphasia). Lichtheim also thought that the area of concepts projected directly to Broca's area and that voluntary speech was mediated by this pathway. Although Lichtheim's model could explain the mechanism underlying transcortical aphasia, his schema could not explain anomic aphasia. Unlike Lichtheim's schema, Kussmaul's schema suggested that the area of concepts projects back to Wernicke's area before projecting to Broca's area. With this schema, a patient with a hypothetical lesion which interrupted the pathway from the area of concepts to Wernicke's area (but did not interrupt the pathway from Wernicke's area to the area of concepts) should be anomic, with normal comprehension and repetition. In order for this latter schema to be plausible there should also be a lesion which interrupts the pathway from Wernicke's area to the area of concepts but does not interrupt the pathway which goes from the area of concepts to Wernicke's area. A patient with this hypothetical lesion should comprehend poorly; however, in spite of poor comprehension, naming and repetition should be intact. We report a patient who demonstrates poor comprehension with intact naming and repetition. This patient could also read aloud but could not comprehend written language. Not only could this patient name objects but he could demonstrate their use

  18. Indications for CSF shunting in normal pressure hydrocephalus following subarachnoid hemorrhage with lateral ventricular size change on cine-MR

    Energy Technology Data Exchange (ETDEWEB)

    Fujitsuka, Mitsuyuki [Kyorin Univ., Mitaka, Tokyo (Japan). School of Medicine

    2002-09-01

    To clarify the indications for cerebrospinal fluid (CSF) shunting in normal pressure hydrocephalus (NPH) following subarachnoid hemorrhage (SAH), the author investigated changes in the pulsatile brain motions during a cardiac cycle in 17 cases with ventriculomegaly following SAH on cardiac gated cine MR images comparing with those in 50 normal adults. In 15 of these seventeen cases, the lateral ventricles not only constricted immediately following the R-wave related to brain expansion but also expanded paradoxically over the initial size during a cardiac diastole. These patterns were different from those of normal adults, and eleven of them showed excellent response to CSF shunting. Theses findings in ventricular motion during a cardiac cycle indicate that the forceful intraventricular CSF flows and stagnancy expand the ventricular walls causing compression of the surrounding brain against the skull. In the remaining two, the lateral ventricles only constricted immediately following the R-wave and the ventricular size change was similar to those of normal adults, and they were diagnosed as not requiring CSF shunting. Assessing ventricular size change on cine-MR enables non-invasive differentiation of NPH from other form of ventriculomegaly, and evaluation of the benefit of CSF shunting is also possible by this technique preoperatively. (author)

  19. Direct detection of radicals in intact soybean nodules

    DEFF Research Database (Denmark)

    Mathieu, C; Moreau, S; Frendo, P

    1998-01-01

    Electron paramagnetic resonance spectroscopy has been employed to examine the nature of the metal ions and radicals present in intact root nodules of soybean plants grown in the absence of nitrate. The spectra obtained from nodules of different ages using this non-invasive technique show dramatic...... of the soybean plants, in a manner analogous to that recently described for Lupinus albus. This Lb-NO complex is present at lower concentrations in older nodules, and is almost completely absent from senescent nodules. Exposure of young and mature nodules to oxidant stress, in the form of hydrogen peroxide...

  20. Rhesus monkey brain imaging through intact skull with thermoacoustic tomography

    OpenAIRE

    Xu, Yuan; Wang, Lihong V.

    2006-01-01

    Two-dimensional microwave-induced thermoacoustic tomography (TAT) is applied to imaging the Rhesus monkey brain through the intact skull. To reduce the wavefront distortion caused by the skull, only the low-frequency components of the thermoacoustic signals (< 1 MHz) are used to reconstruct the TAT images. The methods of signal processing and image reconstruction are validated by imaging a lamb kidney. The resolution of the system is found to be 4 mm when we image a 1-month-old monkey head co...

  1. Fast imaging of intact and shattered cryogenic neon pellets

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Zhehui, E-mail: zwang@lanl.gov [Los Alamos National Laboratory, Los Alamos, New Mexico 87545 (United States); Combs, S. K.; Baylor, L. R.; Foust, C. R.; Lyttle, M. S.; Meitner, S. J.; Rasmussen, D. A. [Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831 (United States)

    2014-11-15

    Compact condensed-matter injection technologies are increasingly used in magnetic fusion. One recent application is in disruption mitigation. An imaging system with less-than-100-µm- and sub-µs-resolution is described and used to characterize intact and shattered cryogenic neon pellets. Shattered pellets contain fine particles ranging from tens of µm to about 7 mm. Time-of-flight analyses indicate that pellets could slow down if hitting the wall of the guide tube. Fast high-resolution imaging systems are thus useful to neon and other condensed-matter injector development.

  2. Fast Imaging of Intact and Shattered Cryogenic Neon Pellets

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Zhehui [Los Alamos National Laboratory (LANL); Combs, Stephen Kirk [ORNL; Baylor, Larry R [ORNL; Foust, Charles R [ORNL; Lyttle, Mark S [ORNL; Meitner, Steven J [ORNL; Rasmussen, David A [ORNL

    2014-01-01

    Compact condensed-matter injection technologies are increasingly used in magnetic fusion. One recent application is in disruption mitigation. An imaging system with less-than-100- m- and sub- s-resolution is described and used to characterize intact and shattered cryogenic neon pellets. Shattered pellets contain fine particles ranging from tens of m to about 7 mm. Time-of-flight analyses indicate that pellets could slow down if hitting the wall of the guide tube. Fast high-resolution imaging systems are thus useful to neon and other condensed-matter injector development.

  3. Fast imaging of intact and shattered cryogenic neon pellets.

    Science.gov (United States)

    Wang, Zhehui; Combs, S K; Baylor, L R; Foust, C R; Lyttle, M S; Meitner, S J; Rasmussen, D A

    2014-11-01

    Compact condensed-matter injection technologies are increasingly used in magnetic fusion. One recent application is in disruption mitigation. An imaging system with less-than-100-µm- and sub-µs-resolution is described and used to characterize intact and shattered cryogenic neon pellets. Shattered pellets contain fine particles ranging from tens of µm to about 7 mm. Time-of-flight analyses indicate that pellets could slow down if hitting the wall of the guide tube. Fast high-resolution imaging systems are thus useful to neon and other condensed-matter injector development.

  4. Left Ventricular Involvement in Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy Assessed by Echocardiography Predicts Adverse Clinical Outcome

    NARCIS (Netherlands)

    Mast, Thomas P.; Teske, Arco J.; van der Heijden, Jeroen F.; Groeneweg, Judith A.; Te Riele, Anneline S J M; Velthuis, Birgitta K.; Hauer, RNW; Doevendans, Pieter A.; Cramer, Maarten J.

    2015-01-01

    Background Among studies describing the phenotype of arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C), significant discrepancy exists regarding the extent and impact of left ventricular (LV) involvement. The capability of conventional and new quantitative echocardiographic techniqu

  5. Adverse ventricular-ventricular interactions in right ventricular pressure load: Insights from pediatric pulmonary hypertension versus pulmonary stenosis.

    Science.gov (United States)

    Driessen, Mieke M P; Hui, Wei; Bijnens, Bart H; Dragulescu, Andreea; Mertens, Luc; Meijboom, Folkert J; Friedberg, Mark K

    2016-06-01

    Right ventricular (RV) pressure overload has a vastly different clinical course in children with idiopathic pulmonary arterial hypertension (iPAH) than in children with pulmonary stenosis (PS). While RV function is well recognized as a key prognostic factor in iPAH, adverse ventricular-ventricular interactions and LV dysfunction are less well characterized and the pathophysiology is incompletely understood. We compared ventricular-ventricular interactions as hypothesized drivers of biventricular dysfunction in pediatric iPAH versus PS Eighteen iPAH, 16 PS patients and 18 age- and size-matched controls were retrospectively studied. Cardiac cycle events were measured by M-mode and Doppler echocardiography. Measurements were compared between groups using ANOVA with post hoc Dunnet's or ANCOVA including RV systolic pressure (RVSP; iPAH 96.8 ± 25.4 mmHg vs. PS 75.4 ± 18.9 mmHg; P = 0.011) as a covariate. RV-free wall thickening was prolonged in iPAH versus PS, extending beyond pulmonary valve closure (638 ± 76 msec vs. 562 ± 76 msec vs. 473 ± 59 msec controls). LV and RV isovolumetric relaxation were prolonged in iPAH (P < 0.001; LV 102.8 ± 24.1 msec vs. 63.1 ± 13.7 msec; RV 95 [61-165] vs. 28 [0-43]), associated with adverse septal kinetics; characterized by rightward displacement in early systole and leftward displacement in late RV systole (i.e., early LV diastole). Early LV diastolic filling was decreased in iPAH (73 ± 15.9 vs. PS 87.4 ± 14.4 vs. controls 95.8 ± 12.5 cm/sec; P = 0.004). Prolonged RVFW thickening, prolonged RVFW isovolumetric times, and profound septal dyskinesia are associated with interventricular mechanical discoordination and decreased early LV filling in pediatric iPAH much more than PS These adverse mechanics affect systolic and diastolic biventricular efficiency in iPAH and may form the basis for worse clinical outcomes. We used clinically derived data to study the pathophysiology of ventricular-ventricular

  6. 21 CFR 870.3545 - Ventricular bypass (assist) device.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ventricular bypass (assist) device. 870.3545... (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Prosthetic Devices § 870.3545 Ventricular bypass (assist) device. (a) Identification. A ventricular bypass (assist) device is a device that...

  7. The relation between bradycardic dyssynchronous ventricular activation, remodeling and arrhythmogenesis

    NARCIS (Netherlands)

    Dunnink, A

    2016-01-01

    Sudden cardiac death (SCD) is a common cause of death and its incidence continues to rise. The occurrence of SCD is mainly due to development of malignant ventricular arrhythmias such as ventricular tachycardia or ventricular fibrillation. The underlying cause of SCD is almost always a complex

  8. The relation between bradycardic dyssynchronous ventricular activation, remodeling and arrhythmogenesis

    NARCIS (Netherlands)

    Dunnink, A

    2016-01-01

    Sudden cardiac death (SCD) is a common cause of death and its incidence continues to rise. The occurrence of SCD is mainly due to development of malignant ventricular arrhythmias such as ventricular tachycardia or ventricular fibrillation. The underlying cause of SCD is almost always a complex remod

  9. Hypertension in young adults.

    Science.gov (United States)

    De Venecia, Toni; Lu, Marvin; Figueredo, Vincent M

    2016-01-01

    Hypertension remains a major societal problem affecting 76 million, or approximately one third, of US adults. While more prevalent in the older population, an increasing incidence in the younger population, including athletes, is being observed. Active individuals, like the young and athletes, are viewed as free of diseases such as hypertension. However, the increased prevalence of traditional risk factors in the young, including obesity, diabetes mellitus, and renal disease, increase the risk of developing hypertension in younger adults. Psychosocial factors may also be contributing factors to the increasing incidence of hypertension in the younger population. Increased left ventricular wall thickness and mass are increasingly found in young adults on routine echocardiograms and predict future cardiovascular events. This increasing incidence of hypertension in the young calls for early surveillance and prompt treatment to prevent future cardiac events. In this review we present the current epidemiological data, potential mechanisms, clinical implications, and treatment of hypertension in young patients and athletes.

  10. Right Ventricular Imaging and Computer Simulation for Electromechanical Substrate Characterization in Arrhythmogenic Right Ventricular Cardiomyopathy

    NARCIS (Netherlands)

    Mast, TP; Teske, Arco J; Walmsley, John; van der Heijden, Jeroen F; van Es, René; Prinzen, Frits W; Delhaas, Tammo; van Veen, Toon A; Loh, KP; Doevendans, Pieter A; Cramer, Maarten J; Lumens, Joost

    2016-01-01

    BACKGROUND: Previous studies suggested that electrical abnormalities precede overt structural disease in arrhythmogenic right ventricular cardiomyopathy (ARVC). Abnormal RV deformation has been reported in early ARVC without structural abnormalities. The pathophysiological mechanisms underlying thes

  11. Effect of berberine on cytosolic free calcium concentration in isolated ventricular myocytes of adult rats%小檗碱对急性分离成年大鼠心室肌细胞内游离钙离子浓度的影响

    Institute of Scientific and Technical Information of China (English)

    孙宏丽; 罗大力; 陈庆文; 董德利; 杨宝峰

    2002-01-01

    Objective To investigate the effect of berberine (Ber) on intracellular calcium concentration ([Ca2+]i) in freshly isolated ventricular cells of rats.Methods An enzymatic method was used to isolate single cardiomyocytes of adult rat, which were loaded with Ca2+-sensitive fluorescent indicator Fluo-3/AM.[Ca2+]i represented by fluorescent intensity (FI) was measured by laser scanning confocal microscope (LSCM).Results At resting levels,[Ca2+]i was not affected by Ber (3~100μmol/L) in Tyrode solution containing Ca2+ 1.8mmol/L or Ca2+-free solution containing EGTA 2mmol/L. The Ca2+ influx induced by KCl 60mmol/L was not influenced by Ber (3~100μmol/L) either. Whereas Ber (30 and 100μmol/L) obviously increased Ca2+ mobilized by caffeine 10 mmol/L (P<0.01). Conclusion Ber has no effect on KCl induced [Ca2+]i elevation via voltage-dependent channel (VDC); however, Ber (30 and 100μmol/L) might promote sarcoplasmic reticulum (SR) Ca2+ efflux by affecting ryanodine receptors (RyRs), or inhibit the SR Ca2+ uptake, the transsarcolemmal Ca2+ efflux and Na+-Ca2+ exchanger.%目的 研究小檗碱对急性分离大鼠心室肌细胞内游离钙离子浓度([Ca2+]i)的影响.方法 采用酶解法分离单个大鼠心肌细胞,用钙敏感的荧光指示剂Fluo-3/AM染色,以荧光强度(FI)来代表[Ca2+]i,应用激光扫描共聚焦显微镜实时监测FI的变化.结果在静息状态下,小檗碱(3~100μmol/L)对[Ca2+]i无影响.3~100μmol/L小檗碱对KCl 60mmol/L介导的钙内流也无影响.但小檗碱(30和100μmol/L)对caffeine 10mmol/L引起的钙动员有明显促进作用(P<0.01).结论小檗碱对于KCl通过电压依赖性钙通道(VDC)介导的[Ca2+]i升高无影响;但小檗碱(30和100μmol/L)可能通过影响RyRs而促进肌浆网(SR)内钙外流,也可能对SR钙摄取,钙的跨膜转运及Na+-Ca2+交换有抑制作用.

  12. 实时三维超声心动图斑点追踪技术评价正常人左心室心肌应变%Evaluation of left ventricular strain by real-time three-dimensional speckle tracking imaging in healthy adults

    Institute of Scientific and Technical Information of China (English)

    汤乔颖; 邓又斌; 黄润青; 杨好意; 王婷

    2012-01-01

    目的 评价三维超声斑点追踪技术测量正常人左室心肌应变的能力,并对心肌总应变矢量的大小和角度进行初步研究.方法 使用三维超声斑点追踪和二维超声斑点追踪技术对31例健康志愿者进行了心肌运动分析,测量左室的纵向、圆周向及径向应变,并通过纵向及圆周向应变计算心肌总应变矢量的大小及角度.结果 三维斑点追踪测得的纵向及圆周向应变在左室整体及各短轴水平均小于二维应变,而径向应变则相反.三维斑点追踪测得的心肌应变在左室不同水平间存在差异,左室中部水平的纵向、圆周向及径向应变均大于基底部及心尖部水平,而二维应变在不同水平间的差异未显示出明显规律.通过测量的纵向及圆周向应变计算得到心肌总应变矢量大小和角度,应用三维应变计算出的心肌总应变矢量绝对值在左室中部水平最大,而总应变矢量角度在不同水平间无明显差异.结论 三维斑点追踪可通过测量心肌应变对左室局部功能进行准确评价且重复性良好,具有潜在的临床应用价值.%Objective To investigate the ability of three-dimensional(3D) speckle tracking imaging (STI) for assessing left ventricular (LV) strain,and measure the value and angle of myocardial main strain vector.Methoods Longitudinal,circumferential and radial strain of LV were measured in 31 healthy adults by 3D-STI and two-dimensional(2D) STI.The main strain vector and the angle between main strain vector and the LV short-axis plane were calculated from longitudinal and circumferential strains.Results The global longitudinal,circumferential strains and strains at basal,middle,apical level of LV by 3D-STI were significantly smaller than those by 2D-STI,whereas radial strain showed an opposite trend.The 3D strains presented significant difference between different levels of LV,longitudinal,circumferential and radial 3D strains were greater at

  13. Diastolic Left Ventricular Dysfunction : A Clinical Appraisal

    NARCIS (Netherlands)

    Bronzwaer, J.G.F.

    2003-01-01

    Diastolic left ventricular (LV) distensibility is determined by the material properties of the LV wall and by LV geometry (i.e., LV shape, LV volume and LV wall thickness). These material properties are influenced both by the physical structure of the LV myocardium and by the dynamic process of myoc

  14. 3-Dimensional Right Ventricular Volume Assessment

    NARCIS (Netherlands)

    Jainandunsing, Jayant S.; Matyal, Robina; Shahul, Sajid S.; Wang, Angela; Woltersom, Bozena; Mahmood, Feroze

    Purpose: The purpose of this review was to evaluate new computer software available for 3-dimensional right ventricular (RV) volume estimation. Description: Based on 2-dimensional echocardiography, various algorithms have been used for RV volume estimation. These are complex, time-consuming

  15. Left ventricular hypertrophy : virtuous intentions, malign consequences

    NARCIS (Netherlands)

    Pokharel, S; Sharma, UC; Pinto, YM

    2003-01-01

    Left ventricular hypertrophy (LVH) is currently the focus of intense cardiovascular research, with the resultant rapid evolution of novel concepts relating to its exceedingly complex pathophysiology. In addition to the alterations in signal transduction and disturbances in Ca2+ homeostasis, there ar

  16. Catheter ablation of parahisian premature ventricular complex.

    Science.gov (United States)

    Kim, Jun; Kim, Jeong Su; Park, Yong Hyun; Kim, June Hong; Chun, Kook Jin

    2011-12-01

    Catheter ablation is performed in selected patients with a symptomatic premature ventricular complex (PVC) or PVC-induced cardiomyopathy. Ablation of PVC from the His region has a high risk of inducing a complete atrioventricular block. Here we report successful catheter ablation of a parahisian PVC in a 63-year-old man.

  17. New test for arrhythmogenic right ventricular cardiomyopathy

    NARCIS (Netherlands)

    van Tintelen, J. Peter; Hauer, Richard N. W.

    Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is challenging to diagnose because of nonspecific findings, particularly in the early phases of the disease. clinical diagnosis is made on the basis of several criteria, but these lack sensitivity. Asimaki et al. suggest that

  18. Congestive cardiomyopathy and left ventricular thrombus.

    Science.gov (United States)

    Gould, L; Gopalaswamy, C; Chandy, F; Kim, B S

    1983-07-01

    A left ventricular thrombus was detected by echocardiography in a 54-year-old man with congestive cardiomyopathy. With the use of anticoagulants, the thrombus completely disappeared. Patients with congestive cardiomyopathy who are at high risk for thrombus formation should be screened with two-dimensional echocardiography. If a thrombus is recognized, anticoagulation therapy can then be instituted.

  19. Diagnosis and management of ventricular dysphonia.

    Science.gov (United States)

    Von Hake, C P; Ganzman, I P; Mauer, T P

    1989-02-01

    Ventricular phonation may develop on a functional level, or it may occur as an alternative voice for the patient who has an organic disease of the true vocal folds. Three cases that represent iatrogenic, traumatic, and neurologic forms of the disorder are reported. Diagnosis, treatment, and guidelines for follow-up speech therapy are discussed.

  20. Diastolic Left Ventricular Dysfunction : A Clinical Appraisal

    NARCIS (Netherlands)

    Bronzwaer, J.G.F.

    2003-01-01

    Diastolic left ventricular (LV) distensibility is determined by the material properties of the LV wall and by LV geometry (i.e., LV shape, LV volume and LV wall thickness). These material properties are influenced both by the physical structure of the LV myocardium and by the dynamic process of

  1. Ventricular tachycardia as a first manifestation of right ventricular myxoma--a case presentation.

    Science.gov (United States)

    Badui, E; Cruz, H; Almazan, A; Enciso, R; Soberanis, N; Garcia, R

    1991-12-01

    The authors present a case of a thirty-nine-year-old white man in good health who developed episodes of ventricular tachycardia as a first manifestation of a right ventricular myxoma, which was diagnosed by two-dimensional echocardiogram and then resected with no complications and total disappearance of the cardiac arrhythmia. After reviewing the literature they consider the present case as a rare manifestation of an infrequent location of an uncommon disease.

  2. Effects of Long-term Right Ventricular Apical Pacing on Left Ventricular Remodeling and Cardiac Function

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    Objective: To investigate the impacts of long-term right ventricular apical pacing on the ventricular remodeling and cardiac functions of patients with high-grade and third-degree atrioventricular blockage with normal heart structures and cardiac functions. In addition, we provide many evidences for choosing an optimal electrode implantation site.Methods: Study participants included patients who were admitted for pacemaker replacements and revisited for examinations of implanted pacemakers at outpatient. Pa...

  3. Angiographic left ventricular wall motion score to predict arrhythmia recurrence in patients with sustained ventricular tachycardia or fibrillation

    NARCIS (Netherlands)

    Wiesfeld, ACP; Crijns, HJGM; VandenBroek, SAJ; Landsman, MLJ; Hillege, HL; vanGilst, WH; Lie, KI

    1996-01-01

    Methods Sixty-nine patients with sustained ventricular tachyarrhythmias were followed up to evaluate the predictive value of functional capacity (i.e. New York Heart Association class and peak oxygen consumption) and resting left ventricular function (i.e. radionuclide left ventricular ejection frac

  4. Epicardial and endocardial mapping determine most successful site of ablation for ventricular tachyarrhythmias originating from left ventricular summit.

    Science.gov (United States)

    Iijima, Kenichi; Chinushi, Masaomi; Furushima, Hiroshi; Aizawa, Yoshifusa

    2012-06-01

    A 34-year-old woman presented with idiopathic premature ventricular complex (PVC) and ventricular tachycardia (VT) originating from the area called the left ventricular summit. Radiofrequency (RF) application both through the coronary sinus and to the epicardial surface transiently suppressed the VT/PVC. Radiofrequency with sufficient energy was only applicable from the endocardial site, and the VT/PVC was successfully eliminated.

  5. A radiological study on lumbar spondylolisthesis with intact neural arch

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Myung Ju; Suh, Young Jun; Joe, Seong Jeh; Yoon, Jong Sup [Han-Gang Sung-Shim Hospital, Seoul (Korea, Republic of)

    1980-12-15

    The purpose of this paper is to evaluate and analyze the radiological findings of 13 cases of lumbar spondylolisthesis with intact neural arch at Han-Gang Sung- Shim Hospital during period from Jan. 1975 to June 1980. 1. The age distribution of the patients varied from 31 to 83 years old. The average of the age was 53 years old. 12 patients were female and only one patient was male. 2. All cases revealed anterior slipping of the L4 body on the L5 body, of which degree was classified by Meyerding's method, first degree in 12 patients and second degree in one patient. 3. The angle between the pedicle and inferior articular facet of affected vertebra was measured by Junghann's method. The average of angle was 123 degree. 4. Of 13 cases, 2 cases who had neural compression caused by dislocation of the vertebral bodies and intrusion of lamina and arthritic facets into stenotic spinal canal treated by laminar decompression including foraminotomy. Good results were obtained. 5. The secondary degenerative change of the vertebra was considered to be the cause of the spondylolisthesis with intact neural arch.

  6. Selective ion changes during spontaneous mitochondrial transients in intact astrocytes.

    Directory of Open Access Journals (Sweden)

    Guillaume Azarias

    Full Text Available The bioenergetic status of cells is tightly regulated by the activity of cytosolic enzymes and mitochondrial ATP production. To adapt their metabolism to cellular energy needs, mitochondria have been shown to exhibit changes in their ionic composition as the result of changes in cytosolic ion concentrations. Individual mitochondria also exhibit spontaneous changes in their electrical potential without altering those of neighboring mitochondria. We recently reported that individual mitochondria of intact astrocytes exhibit spontaneous transient increases in their Na(+ concentration. Here, we investigated whether the concentration of other ionic species were involved during mitochondrial transients. By combining fluorescence imaging methods, we performed a multiparameter study of spontaneous mitochondrial transients in intact resting astrocytes. We show that mitochondria exhibit coincident changes in their Na(+ concentration, electrical potential, matrix pH and mitochondrial reactive oxygen species production during a mitochondrial transient without involving detectable changes in their Ca(2+ concentration. Using widefield and total internal reflection fluorescence imaging, we found evidence for localized transient decreases in the free Mg(2+ concentration accompanying mitochondrial Na(+ spikes that could indicate an associated local and transient enrichment in the ATP concentration. Therefore, we propose a sequential model for mitochondrial transients involving a localized ATP microdomain that triggers a Na(+-mediated mitochondrial depolarization, transiently enhancing the activity of the mitochondrial respiratory chain. Our work provides a model describing ionic changes that could support a bidirectional cytosol-to-mitochondria ionic communication.

  7. Selective ion changes during spontaneous mitochondrial transients in intact astrocytes.

    Science.gov (United States)

    Azarias, Guillaume; Chatton, Jean-Yves

    2011-01-01

    The bioenergetic status of cells is tightly regulated by the activity of cytosolic enzymes and mitochondrial ATP production. To adapt their metabolism to cellular energy needs, mitochondria have been shown to exhibit changes in their ionic composition as the result of changes in cytosolic ion concentrations. Individual mitochondria also exhibit spontaneous changes in their electrical potential without altering those of neighboring mitochondria. We recently reported that individual mitochondria of intact astrocytes exhibit spontaneous transient increases in their Na(+) concentration. Here, we investigated whether the concentration of other ionic species were involved during mitochondrial transients. By combining fluorescence imaging methods, we performed a multiparameter study of spontaneous mitochondrial transients in intact resting astrocytes. We show that mitochondria exhibit coincident changes in their Na(+) concentration, electrical potential, matrix pH and mitochondrial reactive oxygen species production during a mitochondrial transient without involving detectable changes in their Ca(2+) concentration. Using widefield and total internal reflection fluorescence imaging, we found evidence for localized transient decreases in the free Mg(2+) concentration accompanying mitochondrial Na(+) spikes that could indicate an associated local and transient enrichment in the ATP concentration. Therefore, we propose a sequential model for mitochondrial transients involving a localized ATP microdomain that triggers a Na(+)-mediated mitochondrial depolarization, transiently enhancing the activity of the mitochondrial respiratory chain. Our work provides a model describing ionic changes that could support a bidirectional cytosol-to-mitochondria ionic communication.

  8. Sex and regional differences in rabbit right ventricular L-type calcium current levels and mathematical modelling of arrhythmia vulnerability.

    Science.gov (United States)

    Kalik, Zane M; Mike, Joshua L; Slipski, Cassandra; Wright, Moriah; Jalics, Jozsi Z; Womble, Mark D

    2017-07-01

    What is the central question of this study? Regional variations of ventricular L-type calcium current (ICa-L ) amplitude may underlie the increased arrhythmia risk in adult females. Current amplitude variations have been described for the left ventricle but not for the right ventricle. What is the main finding and its importance? Adult female rabbit right ventricular base myocytes exhibit elevated ICa-L compared with female apex or male myocytes. Oestrogen upregulated ICa-L in cultured female myocytes. Mathematical simulations modelling long QT syndrome type 2 demonstrated that elevated ICa-L prolonged action potentials and induced early after-depolarizations. Thus, ventricular arrhythmias in adult females may be associated with an oestrogen-induced upregulation of ICa-L . Previous studies have shown that adult rabbit left ventricular myocytes exhibit sex and regional differences in L-type calcium current (ICa-L ) levels that contribute to increased female susceptibility to arrhythmogenic early after-depolarizations (EADs). We used patch-clamp recordings from isolated adult male and female rabbit right ventricular myocytes to determine apex-base differences in ICa-L density and used mathematical modelling to examine the contribution of ICa-L to EAD formation. Current density measured at 0 mV in female base myocytes was 67% higher than in male base myocytes and 55% higher than in female apex myocytes. No differences were observed between male and female apex myocytes, between male apex and base myocytes, or in the voltage dependences of ICa-L activation or inactivation. The role of oestrogen was investigated using cultured adult female right ventricular base myocytes. After 2 days, 17β-estradiol (1 nm) produced a 65% increase in ICa-L density compared with untreated control myocytes, suggesting an oestrogen-induced upregulation of ICa-L . Action potential simulations using a modified Luo-Rudy cardiomyocyte model showed that increased ICa-L density, at the level

  9. Measurement of intact insulin-like growth factor-binding protein-3 in human plasma using a ligand immunofunctional assay.

    Science.gov (United States)

    Lassarre, C; Binoux, M

    2001-03-01

    Limited proteolysis of insulin-like growth factor binding protein-3 (IGFBP-3) is a fundamental mechanism in the regulation of IGF-I bioavailability in the bloodstream. Its measurement by Western immunoblotting provides only semiquantitative estimation. We have developed a ligand immunofunctional assay (LIFA) for quantifying human (h) intact IGFBP-3 in biological fluids. IGFBP-bound IGFs are dissociated and separated by acid pH ultrafiltration, and a monoclonal antibody specific to the first 160 amino acids of IGFBP-3 is used to capture hIGFBP-3 in a solid-phase assay. The complex is then incubated with (125)I-IGF-I, which binds to intact IGFBP-3 but not to its proteolytic fragments. Binding specificity was demonstrated in competition experiments with unlabeled IGF. Nonspecific binding was 1.4%. The fragments comprising residues 1-160 and 1-95 of recombinant hIGFBP-3 [corresponding to the major proteolytic fragments of approximately 30 kDa and (glycosylated) 20 or (nonglycosylated) 16 kDa detected in serum by Western immunoblotting, respectively] fail to bind (125)I-IGF-I when complexed with the monoclonal antibody. Similarly, no binding of (125)I-IGF-I was obtained in the LIFA when applied to plasmas from pregnant women during the final 3 months of pregnancy, where the characteristic 42- to 39-kDa doublet of intact IGFBP-3 is undetectable. The standard curve was established using a pool of plasmas (EDTA) from healthy adults, for which standardization with glycosylated recombinant hIGFBP-3 yielded an intact IGFBP-3 content of 2 microg/mL. The dynamic range of the LIFA was 0.50-3.75 microL equivalent of the plasma pool in a total volume of 300 microL per assay tube, with a sensitivity threshold of approximately 1 ng intact IGFBP-3. Unknown plasma samples were studied at three concentrations. Intra- and interassay variations were 3.6% and 4%, respectively. In 31 healthy adults, the mean plasma concentration of intact IGFBP-3 was 2.24 +/- 0.08 (SEM) mg/L, and that of

  10. Cavopulmonary Anastomosis in a Patient With Arrhythmogenic Right Ventricular Cardiomyopathy With Severe Right Ventricular Dysfunction.

    Science.gov (United States)

    Vaidyanathan, Swaminathan; Kothandam, Sivakumar; Kumar, Rajesh; Indrajith, Sujatha Desai; Agarwal, Ravi

    2017-01-01

    A 26-year-old lady presented with exertional dyspnea, palpitations, central cyanosis, and oxygen saturations of 80% in room air. Her electrocardiogram, echocardiogram, and cardiac magnetic resonance were diagnostic of arrhythmogenic right ventricular dysplasia. There was no documented ventricular arrhythmia or syncopal episodes and Holter recordings were repeatedly normal. Cardiac hemodynamics showed right to left shunt through atrial septal defect, low pulmonary blood flow, normal atrial pressures, and minimally elevated right ventricular end-diastolic pressures. Since her presenting symptoms and cyanosis were attributed to reduced pulmonary blood flow, she underwent off-pump cavopulmonary anastomosis between right superior vena cava and right pulmonary artery. As we intended to avoid the adverse effect of extracorporeal circulation on the myocardial function and pulmonary vasculature, we did not attempt to reduce the size of the atrial septal defect. Her postoperative period was uneventful; oxygen saturation improved to 89% with significant improvement in effort tolerance. At 18-month follow-up, there were no ventricular arrhythmias on surveillance. The clinical presentation of this disease may vary from serious arrhythmias warranting defibrillators and electrical ablations at one end to right ventricular pump failure warranting cardiomyoplasty or right ventricular exclusion procedures at the other end. However, when the presentation was unusual with severe cyanosis through a stretched foramen ovale leading to reduced pulmonary blood flows, Glenn shunt served as a good palliation and should be considered as one of the options in such patients.

  11. Paucity of Intact Non-Induced Provirus with Early, Long-Term Antiretroviral Therapy of Perinatal HIV Infection

    Science.gov (United States)

    Watson, Douglas; Luzuriaga, Katherine; Siberry, George; Petru, Ann; Chen, YaHui; Uprety, Priyanka; Ho, Ya-Chi; Persaud, Deborah

    2017-01-01

    The latent reservoir is a major barrier to HIV eradication. Reservoir size is emerging as an important biomarker to assess the likelihood of HIV remission in the absence of antiretroviral therapy (ART) and may be reduced by earlier initiation of ART that restricts HIV spread into CD4+ T cells. Reservoir size is traditionally measured with a quantitative viral outgrowth assay (QVOA) that induces replication-competent HIV production through in vitro stimulation of resting CD4+ T cells. However, the recent identification of replication-intact, non-induced proviral genomes (NIPG) suggests the QVOA significantly underestimates (by 62-fold) latent reservoir size in chronically-infected adults. Whether formation and persistence of Intact, NIPG is thwarted by early ART initiation and long-term virologic suppression in perinatal infection is unclear. Here, we show that the latent reservoir in 11 early treated, long-term suppressed perinatally infected children and adolescents was not inducible by QVOA and dominated by defective, NIPG. Single genome analysis of 164 NIPG from 232 million cultured resting CD4+ T cells revealed no replication-intact, near-full length sequences. Forty-three (26%) NIPG contained APOBEC3G-mediated hypermutation, 115 (70%) NIPG contained large internal deletions, one NIPG contained nonsense mutations and indels, and 5 (3%) NIPG were assigned as “Not Evaluable” due to multiple failed sequencing attempts that precluded further classification. The lack of replication competent inducible provirus and intact NIPG in this cohort indicate early, long-term ART of perinatal infection leads to marked diminution of replication-competent HIV-1 reservoirs, creating a favorable state towards interventions aimed at virologic remission. PMID:28178277

  12. The Influence of Therapeutic Radiation on the Patterns of Bone Remodeling in Ovary-Intact and Ovariectomized Mice

    Science.gov (United States)

    Hui, Susanta K; Fairchild, Gregory R; Kidder, Louis S; Sharma, Manju; Bhattacharya, Maryka; Jackson, Scott; Le, Chap; Petryk, Anna; Islam, Mohammad Saiful; Yee, Douglas

    2013-01-01

    Purpose To characterize changes in bone remodeling associated with localized radiation that models therapeutic cancer treatment in ovary-intact and ovariectomized mice and evaluate the influence of radiation on the pattern of bone mineral remodeling. Methods Young adult, female BALB/c mice, ovary-intact (I) and ovariectomized (OVX), were used (n=71). All mice were intravenously injection with 15 μCi 45Ca. Thirty days post-45Ca administration, the hind limbs of 17 mice were exposed to a single 16 Gy radiation (R). The time course of 45Ca excretion, serum CTx and osteocalcin markers, and cancellous bone volume fraction (BV/TV) and cortical thickness (Ct.Th) of the distal femur were measured. Cellular activity and dynamic histomorphometry were performed. Results Irradiation resulted in rapid increases in fecal 45Ca excretion compared to control groups, indicating increased bone remodeling. CTX increased rapidly after irradiation, followed by an increase in osteocalcin concentration. BV/TV decreased in the ovary-intact mice following irradiation. Ct.Th increased in the OVX groups following irradiation. I+R exhibited diminished osteoblasts surface, osteoclast number and mineral apposition rate. Conclusions Our murine model showed the systemic effects (via 45Ca excretion) and local effects (via bone microarchitecture and surface activity) of clinically-relevant, therapeutic radiation exposure. Ovary-intact and ovariectomized murine models have similar 45Ca excretion but different bone microarchitecture responses. 45Ca assay effectively indicates the onset and rate of systemic bone mineral remodeling, providing real time assessment of changes in bone histomorphometric parameters. Monitoring bone health via a bone mineral marker may help identify the appropriate time for clinical intervention to preserve skeletal integrity. PMID:23314741

  13. Children use visual speech to compensate for non-intact auditory speech.

    Science.gov (United States)

    Jerger, Susan; Damian, Markus F; Tye-Murray, Nancy; Abdi, Hervé

    2014-10-01

    We investigated whether visual speech fills in non-intact auditory speech (excised consonant onsets) in typically developing children from 4 to 14 years of age. Stimuli with the excised auditory onsets were presented in the audiovisual (AV) and auditory-only (AO) modes. A visual speech fill-in effect occurs when listeners experience hearing the same non-intact auditory stimulus (e.g., /-b/ag) as different depending on the presence/absence of visual speech such as hearing /bag/ in the AV mode but hearing /ag/ in the AO mode. We quantified the visual speech fill-in effect by the difference in the number of correct consonant onset responses between the modes. We found that easy visual speech cues /b/ provided greater filling in than difficult cues /g/. Only older children benefited from difficult visual speech cues, whereas all children benefited from easy visual speech cues, although 4- and 5-year-olds did not benefit as much as older children. To explore task demands, we compared results on our new task with those on the McGurk task. The influence of visual speech was uniquely associated with age and vocabulary abilities for the visual speech fill--in effect but was uniquely associated with speechreading skills for the McGurk effect. This dissociation implies that visual speech--as processed by children-is a complicated and multifaceted phenomenon underpinned by heterogeneous abilities. These results emphasize that children perceive a speaker's utterance rather than the auditory stimulus per se. In children, as in adults, there is more to speech perception than meets the ear. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Ventricular structure and function in children with sickle cell disease using conventional and tissue Doppler echocardiography.

    Science.gov (United States)

    Eddine, Ahmad Charaf; Alvarez, Ofelia; Lipshultz, Steven E; Kardon, Richard; Arheart, Kristopher; Swaminathan, Sethuraman

    2012-05-01

    Conventional 2-dimensional, M-mode, and spectral Doppler echocardiographic techniques have documented abnormal ventricular function in adults with sickle cell disease (SCD), but assessments in children are conflicting. Tissue Doppler echocardiography (TDE) provides additional information about myocardial function. Two-dimensional, M-mode, tricuspid regurgitation jet velocity (TRJV) data, and tissue Doppler echocardiographically derived myocardial velocity measurements of left ventricular (LV) and right ventricular function were taken from children with SCD compared to those of similar healthy historical controls and correlated with clinical characteristics and hemoglobin levels. Compared to 55 controls, 54 children with SCD (mean age 14.2 years, range 6 to 21) had a larger left ventricle, greater LV mass, and higher LV fractional shortening; 30% had increased pulmonary artery pressure (TRJV ≥2.5 m/s). Conventional echocardiographic measurements of LV systolic function and spectral Doppler measurements of LV and right ventricular diastolic function were essentially normal, but TDE indicated that 31% of SCD children had evidence of LV diastolic dysfunction (peak early diastolic velocity of LV inflow Doppler/peak early diastolic velocity at lateral mitral valve annulus >8), a finding that correlated with lower hemoglobin levels. Although decreasing hemoglobin levels in children with SCD correlated with LV hypertrophy, LV dilation, and LV diastolic dysfunction, long-term transfusion or hydroxyurea therapy did not affect these measurements. In conclusion, 1/3 of children with SCD had tissue Doppler echocardiographic evidence of LV diastolic dysfunction, which was correlated with hemoglobin levels. Adding serial assessments of ventricular function with TDE to conventional echocardiography may detect early cardiac changes, especially in children with severe anemia.

  15. Device Closure of Small Ventricular Septal Defects: When and Why?

    Directory of Open Access Journals (Sweden)

    IB Vijayalakshmi

    2014-10-01

    Full Text Available Ventricular septal defect (VSD accounts for approximately 20-30 % of all forms of congenital heart disease (CHD. They were traditionally closed surgically in the past. The surgery though safe carries the risk of morbidity, complete heart block, wound infection and thoracotomy scar on the chest. On weighing the risk and benefit, the small VSDs were not submitted to surgery in the past. So for many years it has been taught that the small VSDs are to be left alone and surgery is not recommended. Many clinicians believed in spontaneous closure of VSDs. Hence they advised the parents to wait for spontaneous closure till the child is 9 years old. But what if the VSD does not close by 10 years is the question. Are they normal as grown up congenital heart (GUCH. The Jane Somerville GUCH unit showed that spontaneous closure occurred only in 10% between the age of 17 and 45 (mean - 27 years in small VSDs in adults. What is worth noting is about 25% had serious complications: infective endocarditis (11%, progressive aortic regurgitation (5%, age-related symptomatic arrhythmias (8.5% like atrial fibrillation. This means that asymptomatic small VSDs in childhood is not necessarily benign during adult life. This raises the question, when we have a safe non-surgical device closure available to close the small VSDs, should we put the future lives of the young in danger by not giving the benefit of technology to them?

  16. Arrhythmogenic right ventricular dysplasia: MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Wall, E.E. van der; Bootsma, M.M.; Schalij, M.J. [Dept. of Cardiology, Leiden Univ. Medical Center, Leiden (Netherlands); Kayser, H.W.M.; Roos, A. de [Dept. of Radiology, Leiden Univ. Medical Center, Leiden (Netherlands)

    2000-06-01

    Arrhythmogenic right ventricular dysplasia (ARVD) is a heart muscle disorder of unknown cause that is characterized pathologically by fibrofatty replacement of the right ventricular myocardium. Clinical manifestations include structural and functional malformations of the right ventricle, electrocardiographic abnormalities, and presentation with ventricular tachycardias with left bundle branch pattern or sudden death. The disease is often familial with an autosomal inheritance. In addition to right ventricular dilatation, right ventricular aneurysms are typical deformities of ARVD and they are distributed in the so-called ''triangle of dysplasia'', i. e., right ventricular outflow tract, apex, and infundibulum. Ventricular aneurysms at these sites can be considered pathognomonic of ARVD. Another typical hallmark of ARVD is fibrofatty infiltration of the right ventricular free wall. These functional and morphologic characteristics are relevant to clinical imaging investigations such as contrast angiography, echocardiography, radionuclide angiography, ultrafast computed tomography, and magnetic resonance imaging (MRI). Among these techniques, MRI allows the clearest visualization of the heart, in particular because the right ventricle is involved, which is usually more difficult to explore with the other imaging modalities. Furthermore, MRI offers the specific advantage of visualizing adipose infiltration as a bright signal of the right ventricular myocardium. MRI provides the most important anatomic, functional, and morphologic criteria for diagnosis of ARVD within one single study. As a result, MRI appears to be the optimal imaging technique for detecting and following patients with clinical suspicion of ARVD. (orig.) [German] Die arrhythmogene rechtsventrikulaere Dysplasie (ARVD), eine Herzmuskelerkrankung unklarer Aetiologie, ist pathologisch durch fettige Degeneration des rechtsventrikulaeren Myokards gekennzeichnet. Die klinischen Symptome

  17. Biventricular remodeling in murine models of right ventricular pressure overload.

    Directory of Open Access Journals (Sweden)

    Navin K Kapur

    Full Text Available Right ventricular (RV failure is a major cause of mortality in acute or chronic lung disease and left heart failure. The objective of this study was to demonstrate a percutaneous approach to study biventricular hemodynamics in murine models of primary and secondary RV pressure overload (RVPO and further explore biventricular expression of two key proteins that regulate cardiac remodeling: calcineurin and transforming growth factor beta 1 (TGFβ1.Adult, male mice underwent constriction of the pulmonary artery or thoracic aorta as models of primary and secondary RVPO, respectively. Conductance catheterization was performed followed by tissue analysis for changes in myocyte hypertrophy and fibrosis.Both primary and secondary RVPO decreased biventricular stroke work however RV instantaneous peak pressure (dP/dtmax and end-systolic elastance (Ees were preserved in both groups compared to controls. In contrast, left ventricular (LV dP/dtmax and LV-Ees were unchanged by primary, but reduced in the secondary RVPO group. The ratio of RV:LV ventriculo-arterial coupling was increased in primary and reduced in secondary RVPO. Primary and secondary RVPO increased RV mass, while LV mass decreased in primary and increased in the secondary RVPO groups. RV fibrosis and hypertrophy were increased in both groups, while LV fibrosis and hypertrophy were increased in secondary RVPO only. RV calcineurin expression was increased in both groups, while LV expression increased in secondary RVPO only. Biventricular TGFβ1 expression was increased in both groups.These data identify distinct effects of primary and secondary RVPO on biventricular structure, function, and expression of key remodeling pathways.

  18. Is systemic right ventricular function by cardiac MRI related to the degree of tricuspid regurgitation in congenitally corrected transposition of the great arteries?

    Science.gov (United States)

    Lewis, Matthew; Ginns, Jonathan; Rosenbaum, Marlon

    2014-07-01

    Systemic right ventricular dysfunction and tricuspid regurgitation (TR) are frequently encountered in patients with congenitally corrected transposition of the great arteries (CCTGA). Studies using echocardiography have suggested a relationship between the degree of TR and systemic right ventricular dysfunction; however, assessment of systemic right ventricular function by echocardiography is limited. Cardiac MRI (CMR) is the gold standard for volumetric assessment of the systemic right ventricle. We performed a retrospective cohort study at our center evaluating all adult patients with CCTGA who underwent a CMR between 1/1999 and 1/2013 to determine the relationship between the degree of TR and systemic right ventricular function. Of the 33 patients identified, 12 had ≤ mild TR (37%), 13 had moderate TR (40%), and 8 had severe TR (24%). Mean age at CMR was 38 years (23-64). Mean right ventricular ejection fraction (45% vs. 41% vs. 42%, p=0.68) and mean indexed right ventricular end diastolic volume (122 ml/m(2) vs. 136 ml/m(2) vs. 138 ml/m(2)p=0.36) were not significantly different for patients with ≤ mild TR, moderate TR or severe TR. The degree of TR was not associated with additional congenital lesions, prior procedures, presence of an intraventricular conduction delay, or decreased left ventricular function. No association between the degree of TR and right ventricular volume or ejection fraction by CMR was identified. Failure to show worsening function or increased volume with greater degrees of TR suggests that the degree of regurgitation alone may not fully explain the heterogeneity in right ventricular size and function. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. Cardiac response to doxorubicin and dexrazoxane in intact and ovariectomized young female rats at rest and after swim training.

    Science.gov (United States)

    Calvé, Annie; Haddad, Rami; Barama, Sarah-Neiel; Meilleur, Melissa; Sebag, Igal A; Chalifour, Lorraine E

    2012-05-15

    The impact of cancer therapies on adult cardiac function is becoming a concern as more children survive their initial cancer. Cardiovascular disease is now a significant problem to adult survivors of childhood cancer. Specifically, doxorubicin (DOX) may be particularly harmful in young girls. The objective of this study was to characterize DOX damage and determine the ability of dexrazoxane (DEX) to reduce DOX-mediated cardiac damage in sedentary and swim-trained female rats. Female Sprague-Dawley rats were left intact or ovariectomized (OVX) at weaning then injected with DEX (60 mg/kg) before DOX (3 mg/kg), DOX alone, or PBS. Rats were separated into sedentary and swim cohorts. Body weight was reduced in DOX:DEX- but not PBS- or DOX-treated rats. Echocardiographic parameters were similar in sedentary rats. Swim training revealed greater concentric remodeling in DOX-treated rats and reduced fractional shortening in DOX:DEX-treated rats. Calsequestrin 2 was reduced with DOX and increased with DOX:DEX postswim. Sarco(endo)plasmic reticulum Ca(2+)-ATPase 2a was reduced and calsequestrin 2 reduced further by swim training only in intact rats. OVX rats were heavier and developed eccentric remodeling post-swim with DOX and eccentric hypertrophy with DOX:DEX. Changes in SERCA2a and calsequestrin 2 expression were not observed. Ovariectomized DOX- and DOX:DEX-treated rats stopped growing during swim training. DEX coinjection did not relieve DOX-mediated cardiotoxicity in intact or hormone-deficient rats. DOX-mediated reductions in growth, cardiac function, and expression of calcium homeostasis proteins were exacerbated by swim. DEX coadministration did not substantially relieve DOX-mediated cardiotoxicity in young female rats. Ovarian hormones reduce DOX-induced cardiotoxicity.

  20. Calcium Activation Profile In Electrically Stimulated Intact Rat Heart Cells

    Science.gov (United States)

    Geerts, Hugo; Nuydens, Rony; Ver Donck, Luc; Nuyens, Roger; De Brabander, Marc; Borgers, Marcel

    1988-06-01

    Recent advances in fluorescent probe technology and image processing equipment have made available the measurement of calcium in living systems on a real-time basis. We present the use of the calcium indicator Fura-2 in intact normally stimulated rat heart cells for the spatial and dynamic measurement of the calcium excitation profile. After electric stimulation (1 Hz), the activation proceeds from the center of the myocyte toward the periphery. Within two frame times (80 ms), the whole cell is activated. The activation is slightly faster in the center of the cell than in the periphery. The mean recovery time is 200-400 ms. There is no difference along the cell's long axis. The effect of a beta-agonist and of a calcium antagonist is described.

  1. Complete posterior migration of intact vertebral body in spinal tuberculosis

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    Sridhar Krishnamurthy

    2009-01-01

    Full Text Available Spinal tuberculosis most commonly presents as a paradiscal lesion involving the disc space and adjacent vertebral bodies. Atypical forms of spinal tuberculosis have been described and are most often a result of posterior element involvement. The authors report a patient, who presented with complete posterior migration of an intact vertebral body, a complication of spinal tuberculosis that has not been reported till date. A 12-year-old girl with history of pulmonary tuberculosis presented with progressive paraparesis and back pain. Plain X-rays and MRI revealed that the L2 vertebral body had migrated posteriorly into the spinal canal, without significant movement of the posterior elements. The vertebral body was normal, with no erosion or bone loss. However, bilateral pedicle and facet joint involvement was seen. The neural elements were decompressed through an anterolateral retroperitoneal approach and the spine reconstructed. The authors present this rare manifestation of spinal tuberculosis and discuss the possible mechanisms of this presentation.

  2. In vitro adherence of Moraxella bovis to intact corneal epithelium.

    Science.gov (United States)

    Jackman, S H; Rosenbusch, R F

    1984-09-01

    An in vitro assay is described using radiolabeled Moraxella bovis for studying adherence to intact bovine corneal epithelial surfaces. The assay was optimized for time (45 min) and for the ratio of epithelial cells to bacteria (1:1000) that demonstrated a significant difference in adherence between M. bovis strain 118F, a piliated organism and a nonpiliated variant, strain 118F/4-2. Adherence of these organisms correlated with previous pathogenicity studies involving experimental infection of calves. Scanning electron microscopy of tissues treated in the assay revealed a predilection of M. bovis for dark epithelial cells and for association with depressions in the tissue surface. This assay technique is discussed in comparison with other in vitro adherence assay methods.

  3. Rhesus monkey brain imaging through intact skull with thermoacoustic tomography.

    Science.gov (United States)

    Xu, Yuan; Wang, Lihong V

    2006-03-01

    Two-dimensional microwave-induced thermoacoustic tomography (TAT) is applied to imaging the Rhesus monkey brain through the intact skull. To reduce the wavefront distortion caused by the skull, only the low-frequency components of the thermoacoustic signals (images. The methods of signal processing and image reconstruction are validated by imaging a lamb kidney. The resolution of the system is found to be 4 mm when we image a 1-month-old monkey head containing inserted needles. We also image the coronal and axial sections of a 7-month-old monkey head. Brain features that are 3 cm deep in the head are imaged clearly. Our results demonstrate that TAT has potential for use in portable, cost-effective imagers for pediatric brains.

  4. Label-free volumetric optical imaging of intact murine brains

    Science.gov (United States)

    Ren, Jian; Choi, Heejin; Chung, Kwanghun; Bouma, Brett E.

    2017-04-01

    A central effort of today’s neuroscience is to study the brain’s ’wiring diagram’. The nervous system is believed to be a network of neurons interacting with each other through synaptic connection between axons and dendrites, therefore the neuronal connectivity map not only depicts the underlying anatomy, but also has important behavioral implications. Different approaches have been utilized to decipher neuronal circuits, including electron microscopy (EM) and light microscopy (LM). However, these approaches typically demand extensive sectioning and reconstruction for a brain sample. Recently, tissue clearing methods have enabled the investigation of a fully assembled biological system with greatly improved light penetration. Yet, most of these implementations, still require either genetic or exogenous contrast labeling for light microscopy. Here we demonstrate a high-speed approach, termed as Clearing Assisted Scattering Tomography (CAST), where intact brains can be imaged at optical resolution without labeling by leveraging tissue clearing and the scattering contrast of optical frequency domain imaging (OFDI).

  5. Chemical Probes for Visualizing Intact Animal and Human Brain Tissue.

    Science.gov (United States)

    Lai, Hei Ming; Ng, Wai-Lung; Gentleman, Steve M; Wu, Wutian

    2017-06-22

    Newly developed tissue clearing techniques can be used to render intact tissues transparent. When combined with fluorescent labeling technologies and optical sectioning microscopy, this allows visualization of fine structure in three dimensions. Gene-transfection techniques have proved very useful in visualizing cellular structures in animal models, but they are not applicable to human brain tissue. Here, we discuss the characteristics of an ideal chemical fluorescent probe for use in brain and other cleared tissues, and offer a comprehensive overview of currently available chemical probes. We describe their working principles and compare their performance with the goal of simplifying probe selection for neuropathologists and stimulating probe development by chemists. We propose several approaches for the development of innovative chemical labeling methods which, when combined with tissue clearing, have the potential to revolutionize how we study the structure and function of the human brain. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Synthesis of pennogenin utilizing the intact skeleton of diosgenin

    Institute of Scientific and Technical Information of China (English)

    TIAN; Weisheng; XU; Qihai; CHEN; Ling; ZHAO; Chunfeng

    2004-01-01

    The first synthesis of pennogenin, an aglycone of bioactive components of Chinese traditional medicine named "Chonglou"(Paris), starting from diosgenin, has been reported, which displays a new strategy of utilizing the resource compounds. According to this new strategy, the full and rational utilization of the intact skeleton and functional groups of starting material has been realized in the conversion of diosgenin to pennogenin. The key step for synthesis of pennogenin is the regioselective transformation of cholest-5-en-16,22-dion-3,26-diol to cholest5,16-dien-22-on-3,26-diol, which can be used to synthesize other bioactive steroids such as cephalostatin and OSW-1.

  7. Simple Genome Editing of Rodent Intact Embryos by Electroporation.

    Directory of Open Access Journals (Sweden)

    Takehito Kaneko

    Full Text Available The clustered regularly interspaced short palindromic repeat (CRISPR/CRISPR-associated (Cas system is a powerful tool for genome editing in animals. Recently, new technology has been developed to genetically modify animals without using highly skilled techniques, such as pronuclear microinjection of endonucleases. Technique for animal knockout system by electroporation (TAKE method is a simple and effective technology that produces knockout rats by introducing endonuclease mRNAs into intact embryos using electroporation. Using TAKE method and CRISPR/Cas system, the present study successfully produced knockout and knock-in mice and rats. The mice and rats derived from embryos electroporated with Cas9 mRNA, gRNA and single-stranded oligodeoxynucleotide (ssODN comprised the edited targeted gene as a knockout (67% of mice and 88% of rats or knock-in (both 33%. The TAKE method could be widely used as a powerful tool to produce genetically modified animals by genome editing.

  8. The role of secondary hyperparathyroidism in left ventricular hypertrophy of patients under chronic hemodialysis

    Directory of Open Access Journals (Sweden)

    Randon R.B.

    2005-01-01

    Full Text Available End-stage renal disease (ESRD patients frequently develop structural cardiac abnormalities, particularly left ventricular hypertrophy (LVH. The mechanisms involved in these processes are not completely understood. In the present study, we evaluated a possible association between parathyroid hormone (PTH levels and left ventricular mass (LVM in patients with ESRD. Stable uremic patients on intermittent hemodialysis treatment were evaluated by standard two-dimensional echocardiography and their sera were analyzed for intact PTH. Forty-one patients (mean age 45 years, range 18 to 61 years, 61% males, who had been on hemodialysis for 3 to 186 months, were evaluated. Patients were stratified into 3 groups according to serum PTH: low levels (280 pg/ml; group III = 21 patients. A positive statistically significant association between LVM index and PTH was identified (r = 0.34; P = 0.03, Pearson's correlation coefficient in the sample as a whole. In subgroup analyses, we did not observe significant associations in the low and intermediate PTH groups; nevertheless, PTH and LVM index were correlated in patients with high PTH levels (r = 0.62; P = 0.003. LVM index was also inversely associated with hemoglobin (r = -0.34; P = 0.03. In multivariate analysis, after adjustment for age, hemoglobin, body mass index, and blood pressure, the only independent predictor of LVM index was PTH level. Therefore, PTH is an independent predictor of LVH in patients undergoing chronic hemodialysis. Secondary hyperparathyroidism may contribute to the elevated cardiovascular morbidity associated with LVH in ESRD.

  9. Calcium sparks in the intact gerbil spiral modiolar artery

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    Berge Samantha

    2011-08-01

    Full Text Available Abstract Background Calcium sparks are ryanodine receptor mediated transient calcium signals that have been shown to hyperpolarize the membrane potential by activating large conductance calcium activated potassium (BK channels in vascular smooth muscle cells. Along with voltage-dependent calcium channels, they form a signaling unit that has a vasodilatory influence on vascular diameter and regulation of myogenic tone. The existence and role of calcium sparks has hitherto been unexplored in the spiral modiolar artery, the end artery that controls blood flow to the cochlea. The goal of the present study was to determine the presence and properties of calcium sparks in the intact gerbil spiral modiolar artery. Results Calcium sparks were recorded from smooth muscle cells of intact arteries loaded with fluo-4 AM. Calcium sparks occurred with a frequency of 2.6 Hz, a rise time of 17 ms and a time to half-decay of 20 ms. Ryanodine reduced spark frequency within 3 min from 2.6 to 0.6 Hz. Caffeine (1 mM increased spark frequency from 2.3 to 3.3 Hz and prolonged rise and half-decay times from 17 to 19 ms and from 20 to 23 ms, respectively. Elevation of potassium (3.6 to 37.5 mM, presumably via depolarization, increased spark frequency from 2.4 to 3.2 Hz. Neither ryanodine nor depolarization changed rise or decay times. Conclusions This is the first characterization of calcium sparks in smooth muscle cells of the spiral modiolar artery. The results suggest that calcium sparks may regulate the diameter of the spiral modiolar artery and cochlear blood flow.

  10. Static cerebrovascular pressure autoregulation remains intact during deep hypothermia.

    Science.gov (United States)

    Goswami, Dheeraj; McLeod, Katherine; Leonard, Samantha; Kibler, Kathleen; Easley, Ronald Blaine; Fraser, Charles D; Andropoulos, Dean; Brady, Ken

    2017-09-01

    Clinical studies measuring cerebral blood flow in infants during deep hypothermia have demonstrated diminished cerebrovascular pressure autoregulation. The coexistence of hypotension in these cohorts confounds the conclusion that deep hypothermia impairs cerebrovascular pressure autoregulation. We sought to compare the lower limit of autoregulation and the static rate of autoregulation between normothermic and hypothermic piglets. Twenty anesthetized neonatal piglets (5-7 days old; 10 normothermic and 10 hypothermic to 20°C) had continuous measurements of cortical red cell flux using laser Doppler flowmetry, while hemorrhagic hypotension was induced without cardiopulmonary bypass. Lower limit of autoregulation was determined for each subject using piecewise regression and SRoR was determined above and below each lower limit of autoregulation as (%change cerebrovascular resistance/%change cerebral perfusion pressure). The estimated difference in lower limit of autoregulation was 1.4 mm Hg (lower in the hypothermic piglets; 95% C.I. -10 to 14 mm Hg; P=0.6). The median lower limit of autoregulation in the normothermic group was 39 mm Hg [IQR 38-51] vs 35 mm Hg [31-50] in the hypothermic group. Intact steady-state pressure autoregulation was defined as static rate of autoregulation >0.5 and was demonstrated in all normothermic subjects (static rate of autoregulation=0.72 [0.65-0.87]) and in 9/10 of the hypothermic subjects (static rate of autoregulation=0.65 [0.52-0.87]). This difference in static rate of autoregulation of 0.06 (95% C.I. -0.3 to 0.1) was not significant (P=0.4). Intact steady-state cerebrovascular pressure autoregulation is demonstrated in a swine model of profound hypothermia. Lower limit of autoregulation and static rate of autoregulation were similar in hypothermic and normothermic subjects. © 2017 John Wiley & Sons Ltd.

  11. The Level of Serum Intact Terminal Peptide of Procollagen and Its Clinical Significance in Patients with Chronic Keshan Disease

    Institute of Scientific and Technical Information of China (English)

    Ma Bin; Niu Xiaolin; Dong Xin; Ren Fuxian

    2005-01-01

    Objectives To evaluate the changes of serum intact terminal peptide of procollagen in patients with chronic Keshan disease (KD) and investigate their clinical significance. Methods The concentrations of serum intact N-terminal peptide of type Ⅰ procollagen (P Ⅰ NP) and intact N-terminal peptide of type Ⅲ procollagen (P Ⅲ NP) were measured by radioimmunoassay in 35 patients with chronic KD and 31 normal control. Doppler ultrasounds was used to determine several parameters of left ventricular systole and diastole functions. Results The concentration of serum P Ⅰ NP (74.07±16.74)μg/L and the ratio of P ⅠNP/ P Ⅲ NP (18.02±4.60) in chronic KD were significantly increased as compared to the control (39.63±12.07 μg/L, 12.12±4.24; P < 0.001). Serum P Ⅲ NP (4.19±0.64)μg/L in chronic KD was higher than that in the control (3.36±0.65 μg/L,P < 0.001)too. The higher of serum concentration of P Ⅰ NP and the ratio of P Ⅰ NP/ P Ⅲ NP, the worse of cardiac function in patients with chronic KD. A negative correlation was found between serum P Ⅰ NP/P Ⅲ NP,P Ⅰ NP and VE/VA, LVEF(γ=-0.4502, -0.4608, P<0.01 and γ=-0.3936, -0.3904, respectively; P < 0.05).Conclusions These findings suggested that tissue synthesis of collagen type Ⅲ and type I was abnormally increased in chronic KD. On the other hand, our results indicated that P Ⅰ NP and P Ⅲ NP were related to several functional alterations of the left ventricle. Serum procollagen peptide measurements might therefore provide indirectly diagnostic information on myocardial fibrosis associated with chronic KD.

  12. The Frank-Starling mechanism involves deceleration of cross-bridge kinetics and is preserved in failing human right ventricular myocardium.

    Science.gov (United States)

    Milani-Nejad, Nima; Canan, Benjamin D; Elnakish, Mohammad T; Davis, Jonathan P; Chung, Jae-Hoon; Fedorov, Vadim V; Binkley, Philip F; Higgins, Robert S D; Kilic, Ahmet; Mohler, Peter J; Janssen, Paul M L

    2015-12-15

    Cross-bridge cycling rate is an important determinant of cardiac output, and its alteration can potentially contribute to reduced output in heart failure patients. Additionally, animal studies suggest that this rate can be regulated by muscle length. The purpose of this study was to investigate cross-bridge cycling rate and its regulation by muscle length under near-physiological conditions in intact right ventricular muscles of nonfailing and failing human hearts. We acquired freshly explanted nonfailing (n = 9) and failing (n = 10) human hearts. All experiments were performed on intact right ventricular cardiac trabeculae (n = 40) at physiological temperature and near the normal heart rate range. The failing myocardium showed the typical heart failure phenotype: a negative force-frequency relationship and β-adrenergic desensitization (P 0.05), indicating that this regulatory mechanism is preserved in heart failure. Length-dependent assessment of twitch kinetics mirrored these findings; normalized dF/dt slowed down with increasing length of the muscle and was virtually identical in diseased tissue. This study shows for the first time that muscle length regulates cross-bridge kinetics in human myocardium under near-physiological conditions and that those kinetics are preserved in the right ventricular tissues of heart failure patients.

  13. Association of White Matter Lesions, Cerebral Atrophy, Intracranial Extravascular Calcifications, and Ventricular-Communicating Hydrocephalus with Delirium Among Veterans.

    Science.gov (United States)

    Detweiler, Mark B; Sherigar, Rathnakara M; Bader, Geoffrey; Sullivan, Kelly; Kenneth, Arline; Kalafat, Naciye; Reddy, Pavan; Lutgens, Brian

    2017-06-01

    The literature regarding the underlying neuropathogenesis of delirium on head computed tomography (CT) is limited. The aim of this research was to investigate, using case-control retrospective chart review, the association of white matter lesions (WML), cerebral atrophy, intracranial extravascular calcifications, and ventricular-communicating hydrocephalus in older adult military veterans with and without delirium hospitalized in a Veterans Affairs Medical Center. Head CT scans were examined for WML, atrophy, and intracranial extravascular calcifications globally in the cortex, subcortex (frontal, temporal, parietal, occipital lobes), basal ganglia (globus pallidus, caudate, putamen), and internal capsule, in addition to the presence of ventricular-communicating hydrocephalus. WML were graded as not present, 2 cm. Atrophy, cerebral atrophy, intracranial extravascular calcifications, and ventricular-communicating hydrocephalus were graded as present or not present. There was a significant association of WML in the temporal lobe periventricular cortical and subcortical brain and a significant association of atrophy in the parietal lobes and the cerebellum in hospitalized older adult military veterans with delirium compared with hospitalized older adult military veterans without delirium. There were no differences between the delirium and nondelirium groups for intracranial extravascular calcifications and ventricular-communicating hydrocephalus. The results suggest that atrophy in the parietal lobes and the cerebellum of hospitalized older adult military veterans may be associated with an elevated risk of delirium when compared with age, race, and sex-matched control veterans. Continuing efforts are needed to clarify the role of atrophy during delirium in the veteran and nonveteran older adult population to reduce progressive frailty and decreased quality of life secondary to hospital and posthospital-discharge delirium.

  14. Ventricular assist device in univentricular heart physiology.

    Science.gov (United States)

    Brancaccio, Gianluca; Gandolfo, Fabrizio; Carotti, Adriano; Amodeo, Antonio

    2013-04-01

    The use of mechanical cardiac assistance is well established as a bridge to orthotopic heart transplantation (OHT) or to recovery for patients with congestive heart failure, however, the experience in single ventricle (SV) physiology is still limited. We report two cases of mechanical assistance in patients with SV physiology: a 2-year old male with hypoplastic left heart syndrome who underwent Norwood Stage I and II followed by HF and a 4-year old female with a univentricular heart who developed a severe right ventricular dysfunction 2 years after a cavopulmonary shunt. Mechanical support utilizing ventricular assist devices (VADs) is considered a valid tool to bridge patients with congestive heart failure to either OHT or to recovery. Increasing experience and improved outcomes utilizing this technology in children with biventricular hearts have led to considering employing these devices in failing SV treatment. We present 2 cases of terminally ill children with SV who were assisted with a VAD.

  15. Inherited cardiomyopathies mimicking arrhythmogenic right ventricular cardiomyopathy.

    Science.gov (United States)

    Roberts, Jason D; Veinot, John P; Rutberg, Julie; Gollob, Michael H

    2010-01-01

    Arrhythmogenic right ventricular cardiomyopathy (ARVC) represents an inherited cardiomyopathy that manifests clinically with malignant ventricular arrhythmias, sudden cardiac death, and less commonly heart failure. The condition is characterized by replacement of the myocardium, primarily of the right ventricle, with fibrofatty tissue. Extensive fibrofatty replacement of the myocardium has been previously thought to be pathognomonic of ARVC; however, this report details two other forms of inherited cardiomyopathy, namely hypertrophic cardiomyopathy (HCM) and the PRKAG2 cardiac syndrome, that were found to have significant fibrofatty myocardial replacement at pathologic examination. This report represents the first documentation of inherited cardiomyopathies mimicking ARVC and highlights the concept that other cardiac conditions can be associated with fibrofatty replacement of the myocardium. Copyright 2010 Elsevier Inc. All rights reserved.

  16. Right ventricular hydatid cyst ruptured to pericardium

    Directory of Open Access Journals (Sweden)

    Feridoun Sabzi

    2015-01-01

    Full Text Available Cardiac hydatidosis is rare presentation of body hydatidosis. Incidence of cardiac involvements range from 5% to 5% of patients with hydatid disease. Most common site of hydatid cyst in heart is interventricular septum and left ventricular free wall. Right ventricular free wall involvement by cyst that ruptured to pericardial cavity is very rare presentation of hydatid cyst. Cardiac involvement may have serious consequences such as rupture to blood steam or pericardial cavity. Both the disease and its surgical treatment carry a high complication rate, including rupture leading to cardiac tamponade, anaphylaxis and also death. In the present report, a 43-year-old man with constrictive pericarditis secondary to a pericardial hydatid cyst is described.

  17. The Downside of Right Ventricular Apical Pacing

    Directory of Open Access Journals (Sweden)

    Andrew Brenyo, MD

    2012-05-01

    Full Text Available The right ventricular (RV apex has been the standard pacing site since the development of implantable pacemaker technology. Although RV pacing was initially only utilized for the treatment of severe bradyarrhythmias usually due to complete heart block, today the indications for and implantation of RV pacing devices is dramatically larger. Recently, the adverse effects of chronic RV apical pacing have been described including an increased risk of heart failure and death. This review details the detrimental effects of RV apical pacing and their shared hemodynamic pathophysiology. In particular, the role of RV apical pacing induced ventricular dyssynchrony is highlighted with a specific focus on differential outcome based upon QRS morphology at implant.

  18. Right ventricular plasticity and functional imaging

    Science.gov (United States)

    Brittain, Evan L.; Hemnes, Anna R.; Keebler, Mary; Lawson, Mark; Byrd, Benjamin F.; DiSalvo, Tom

    2012-01-01

    Right ventricular (RV) function is a strong independent predictor of outcome in a number of distinct cardiopulmonary diseases. The RV has a remarkable ability to sustain damage and recover function which may be related to unique anatomic, physiologic, and genetic factors that differentiate it from the left ventricle. This capacity has been described in patients with RV myocardial infarction, pulmonary arterial hypertension, and chronic thromboembolic disease as well as post-lung transplant and post-left ventricular assist device implantation. Various echocardiographic and magnetic resonance imaging parameters of RV function contribute to the clinical assessment and predict outcomes in these patients; however, limitations remain with these techniques. Early diagnosis of RV function and better insight into the mechanisms of RV recovery could improve patient outcomes. Further refinement of established and emerging imaging techniques is necessary to aid subclinical diagnosis and inform treatment decisions. PMID:23130100

  19. Late presentation of arrhythmogenic right ventricular cardiomyopathy: a case report

    Directory of Open Access Journals (Sweden)

    Papaioannou Georgios I

    2009-08-01

    Full Text Available Abstract Introduction Arrhythmogenic right ventricular cardiomyopathy is an inherited myocardial disease affecting predominantly young people and manifests as sustained ventricular tachycardia with left bundle branch block morphology, sudden death or isolated right or biventricular heart failure. However, its first manifestation as sustained ventricular tachycardia in older patients without preceding symptoms of heart failure is infrequent. To our knowledge, our patient is among the oldest reported in the literature presenting with ventricular tachycardia because of arrhythmogenic right ventricular cardiomyopathy without preceding symptoms of heart failure. Case presentation We present an unusual case of a very late presentation of a right ventricular cardiomyopathy in a 72-year-old white Caucasian man. The patient was admitted with symptoms of weakness, dizziness and chest discomfort for several hours. His electrocardiogram showed a wide-complex tachycardia with left bundle branch block morphology and left axis deviation. Because of continuing hemodynamic instability, the patient was cardioverted to sinus rhythm with a single 300 J shock. His post-cardioversion electrocardiogram, cardiac echocardiogram, coronary angiogram, magnetic resonance imaging and electrophysiological study confirmed the diagnosis of arrhythmogenic right ventricular cardiomyopathy. The patient was treated with an implantable cardioverter defibrillator and discharged on sotalol. Conclusion This case report demonstrates that arrhythmogenic right ventricular cardiomyopathy may have a very late presentation and this diagnosis should be considered as a potential cause of sustained ventricular tachycardia of right ventricular origin among the elderly and should be treated accordingly.

  20. Predictors of left ventricular remodelling and failure in right ventricular pacing in the young

    Science.gov (United States)

    Gebauer, Roman A.; Tomek, Viktor; Salameh, Aida; Marek, Jan; Chaloupecký, Václav; Gebauer, Roman; Matějka, Tomáš; Vojtovič, Pavel; Janoušek, Jan

    2009-01-01

    Aims To identify risk factors for left ventricular (LV) dysfunction in right ventricular (RV) pacing in the young. Methods and results Left ventricular function was evaluated in 82 paediatric patients with either non-surgical (n = 41) or surgical (n= 41) complete atrioventricular block who have been 100% RV paced for a mean period of 7.4 years. Left ventricular shortening fraction (SF) decreased from a median (range) of 39 (24–62)% prior to implantation to 32 (8–49)% at last follow-up (P +2z-values) and dysfunction (SF < 0.26) was found to increase from 1.3% prior to pacemaker implantation to 13.4% (11/82 patients) at last follow-up (P = 0.01). Ten of these 11 patients had progressive LV remodelling and 8 of 11 were symptomatic. The only significant risk factor for the development of LV dilatation and dysfunction was the presence of epicardial RV free wall pacing (OR = 14.3, P < 0.001). Other pre-implantation demographic, diagnostic, and haemodynamic factors including block aetiology, pacing variables, and pacing duration did not show independent significance. Conclusion Right ventricular pacing leads to pathologic LV remodelling in a significant proportion of paediatric patients. The major independent risk factor is the presence of epicardial RV free wall pacing, which should be avoided whenever possible. PMID:19286675

  1. Amiodarone for the treatment and prevention of ventricular fibrillation and ventricular tachycardia

    Directory of Open Access Journals (Sweden)

    Hugo Van Herendael

    2010-06-01

    Full Text Available Hugo Van Herendael, Paul DorianDivision of Cardiology, St. Michael’s Hospital, University of Toronto, Toronto, CanadaAbstract: Amiodarone has emerged as the leading antiarrhythmic therapy for termination and prevention of ventricular arrhythmia in different clinical settings because of its proven efficacy and safety. In patients with shock refractory out-of-hospital cardiac arrest and hemodynamically destabilizing ventricular arrhythmia, amiodarone is the most effective drug available to assist in resuscitation. Although the superiority of the transvenous implantable cardioverter defibrillator (ICD over amiodarone has been well established in the preventive treatment of patients at high risk of life-threatening ventricular arrhythmias, amiodarone (if used with a beta-blocker is the most effective antiarrhythmic drug to prevent ICD shocks and treat electrical storm. Both the pharmacokinetics and the electrophysiologic profile of amiodarone are complex, and its optimal and safe use requires careful patient surveillance with respect to potential adverse effects.Keywords: amiodarone, ventricular fibrillation, unstable ventricular tachycardia

  2. [Ventricular fibrillation following deodorant spray inhalation].

    Science.gov (United States)

    Girard, F; Le Tacon, S; Maria, M; Pierrard, O; Monin, P

    2008-01-01

    We report one case of out-of-hospital cardiac arrest with ventricular fibrillation following butane poisoning after inhalation of antiperspiration aerosol. An early management using semi-automatic defibrillator explained the success of the resuscitation. The mechanism of butane toxicity could be an increased sensitivity of cardiac receptors to circulating catecholamines, responsible for cardiac arrest during exercise and for resuscitation difficulties. The indication of epinephrine is discussed.

  3. Ventricular Assist Devices: Physiology Meets Technology

    Science.gov (United States)

    1993-01-01

    vaslr resbane, and icrue systemic cir(nlatkm O(Mchet at aL. 1988). Non-ulsatile flow results in VADs 19 mico ulatory shiting snd edema formation...than 45 ininHg, and the oxygen saturation greater than 95 percent (Ley,, 1991). Hypoxeinia. initially may be due to pulmonary edema or a mild form of...1990). Combined Registry for the clinical use of mechanical ventricular assist devices: postcardiotomy cardiogenic shock. o36(1), 43-46. Mondejar, E

  4. Diastolic Left Ventricular Dysfunction : A Clinical Appraisal

    OpenAIRE

    Bronzwaer, J.G.F.

    2003-01-01

    Diastolic left ventricular (LV) distensibility is determined by the material properties of the LV wall and by LV geometry (i.e., LV shape, LV volume and LV wall thickness). These material properties are influenced both by the physical structure of the LV myocardium and by the dynamic process of myocardial relaxation. The material properties of the myocardium dictate the strain that follows a given stress, and determine position and shape of the myocardial stress-strain relationship. The mater...

  5. Positional Right Ventricular Obstruction in Pectus Excavatum.

    Science.gov (United States)

    Underwood, Katherine; Vorsanger, Matthew; Saric, Muhamed; Skolnick, Adam H

    2017-01-25

    Pectus excavatum is one of the most common congenital chest wall deformities. The degree of sternal depression, which may result in compression of the right heart by the chest wall, is variable. While typically asymptomatic, there are various symptoms that can result from severe pectus excavatum. We report on a patient with severe pectus excavatum leading to dynamic obstruction of the right ventricular outflow tract in the seated position.

  6. Left ventricular heart failure and pulmonary hypertension†

    Science.gov (United States)

    Rosenkranz, Stephan; Gibbs, J. Simon R.; Wachter, Rolf; De Marco, Teresa; Vonk-Noordegraaf, Anton; Vachiéry, Jean-Luc

    2016-01-01

    In patients with left ventricular heart failure (HF), the development of pulmonary hypertension (PH) and right ventricular (RV) dysfunction are frequent and have important impact on disease progression, morbidity, and mortality, and therefore warrant clinical attention. Pulmonary hypertension related to left heart disease (LHD) by far represents the most common form of PH, accounting for 65–80% of cases. The proper distinction between pulmonary arterial hypertension and PH-LHD may be challenging, yet it has direct therapeutic consequences. Despite recent advances in the pathophysiological understanding and clinical assessment, and adjustments in the haemodynamic definitions and classification of PH-LHD, the haemodynamic interrelations in combined post- and pre-capillary PH are complex, definitions and prognostic significance of haemodynamic variables characterizing the degree of pre-capillary PH in LHD remain suboptimal, and there are currently no evidence-based recommendations for the management of PH-LHD. Here, we highlight the prevalence and significance of PH and RV dysfunction in patients with both HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF), and provide insights into the complex pathophysiology of cardiopulmonary interaction in LHD, which may lead to the evolution from a ‘left ventricular phenotype’ to a ‘right ventricular phenotype’ across the natural history of HF. Furthermore, we propose to better define the individual phenotype of PH by integrating the clinical context, non-invasive assessment, and invasive haemodynamic variables in a structured diagnostic work-up. Finally, we challenge current definitions and diagnostic short falls, and discuss gaps in evidence, therapeutic options and the necessity for future developments in this context. PMID:26508169

  7. Non-compaction of the ventricular myocardium

    Directory of Open Access Journals (Sweden)

    Livio Dei Cas

    2006-12-01

    Full Text Available Non-compaction of the left ventricle (LVNC is a disorder of endomyocardial morphogenesis that results in multiple trabeculations in the left ventricular (LV myocardium. This rare disorder is characterized by an excessively prominent trabecular meshwork and deep intratrabecular recesses. This idiopathic cardiomyopathy is characterized by an altered structure of the myocardial wall as a result of intrauterine arrest of compaction of the myocardial fibers in the absence of any coexisting congenital lesion. It can be associated with neuromuscular disorders and can co-exist with other cardiac malformations, and it is accompanied by depressed ventricular function, systemic embolism and ventricular arrhythmia. Echocardiography is the method of choice for diagnosing LVNC, but the correct diagnosis is often missed or delayed due to a lack of knowledge concerning this uncommon disease and its similarity to other diseases of the myocardium and endocardium. There is a two-layered structure of the myocardial wall consisting of a thin compacted epicardial layer and a thick non-compacted endocardial layer with prominent trabeculations and deep recesses. (Heart International 2006; 3-4: 178-83

  8. Prophylactic antibiotics for inhibiting preterm labour with intact membranes.

    Science.gov (United States)

    Flenady, Vicki; Hawley, Glenda; Stock, Owen M; Kenyon, Sara; Badawi, Nadia

    2013-12-05

    The aetiology of preterm birth is complex and there is evidence that subclinical genital tract infection influences preterm labour in some women but the role of prophylactic antibiotic treatment in the management of preterm labour is controversial. Since rupture of the membranes is an important factor in the progression of preterm labour, it is important to see if the routine administration of antibiotics confers any benefit or causes harm, prior to membrane rupture. To assess the effects of prophylactic antibiotics administered to women in preterm labour with intact membranes, on maternal and neonatal outcomes. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 August 2013). Randomised trials that compared antibiotic treatment with placebo or no treatment for women in preterm labour (between 20 and 36 weeks' gestation) with intact membranes. Two review authors independently assessed trial eligibility, and undertook quality assessment and data extraction. We contacted study authors for additional information. Results are presented using risk ratio (RR) for categorical data and mean difference (MD) for data measured on a continuous scale with their respective 95% confidence intervals (CI). The number needed to treat to benefit (NNTB) and the number needed to treat to harm (NNTH) was calculated where appropriate. In this update (2013), with the addition of three trials (305 women), the large ORACLE II 2001 trial continues to dominate the results of this review. This review now includes a total of 14 studies randomising 7837 women. No significant difference was shown in perinatal or infant mortality for infants of women allocated to any prophylactic antibiotics compared with no antibiotics. However, an increase in neonatal deaths was shown for infants of women receiving any prophylactic antibiotics when compared with placebo (RR 1.57, 95% CI 1.03 to 2.40; NNTH 149, 95% CI 2500 to 61). No reduction in preterm birth or other clinically

  9. Congenital left ventricular aneurysm coexisting with left ventricular non-compaction in a newborn.

    Science.gov (United States)

    Ootani, Katsuki; Shimada, Jun; Kitagawa, Yosuke; Konno, Yuki; Miura, Fumitake; Takahashi, Toru; Ito, Etsuro; Ichinose, Kouta; Yonesaka, Susumu

    2014-10-01

    Described herein is the case of a rare combination of congenital left ventricular (LV) aneurysm and left ventricular non-compaction (LVNC) in a newborn. The patient developed refractory heart failure soon after birth and died at 5 months of age. The etiology of both congenital LV aneurysm and LVNC seems to be maldevelopment of the ventricular myocardium during early fetal life. Treatment should be individually tailored depending on clinical severity, and treatment options are limited. Given that this combination of congenital LV aneurysm and LVNC is significantly associated with poor prognosis, it appears that patients with congenital LV aneurysm and LVNC are candidates for early, aggressive intervention, including surgical aneurysmectomy and evaluation for transplantation. It is important to be aware of this combination of congenital LV aneurysm and LVNC, and to make earlier decisions on therapeutic strategy.

  10. [Ventricular tachyarrhythmias. A retrospective analysis of etiology, demography and treatment

    DEFF Research Database (Denmark)

    Christensen, A.H.; Henningsen, K.; Svendsen, Jesper Hastrup

    2008-01-01

    to ventricular tachyarrhythmias. MATERIALS AND METHODS: We conducted a retrospective review of 993 patients discharged from Rigshospitalet over 6 years and 5 months with the diagnostic codes ventricular tachycardia, ventricular fibrillation or premature ventricular contractions. RESULTS: The population had...... an average age of 59 years (ranging 15-95 years) with a majority of males (76%). Among the patients with known etiology ischemic heart disease (60%), dilated cardiomyopathy (6%) and arrhythmogenic right ventricular cardiomyopathy (6%) were the most frequent. A substantial number of the patients (15%) had...... unknown etiology; 492 (50%) of the patients overall had an ICD implanted, the majority of whom had been categorized as having ventricular tachycardia (92%); 168 patients had previous cardiac arrest, 127 of whom did not have a potential reversible cause. Of this group 75 (59%) had an ICD implanted...

  11. MECHANISMS OF RIGHT VENTRICULAR FAILURE AND BIVENTRICULAR MECHANICAL CIRCULATORY SUPPORT

    Directory of Open Access Journals (Sweden)

    G. P. Itkin

    2013-01-01

    Full Text Available The paper presents a review of the problems of mechanical circulatory support with left ventricular bypass in total cardiac failure. Dysfunction of right ventricular defines the high mortality on left ventricular device. One of the effective methods for solving this problem is the use of right ventricular assisted devices. There are considered of the basic physiological mechanisms of interaction between the right and left ventricles of the heart, affecting on the function of the right heart. Shows the need to assess right ventricular function before deciding on mechanical circulatory support. Provides examples of the estimation the predictors of the right ventricular failure. The basic methods and devices of biventricular circulatory support were con- sidered. 

  12. Fatal venous air embolism during anesthesia in an apparently healthy adult Chihuahua.

    Science.gov (United States)

    Mouser, Pamela J; Wilson, Jeffrey D

    2015-01-01

    An apparently healthy adult female Chihuahua was presented for elective ovariohysterectomy. After induction of general anesthesia, but prior to the start of the surgery, air was inadvertently administered to the patient via the i.v. fluid line. The patient convulsed, became apneic, arrested, and died despite attempted cardiopulmonary resuscitation. At necropsy, the pericardial sac was incised and filled with water to entirely submerge the intact heart. The right ventricular free wall was punctured, releasing several air bubbles from the right ventricle. Death was attributed to venous air embolism based on the clinical history, gross findings, and paucity of underlying gross and microscopic pathology that might have predisposed the dog to an anesthetic-related death. The discussion of this case includes a review of previously reported veterinary cases of fatal venous air embolism, including the varied mechanisms of embolus formation, the potential impact of pre-existing cardiopulmonary disease, and the methods used to detect emboli. This report outlines the events of fatal iatrogenic venous air embolization and emphasizes the importance of considering this entity in the case of sudden death of a patient with an indwelling catheter in order to pursue either appropriate diagnostic tests or necropsy techniques to aid in the diagnosis.

  13. 心室憩室的超声心动图特征分析%Analysis of the echocardiographic characteristics of ventricular diverticula

    Institute of Scientific and Technical Information of China (English)

    孙琳; 何怡华; 赵映; 刘文旭; 韩建成; 张烨; 谷孝艳

    2016-01-01

    Objective To retrospectively analyzed the echocardiographic characteristics of ventricular diverticula in fetuses ,children and adults ,and discuss the main points of diagnoses and prognoses of ventricular diverticula . Methods Echocardiographic characteristics ,clinical data and intraoperative findings of ventricular diverticula of 8 fetuses ,3 children and 14 adults were summarized . Results The ventricular diverticula in 8 fetuses and 3 children were all single . Twenty five diverticula were found in the 14 adult patients ;in other words ,there were 3 multiple diverticula found in adult group . A statistical difference was found in ratio of diverticula area and corresponding ventricular area ( P = 0 .021 ) ,and corresponding ventricular fractional shortening ( P =0 .003) between fetal and single adult ventricular diverticula . There were 2 cases with ventricular septal defects ,1 with pericardial effusion ,1 with single umbilical artery ,and 2 with atrioventricular valvular regurgitation in fetal cases . Congenital complex cardiac disease and dextrocardia were found in 1 child . There were 1 case with supravalvular aortic stenosis , 1 with nonobstructive hypertrophic cardiomyopathy ,1 with left ventricular noncompaction ,and 1 with mitral reguigitation in adult group . All the 7 diverticula with ventricular arrhythmias ,ST‐T changes and abnormal Q wave were fibrous type . And 2 multiple diverticula were accompanied with ventricular dysfunction . Among the fetal cases ,2 cases were born ,3 cases were terminated pregnancy ,and 3 cases were lost to follow up . Three children and 2 adults were underwent cardiac operations for diverticula with good outcomes . No such complications as cardiac rupture ,thromboembolism ,and sudden death were found . Conclusions Echocardiography is a useful method to diagnose ventricular diverticulum ,especially for fetuses ,and provide the basis for prognosis consultation .%目的:回顾性对比分析胎儿、儿童与成人心室

  14. Postexertional Supraventricular Tachycardia in Children with Catecholaminergic Polymorphic Ventricular Tachycardia

    Directory of Open Access Journals (Sweden)

    Scott D. N. Else

    2012-01-01

    Full Text Available Catecholaminergic polymorphic ventricular tachycardia (CPVT is a severe arrhythmia associated with sudden death in the young. It is caused by defective calcium handling in ventricular myocytes. The association of supraventricular tachycardia (SVT with CPVT is described in the literature, occurring in the lead-up to ventricular tachycardia during exercise testing. We describe three cases of SVT that were initiated in the recovery period of exercise testing in children with CPVT.

  15. Tamponade by an expanding left ventricular pseudoaneurysm: A unique presentation.

    Science.gov (United States)

    Mahesh, Balakrishnan; Ong, Ping; Kutty, Ramesh; Abu-Omar, Yasir

    2015-10-01

    Left ventricular free wall rupture secondary to myocardial infarction is an uncommon but catastrophic event requiring emergency surgery. We describe a unique presentation of left ventricular free wall rupture as delayed tamponade caused by a gradually expanding pseudoaneurysm compressing the left atrium, leading to pulmonary congestion that required increasing respiratory support to maintain oxygenation, and necessitated emergency surgery. We discuss the options available to treat pseudoaneurysms due to left ventricular free wall rupture.

  16. The Ventricular System of the Brain: Anatomy and Normal Variations.

    Science.gov (United States)

    Stratchko, Lindsay; Filatova, Irina; Agarwal, Amit; Kanekar, Sangam

    2016-04-01

    The cerebral ventricular system is intimately associated with the forebrain and brainstem. The ventricular system functions to produce and circulate cerebrospinal fluid, which plays an important role in mechanical protection and regulation of homeostasis in the central nervous system. This article discusses anatomy and neuroimaging of the ventricular system and highlights normal anatomical variations that may be mistaken for pathology. Applied surgical anatomy is reviewed with emphasis on operative approach and potential risk to adjacent central nervous system structures.

  17. Determination of Serotonin and Dopamine Metabolites in Human Brain Microdialysis and Cerebrospinal Fluid Samples by UPLC-MS/MS: Discovery of Intact Glucuronide and Sulfate Conjugates.

    Directory of Open Access Journals (Sweden)

    Tina Suominen

    Full Text Available An UPLC-MS/MS method was developed for the determination of serotonin (5-HT, dopamine (DA, their phase I metabolites 5-HIAA, DOPAC and HVA, and their sulfate and glucuronide conjugates in human brain microdialysis samples obtained from two patients with acute brain injuries, ventricular cerebrospinal fluid (CSF samples obtained from four patients with obstructive hydrocephalus, and a lumbar CSF sample pooled mainly from patients undergoing spinal anesthesia in preparation for orthopedic surgery. The method was validated by determining the limits of detection and quantification, linearity, repeatability and specificity. The direct method enabled the analysis of the intact phase II metabolites of 5-HT and DA, without hydrolysis of the conjugates. The method also enabled the analysis of the regioisomers of the conjugates, and several intact glucuronide and sulfate conjugates were identified and quantified for the first time in the human brain microdialysis and CSF samples. We were able to show the presence of 5-HIAA sulfate, and that dopamine-3-O-sulfate predominates over dopamine-4-O-sulfate in the human brain. The quantitative results suggest that sulfonation is a more important phase II metabolism pathway than glucuronidation in the human brain.

  18. True navigation in migrating gulls requires intact olfactory nerves

    DEFF Research Database (Denmark)

    Wikelski, Martin; Arriero, Elena; Gagliardo, Anna

    2015-01-01

    During migratory journeys, birds may become displaced from their normal migratory route. Experimental evidence has shown that adult birds can correct for such displacements and return to their goal. However, the nature of the cues used by migratory birds to perform long distance navigation is sti...

  19. Cryopreservation of intact testicular tissue from boys with cryptorchidism

    DEFF Research Database (Denmark)

    Kvist, K; Thorup, Jørgen Mogens; Byskov, A G

    2006-01-01

    Boys with cryptorchidism often face fertility problems in adult life despite having orchiopexy performed at a very young age. During this operation, a biopsy of the testis is normally taken in order to evaluate their infertility potential and the presence of malignant cells. This study evaluated ...... the morphology and functional capacity of cryopreserved testes biopsies and their possible use in fertility preservation....

  20. Bryostatins activate protein kinase C in intact human platelets

    Energy Technology Data Exchange (ETDEWEB)

    Smith, J.B.; Tallant, E.A.; Pettit, G.R.; Wallace, R.W.

    1986-05-01

    Bryostatins, macrocyclic lactones isolated from a marine bryozoan, have antineoplastic activity in the P388 lymphocytic leukemia system. These compounds also stimulate growth in Swiss 3T3 cells, induce secretion in leukocytes, inhibit phorbol dibutyrate binding to a high affinity receptor, and activate the C-kinase in vitro. In human platelets, phorbol esters induce aggregation and activate protein kinase C, resulting in phosphorylation of a 47K protein and the 20K myosin light chain. The authors now show that bryostatin 7 (B-7) triggers platelet aggregation to the same rate and extent as phorbol 12-myristate 13-acetate (PMA). B-7 also causes the in vivo activation of the C-kinase, resulting in phosphorylation of both the 47K and the 20K proteins; the time courses and dose-responses of these B-7-induced phosphorylations were similar to those found with PMA. In addition, B-7 increases the level of /sup 32/P-incorporation into the platelet polyphosphoinositides, which also occurs in response to PMA. Bryostatin 3 (B-3), which has been shown to be much less potent than B-7 in mimicking other PMA effects, was much less effective than PMA or B-7 in inducing platelet aggregation and in stimulating /sup 32/P-incorporation into both proteins and the phosphoinositides. These results demonstrate that, intact human platelets, bryostatins mimic the phorbol esters tumor promoters and directly activate protein kinase C.

  1. Rapid isolation of intact, viable fetal cartilage models

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt, R.R.; Chepenik, K.P.; Paynton, B.V.; Cotler, J.M.

    1982-04-01

    A rapid procedure is described for the isolation of viable, intact, femoral cartilage models (humeri and femora) obtained from pregnant rats on the 18th day of gestation. Viability of these models is demonstrated in an in vitro system where the incorporation of /sup 35/S-sulfate was linear with time of incubation and with numbers of cartilage models utilized. Treatment of cartilage models with ice-cold trichloroacetic acid and a boiling water bath prior to incubation with radiolabel, reduced the amount of radioactivity incorporated to 1.3% of that observed for models incubated by routine procedures. Furthermore, digestion of cartilage model homogenates with protease yielded a supernatant from which 51% to 57% of the radioactivity was precipitated as GAG. This method may also be used to isolate fetal cartilage models as early as the 16th day of gestation. with this system, specific biochemical parameters of mammalian fetal chondrogenesis may be surveyed in normally and abnormally developing fetal cartilage free of surrounding soft tissue.

  2. Compensatory mechanisms underlie intact task-switching performance in schizophrenia.

    Science.gov (United States)

    Jamadar, S; Michie, P; Karayanidis, F

    2010-04-01

    Individuals with schizophrenia tend to perform poorly on many measures of cognitive control. However, recent task-switching studies suggest that they show intact task-switching performance, despite the fact that the regions involved in task-switching are known to be structurally and functionally impaired in the disorder. Behavioral, event-related potential (ERP) and functional magnetic resonance imaging (fMRI) measures were used to compare the temporal and spatial dynamics of task-switching performance in individuals with schizophrenia and controls. Consistent with previous studies, reaction time (RT) switch cost and its reduction with anticipatory preparation did not differ between groups. There were also no group differences on cue-locked ERP components associated with anticipatory preparation processes. However, both stimulus- and response-locked ERPs were significantly disrupted in schizophrenia, suggesting difficulty with task-set implementation. fMRI analyses indicated that individuals with schizophrenia showed hyperactivity in the dorsolateral prefrontal cortex and posterior parietal cortex. RT-fMRI and ERP-fMRI associations suggested that individuals with schizophrenia employ compensatory mechanisms to overcome difficulties in task-set implementation and thereby achieve the same behavioral outcomes as controls.

  3. Spontaneous NA+ transients in individual mitochondria of intact astrocytes.

    Science.gov (United States)

    Azarias, Guillaume; Van de Ville, Dimitri; Unser, Michael; Chatton, Jean-Yves

    2008-02-01

    Mitochondria in intact cells maintain low Na(+) levels despite the large electrochemical gradient favoring cation influx into the matrix. In addition, they display individual spontaneous transient depolarizations. The authors report here that individual mitochondria in living astrocytes exhibit spontaneous increases in their Na(+) concentration (Na(mit)(+) spiking), as measured using the mitochondrial probe CoroNa Red. In a field of view with approximately 30 astrocytes, up to 1,400 transients per minute were typically detected under resting conditions. Na(mit)(+) spiking was also observed in neurons, but was scarce in two nonneural cell types tested. Astrocytic Na(mit)(+) spikes averaged 12.2 +/- 0.8 s in duration and 35.5 +/- 3.2 mM in amplitude and coincided with brief mitochondrial depolarizations; they were impaired by mitochondrial depolarization and ruthenium red pointing to the involvement of a cation uniporter. Na(mit)(+) spiking activity was significantly inhibited by mitochondrial Na(+)/H(+) exchanger inhibition and sensitive to cellular pH and Na(+) concentration. Ca(2+) played a permissive role on Na(mit)(+) spiking activity. Finally, the authors present evidence suggesting that Na(mit)(+) spiking frequency was correlated with cellular ATP levels. This study shows that, under physiological conditions, individual mitochondria in living astrocytes exhibit fast Na(+) exchange across their inner membrane, which reveals a new form of highly dynamic and localized functional regulation.

  4. Intact implicit statistical learning in borderline personality disorder.

    Science.gov (United States)

    Unoka, Zsolt; Vizin, Gabriella; Bjelik, Anna; Radics, Dóra; Nemeth, Dezso; Janacsek, Karolina

    2017-09-01

    Wide-spread neuropsychological deficits have been identified in borderline personality disorder (BPD). Previous research found impairments in decision making, declarative memory, working memory and executive functions; however, no studies have focused on implicit learning in BPD yet. The aim of our study was to investigate implicit statistical learning by comparing learning performance of 19 BPD patients and 19 healthy, age-, education- and gender-matched controls on a probabilistic sequence learning task. Moreover, we also tested whether participants retain the acquired knowledge after a delay period. To this end, participants were retested on a shorter version of the same task 24h after the learning phase. We found intact implicit statistical learning as well as retention of the acquired knowledge in this personality disorder. BPD patients seem to be able to extract and represent regularities implicitly, which is in line with the notion that implicit learning is less susceptible to illness compared to the more explicit processes. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  5. Stress dependence of permeability of intact and fractured shale cores.

    Science.gov (United States)

    van Noort, Reinier; Yarushina, Viktoriya

    2016-04-01

    Whether a shale acts as a caprock, source rock, or reservoir, understanding fluid flow through shale is of major importance for understanding fluid flow in geological systems. Because of the low permeability of shale, flow is thought to be largely confined to fractures and similar features. In fracking operations, fractures are induced specifically to allow for hydrocarbon exploration. We have constructed an experimental setup to measure core permeabilities, using constant flow or a transient pulse. In this setup, we have measured the permeability of intact and fractured shale core samples, using either water or supercritical CO2 as the transporting fluid. Our measurements show decreasing permeability with increasing confining pressure, mainly due to time-dependent creep. Furthermore, our measurements show that for a simple splitting fracture, time-dependent creep will also eliminate any significant effect of this fracture on permeability. This effect of confinement on fracture permeability can have important implications regarding the effects of fracturing on shale permeability, and hence for operations depending on that.

  6. Structure of the intact ATM/Tel1 kinase.

    Science.gov (United States)

    Wang, Xuejuan; Chu, Huanyu; Lv, Mengjuan; Zhang, Zhihui; Qiu, Shuwan; Liu, Haiyan; Shen, Xuetong; Wang, Weiwu; Cai, Gang

    2016-05-27

    The ataxia-telangiectasia mutated (ATM) protein is an apical kinase that orchestrates the multifaceted DNA-damage response. Normally, ATM kinase is in an inactive, homodimer form and is transformed into monomers upon activation. Besides a conserved kinase domain at the C terminus, ATM contains three other structural modules, referred to as FAT, FATC and N-terminal helical solenoid. Here we report the first cryo-EM structure of ATM kinase, which is an intact homodimeric ATM/Tel1 from Schizosaccharomyces pombe. We show that two monomers directly contact head-to-head through the FAT and kinase domains. The tandem N-terminal helical solenoid tightly packs against the FAT and kinase domains. The structure suggests that ATM/Tel1 dimer interface and the consecutive HEAT repeats inhibit the binding of kinase substrates and regulators by steric hindrance. Our study provides a structural framework for understanding the mechanisms of ATM/Tel1 regulation as well as the development of new therapeutic agents.

  7. Measurement of the Mechanical Properties of Intact Collagen Fibrils

    Science.gov (United States)

    Mercedes, H.; Heim, A.; Matthews, W. G.; Koob, T.

    2006-03-01

    Motivated by the genetic disorder Ehlers-Danlos syndrome (EDS), in which proper collagen synthesis is interrupted, we are investigating the structural and mechanical properties of collagen fibrils. The fibrous glycoprotein collagen is the most abundant protein found in the human body and plays a key role in the extracellular matrix of the connective tissue, the properties of which are altered in EDS. We have selected as our model system the collagen fibrils of the sea cucumber dermis, a naturally mutable tissue. This system allows us to work with native fibrils which have their proteoglycan complement intact, something that is not possible with reconstituted mammalian collagen fibrils. Using atomic force microscopy, we measure, as a function of the concentration of divalent cations, the fibril diameter, its response to force loading, and the changes in its rigidity. Through these experiments, we will shed light on the mechanisms which control the properties of the sea cucumber dermis and hope to help explain the altered connective tissue extracellular matrix properties associated with EDS.

  8. HIV-2 neutralization by intact V3-specific Fab fragments

    Directory of Open Access Journals (Sweden)

    Sourial Samer

    2008-08-01

    Full Text Available Abstract The V3 region of both HIV-1 gp120 and HIV-2 gp125 surface glycoprotein has been described as a target for neutralizing antibodies. In this study a conformation-sensitive (3C4 and a linear site-specific (7C8 anti-HIV-2 V3 monoclonal antibody (mAb were characterized. The neutralization capacity of the purified mAbs and their respective papain-generated Fab fragments was analyzed. The Fabs were further characterized by sequence analysis. Our results demonstrate that neither purified mAbs were capable of neutralizing HIV-2, while intact Fab fragments from both mAbs blocked in vitro infection of HIV-2 isolates. Moreover, the conformation sensitive 3C4 Fab neutralized both subtype A and B HIV-2 isolates and SIVsm. Sequence analysis of the hypervariable regions of 3C4 Fab and 7C8 Fab revealed that the third CDR of the heavy chain (CDRH3 of the antibodies was not as long as many of the previously characterized neutralizing antibodies. Our findings suggest that whole 7C8 and 3C4 mAbs are sterically hindered from neutralizing HIV-2, whereas the smaller size of Fab fragments enables access to the V3 region on the virion surface.

  9. Visual associative learning in restrained honey bees with intact antennae.

    Directory of Open Access Journals (Sweden)

    Scott E Dobrin

    Full Text Available A restrained honey bee can be trained to extend its proboscis in response to the pairing of an odor with a sucrose reward, a form of olfactory associative learning referred to as the proboscis extension response (PER. Although the ability of flying honey bees to respond to visual cues is well-established, associative visual learning in restrained honey bees has been challenging to demonstrate. Those few groups that have documented vision-based PER have reported that removing the antennae prior to training is a prerequisite for learning. Here we report, for a simple visual learning task, the first successful performance by restrained honey bees with intact antennae. Honey bee foragers were trained on a differential visual association task by pairing the presentation of a blue light with a sucrose reward and leaving the presentation of a green light unrewarded. A negative correlation was found between age of foragers and their performance in the visual PER task. Using the adaptations to the traditional PER task outlined here, future studies can exploit pharmacological and physiological techniques to explore the neural circuit basis of visual learning in the honey bee.

  10. Activation and deactivation of vibronic channels in intact phycocyanin rods

    Science.gov (United States)

    Nganou, C.; David, L.; Meinke, R.; Adir, N.; Maultzsch, J.; Mkandawire, M.; Pouhè, D.; Thomsen, C.

    2014-02-01

    We investigated the excitation modes of the light-harvesting protein phycocyanin (PC) from Thermosynechococcus vulcanus in the crystalline state using UV and near-infrared Raman spectroscopy. The spectra revealed the absence of a hydrogen out-of-plane wagging (HOOP) mode in the PC trimer, which suggests that the HOOP mode is activated in the intact PC rod, while it is not active in the PC trimer. Furthermore, in the PC trimer an intense mode at 984 cm-1 is assigned to the C-C stretching vibration while the mode at 454 cm-1 is likely due to ethyl group torsion. In contrast, in the similar chromophore phytochromobilin the C5,10,15-D wag mode at 622 cm-1 does not come from a downshift of the HOOP. Additionally, the absence of modes between 1200 and 1300 cm-1 rules out functional monomerization. A correlation between phycocyanobilin (PCB) and phycoerythrobilin (PEB) suggests that the PCB cofactors of the PC trimer appear in a conformation similar to that of PEB. The conformation of the PC rod is consistent with that of the allophycocyanin (APC) trimer, and thus excitonic flow is facilitated between these two independent light-harvesting compounds. This excitonic flow from the PC rod to APC appears to be modulated by the vibration channels during HOOP wagging, C = C stretching, and the N-H rocking in-plan vibration.

  11. Amniotic Fluid Infection in Preterm Pregnancies with Intact Membranes

    Science.gov (United States)

    Rahkonen, Leena; Nupponen, Irmeli; Pätäri-Sampo, Anu; Tikkanen, Minna; Sorsa, Timo; Juhila, Juuso; Andersson, Sture; Paavonen, Jorma; Stefanovic, Vedran

    2017-01-01

    Introduction. Intra-amniotic infection (IAI) is a major cause of preterm labor and adverse neonatal outcome. We evaluated amniotic fluid (AF) proteolytic cascade forming biomarkers in relation to microbial invasion of the amniotic cavity (MIAC) and IAI in preterm pregnancies with intact membranes. Material and Methods. Amniocentesis was made to 73 women with singleton pregnancies; 27 with suspected IAI; and 46 controls. AF biomarkers were divided into three cascades: Cascade 1: matrix metalloproteinase-8 (MMP-8), MMP-9, myeloperoxidase (MPO), and interleukin-6; Cascade 2: neutrophil elastase (HNE), elafin, and MMP-9; Cascade 3: MMP-2, tissue inhibitor of matrix metalloproteinases-1 (TIMP-1), MMP-8/TIMP-1 molar ratio, and C-reactive protein (CRP). MMP-8 was measured by an immunoenzymometric assay and the others were measured by ELISA. Standard biochemical methods, molecular microbiology, and culture techniques were used. Results. MMP-8, MMP-9, MPO, elafin, and TIMP-1 concentrations were higher in IAI suspected cases compared to controls and also in IAI suspected cases with MIAC compared to those without MIAC when adjusted by gestational age at amniocentesis. All biomarkers except elafin and MMP-2 had the sensitivity of 100% with thresholds based on ROC-curve. Odd ratios of biomarkers for MIAC were 1.2-38 and 95% confidential intervals 1.0-353.6. Conclusions. Neutrophil based AF biomarkers were associated with IAI and MIAC. PMID:28167848

  12. Postnatal Hyperoxia Exposure Durably Impairs Right Ventricular Function and Mitochondrial Biogenesis.

    Science.gov (United States)

    Goss, Kara N; Kumari, Santosh; Tetri, Laura H; Barton, Greg; Braun, Rudolf K; Hacker, Timothy A; Eldridge, Marlowe W

    2017-05-01

    Prematurity complicates 12% of births, and young adults with a history of prematurity are at risk to develop right ventricular (RV) hypertrophy and impairment. The long-term risk for pulmonary vascular disease, as well as mechanisms of RV dysfunction and ventricular-vascular uncoupling after prematurity, remain poorly defined. Using an established model of prematurity-related lung disease, pups from timed-pregnant Sprague Dawley rats were randomized to normoxia or hyperoxia (fraction of inspired oxygen, 0.85) exposure for the first 14 days of life. After aging to 1 year in standard conditions, rats underwent hemodynamic assessment followed by tissue harvest for biochemical and histological evaluation. Aged hyperoxia-exposed rats developed significantly greater RV hypertrophy, associated with a 40% increase in RV systolic pressures. Although cardiac index was similar, hyperoxia-exposed rats demonstrated a reduced RV ejection fraction and significant RV-pulmonary vascular uncoupling. Hyperoxia-exposed RV cardiomyocytes demonstrated evidence of mitochondrial dysregulation and mitochondrial DNA damage, suggesting potential mitochondrial dysfunction as a cause of RV dysfunction. Aged rats exposed to postnatal hyperoxia recapitulate many features of young adults born prematurely, including increased RV hypertrophy and decreased RV ejection fraction. Our data suggest that postnatal hyperoxia exposure results in mitochondrial dysregulation that persists into adulthood with eventual RV dysfunction. Further evaluation of long-term mitochondrial function is warranted in both animal models of premature lung disease and in human adults who were born preterm.

  13. Ventricular rate control of atrial fibrillation in heart failure.

    Science.gov (United States)

    Rienstra, Michiel; Van Gelder, Isabelle C

    2013-10-01

    In the last few years, there has been a major shift in the treatment of atrial fibrillation (AF) in the setting of hear failure (HF), from rhythm to ventricular rate control in most patients with both conditions. In this article, the authors focus on ventricular rate control and discuss the indications; the optimal ventricular rate-control target, including detailed results of the Rate Control Efficacy in Permanent Atrial Fibrillation: a Comparison Between Lenient versus Strict Rate Control II (RACE II) study; and the pharmacologic and nonpharmacologic options to control the ventricular rate during AF in the setting of HF.

  14. Right ventricular function before and after percutaneous balloon mitral valvuloplasty.

    Science.gov (United States)

    Burger, W; Brinkies, C; Illert, S; Teupe, C; Kneissl, G D; Schräder, R

    1997-01-01

    Aim of this study was to evaluate right ventricular performance in patients with mitral stenosis and its modification by balloon valvuloplasty. Right ventricular volumes of 24 patients with postrheumatic mitral stenosis were determined by thermodilution 1 or 2 days before and 1 or 2 days after valvuloplasty. Right ventricular ejection fraction at rest was 43 (36-47)% (median and interquartile range). Right ventricular end-diastolic volume was 100 (86-119) ml/m2. Supine bicycle exercise (50 Watt) reduced right ventricular ejection fraction to 30 (29-37)% (P volume to 124 (112-141) ml/m2 (P improvement of right ventricular ejection fraction correlated inversely with the value of this parameter before valvuloplasty (r = -0.88, P volume (r = 0.57, P < 0.01). The right ventricular function curve, disturbed before commissurotomy, was reestablished by the procedure. In conclusion, at the here investigated stage of mitral stenosis right ventricular function is reversibly impaired. This is predominantly caused by the hemodynamic consequences of the valvular defect and not by an impairment of right ventricular myocardial function.

  15. A dual-chamber pacing mode to minimize ventricular pacing

    Directory of Open Access Journals (Sweden)

    Peter Rakovec

    2005-12-01

    Full Text Available Background: Though patients with sick sinus syndrome theoretically need an atrial pacemaker only, they usually receive a ventricular or a dual-chamber pacemaker because of possible developement of atrioventricular conduction abnormalities. Right ventricular pacing produces left bundle branch block (i.e. pacing-induced ventricular desynchronization, promoting heart failure and atrial fibrillation. This problem can be solved by a special pacing mode which on one hand preserves the safety of dual-chamber pacing and on the other hand minimizes right ventricular pacing.

  16. Right ventricular strain in heart failure: Clinical perspective.

    Science.gov (United States)

    Tadic, Marijana; Pieske-Kraigher, Elisabeth; Cuspidi, Cesare; Morris, Daniel A; Burkhardt, Franziska; Baudisch, Ana; Haßfeld, Sabine; Tschöpe, Carsten; Pieske, Burket

    2017-06-29

    The number of studies demonstrating the importance of right ventricular remodelling in a wide range of cardiovascular diseases has increased in the past two decades. Speckle-tracking imaging provides new variables that give comprehensive information about right ventricular function and mechanics. In this review, we summarize current knowledge of right ventricular mechanics in heart failure with reduced ejection fraction and preserved ejection fraction. We searched PubMed, MEDLINE, Ovid and Embase databases for studies published from January 2000 to December 2016 in the English language using the following keywords: "right ventricle"; "strain"; "speckle tracking"; "heart failure with reduced ejection fraction"; and "heart failure with preserved ejection fraction". Investigations showed that right ventricular dysfunction is associated with higher cardiovascular and overall mortality in patients with heart failure, irrespective of ejection fraction. The number of studies investigating right ventricular strain in patients with heart failure with reduced ejection fraction is constantly increasing, whereas data on right ventricular mechanics in patients with heart failure with preserved ejection fraction are limited. Given the high feasibility, accuracy and clinical implications of right ventricular strain in the population with heart failure, it is of great importance to try to include the evaluation of right ventricular strain as a regular part of each echocardiographic examination in patients with heart failure. However, further investigations are necessary to establish right ventricular strain as a standard variable for decision-making. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  17. Constitutive Intracellular Na+ Excess in Purkinje Cells Promotes Arrhythmogenesis at Lower Levels of Stress Than Ventricular Myocytes From Mice With Catecholaminergic Polymorphic Ventricular Tachycardia.

    Science.gov (United States)

    Willis, B Cicero; Pandit, Sandeep V; Ponce-Balbuena, Daniela; Zarzoso, Manuel; Guerrero-Serna, Guadalupe; Limbu, Bijay; Deo, Makarand; Camors, Emmanuel; Ramirez, Rafael J; Mironov, Sergey; Herron, Todd J; Valdivia, Héctor H; Jalife, José

    2016-06-14

    In catecholaminergic polymorphic ventricular tachycardia (CPVT), cardiac Purkinje cells (PCs) appear more susceptible to Ca(2+) dysfunction than ventricular myocytes (VMs). The underlying mechanisms remain unknown. Using a CPVT mouse (RyR2(R4496C+/Cx40eGFP)), we tested whether PC intracellular Ca(2+) ([Ca(2+)]i) dysregulation results from a constitutive [Na(+)]i surplus relative to VMs. Simultaneous optical mapping of voltage and [Ca(2+)]i in CPVT hearts showed that spontaneous Ca(2+) release preceded pacing-induced triggered activity at subendocardial PCs. On simultaneous current-clamp and Ca(2+) imaging, early and delayed afterdepolarizations trailed spontaneous Ca(2+) release and were more frequent in CPVT PCs than CPVT VMs. As a result of increased activity of mutant ryanodine receptor type 2 channels, sarcoplasmic reticulum Ca(2+) load, measured by caffeine-induced Ca(2+) transients, was lower in CPVT VMs and PCs than respective controls, and sarcoplasmic reticulum fractional release was greater in both CPVT PCs and VMs than respective controls. [Na(+)]i was higher in both control and CPVT PCs than VMs, whereas the density of the Na(+)/Ca(2+) exchanger current was not different between PCs and VMs. Computer simulations using a PC model predicted that the elevated [Na(+)]i of PCs promoted delayed afterdepolarizations, which were always preceded by spontaneous Ca(2+) release events from hyperactive ryanodine receptor type 2 channels. Increasing [Na(+)]i monotonically increased delayed afterdepolarization frequency. Confocal imaging experiments showed that postpacing Ca(2+) spark frequency was highest in intact CPVT PCs, but such differences were reversed on saponin-induced membrane permeabilization, indicating that differences in [Na(+)]i played a central role. In CPVT mice, the constitutive [Na(+)]i excess of PCs promotes triggered activity and arrhythmogenesis at lower levels of stress than VMs. © 2016 The Authors.

  18. Biventricular non-compaction with predominant right ventricular involvement, reduced left ventricular systolic and diastolic function, and pulmonary hypertension in a Hispanic male

    Science.gov (United States)

    Said, Sarmad; Cooper, Chad J.; Quevedo, Karla; Rodriguez, Emmanuel; Hernandez, German T.

    2013-01-01

    Patient: Male, 22 Final Diagnosis: Cardiomyopathy Symptoms: Shortness of breath • dispnoea • chest discomfort Medication: — Clinical Procedure: Echocardiogram • cardiac MRI Specialty: Cardiology Objective: Challenging differential diagnosis Background: Non-compaction cardiomyopathy (NCM) is a rare congenital cardiomyopathy characterized by increased trabeculation in one or more segments of the ventricle. The left ventricle is most commonly affected. However, biventricular involvement or right ventricle predominance has also been described. Clinical features of NCM are non-specific and can range from being asymptomatic to symptoms of congestive heart failure, arrhythmia, and systemic thromboembolism. Case Report: 22-year-old Hispanic male presented with two month history of chest discomfort. Laboratory workup revealed an elevated brain-natriuretic-peptide of 1768 pg/ml. ECG and chest x-ray was nonspecific. Transthoracic echocardiogram revealed prominent trabeculae and spongiform appearance of the left ventricle (LV) with an ejection-fraction of 15–20%; 5 of 9 segments of the LV were trabeculated with deep intertrabecular recesses also involving the right ventricle (RV) with demonstrated blood flow in these recesses on color-doppler. The biventricular spongiform appearance was morphologically suggestive for NCM with involvement of the RV. Confirmatory cardiac MRI was performed, demonstrating excessive trabeculation of the left-ventricular apex and mid-ventricular segments. Hypertrabecularion was exhibited at the apical and lateral wall of the RV. Cardiac catheterization showed an intact cardiac vessel system. The patient was discharged on heart failure treatment and was placed on the heart transplantation list. Conclusions: NCM is a unique disorder resulting in serious and severe complications. The majority of the reported cases describe the involvement of the left ventricle. However, the right ventricle should be taken into careful consideration. The early

  19. Constitutive Intracellular Na+ Excess in Purkinje Cells Promotes Arrhythmogenesis at Lower Levels of Stress Than Ventricular Myocytes From Mice With Catecholaminergic Polymorphic Ventricular Tachycardia

    Science.gov (United States)

    Willis, B. Cicero; Pandit, Sandeep V.; Ponce-Balbuena, Daniela; Zarzoso, Manuel; Guerrero-Serna, Guadalupe; Limbu, Bijay; Deo, Makarand; Camors, Emmanuel; Ramirez, Rafael J.; Mironov, Sergey; Herron, Todd J.; Valdivia, Héctor H.

    2016-01-01

    Background— In catecholaminergic polymorphic ventricular tachycardia (CPVT), cardiac Purkinje cells (PCs) appear more susceptible to Ca2+ dysfunction than ventricular myocytes (VMs). The underlying mechanisms remain unknown. Using a CPVT mouse (RyR2R4496C+/Cx40eGFP), we tested whether PC intracellular Ca2+ ([Ca2+]i) dysregulation results from a constitutive [Na+]i surplus relative to VMs. Methods and Results— Simultaneous optical mapping of voltage and [Ca2+]i in CPVT hearts showed that spontaneous Ca2+ release preceded pacing-induced triggered activity at subendocardial PCs. On simultaneous current-clamp and Ca2+ imaging, early and delayed afterdepolarizations trailed spontaneous Ca2+ release and were more frequent in CPVT PCs than CPVT VMs. As a result of increased activity of mutant ryanodine receptor type 2 channels, sarcoplasmic reticulum Ca2+ load, measured by caffeine-induced Ca2+ transients, was lower in CPVT VMs and PCs than respective controls, and sarcoplasmic reticulum fractional release was greater in both CPVT PCs and VMs than respective controls. [Na+]i was higher in both control and CPVT PCs than VMs, whereas the density of the Na+/Ca2+ exchanger current was not different between PCs and VMs. Computer simulations using a PC model predicted that the elevated [Na+]i of PCs promoted delayed afterdepolarizations, which were always preceded by spontaneous Ca2+ release events from hyperactive ryanodine receptor type 2 channels. Increasing [Na+]i monotonically increased delayed afterdepolarization frequency. Confocal imaging experiments showed that postpacing Ca2+ spark frequency was highest in intact CPVT PCs, but such differences were reversed on saponin-induced membrane permeabilization, indicating that differences in [Na+]i played a central role. Conclusions— In CPVT mice, the constitutive [Na+]i excess of PCs promotes triggered activity and arrhythmogenesis at lower levels of stress than VMs. PMID:27169737

  20. Longitudinal left ventricular myocardial dysfunction assessed by 2D colour tissue Doppler imaging in a dog with systemic hypertension and severe arteriosclerosis.

    Science.gov (United States)

    Nicolle, A P; Carlos Sampedrano, C; Fontaine, J J; Tessier-Vetzel, D; Goumi, V; Pelligand, L; Pouchelon, J-L; Chetboul, V

    2005-03-01

    A 12-year-old sexually intact male Vendee Griffon Basset was presented for acute pulmonary oedema. Severe systemic systolic arterial hypertension (SAH) was diagnosed (290 mmHg). Despite blood and abdominal ultrasound tests, the underlying cause of the systemic hypertension could not be determined, and primary SAH was therefore suspected. Conventional echocardiography showed eccentric left ventricular hypertrophy with normal fractional shortening. Despite this apparent normal systolic function, 2D colour tissue Doppler imaging (TDI) identified a marked longitudinal systolic left ventricular myocardial alteration, whereas radial function was still preserved. Three months later, the dog underwent euthanasia because of an acute episode of distal aortic thromboembolism. Necropsy revealed severe aortic and iliac arteriosclerosis. SAH related to arteriosclerosis is a common finding in humans, but has not been previously described in dogs. Moreover, its consequence on longitudinal myocardial function using TDI has never been documented before in this species.

  1. Echocardiographic Assessment of Left Ventricular Function in Type 1 Gaucher's Disease

    Directory of Open Access Journals (Sweden)

    Mirta Koželj

    2010-01-01

    Full Text Available There is predominate opinion among physicians managing type 1 Gauchers' disease (GD that cardiac involvement is not an issue in these patients. In order to follow this hypothesis, we prospectively investigated 15 adult imiglucerase-treated type 1 GD patients by echocardiography, Doppler, and tissue Doppler echocardiography. This was a case-controlled study with 18 matched healthy volunteers. The obtained data was correlated with the levels of NT-proBNP (brain natriuretic peptide. None of the GD patients had clinical signs of heart disease. In 3 of the 15 patients, we observed echocardiographic signs of aortic and mitral valve calcification. The left ventricular systolic function was within normal limits. Compared to the control group, there was no statistically significant difference observed in the most sensitive indices of left ventricular diastolic function, parameter Em (P=.095, and E/Em ratio (P=.097, as demonstrated by tissue Doppler echocardiography. However, there was a positive correlation between the E/Em ratio and NT-proBNP plasma levels (P=.009. In conclusion, the prospective echocardiographic study of type 1 GD patients did not validate any left ventricular dysfunction. But, the E/Em ratio showed a strong statistical correlation with the most sensitive indicators of heart failure, NT-proBNP. Research on larger groups of patients and the usage of even more sensitive methods as strain-rate imaging will be necessary to confirm eventual myocardial involvement in GD patients.

  2. Lesson Three Ventricular premature complexes%第3课 室性期前收缩

    Institute of Scientific and Technical Information of China (English)

    鲁端; 顾晓燕

    2002-01-01

    @@ Ventricular premature complexes(VPCs) are among the most common arrhythmias and occur in patients with and without heart disease. Of adult males. ≥ 60 percent will exhibit VPCs during a 24 - h Holter monitoring. In patients without heart disease, VPCs have not been shown 1 to be associated with 2 any increased incidence in mortality or morbidity. VPCs may occur in up to 80 percent of patients with previous myocardial infarction, and in this setting, if frequent( > 10 per hour) and/ or complex(occurring in couplets), they have been associated with increased mortality.

  3. Left ventricular thrombus formation after repair of anomalous left coronary artery from the pulmonary artery.

    Science.gov (United States)

    Freud, Lindsay R; Koenig, Peter R; Russell, Hyde M; Patel, Angira

    2014-04-01

    Although thrombus formation following myocardial infarction in adults is well known, intracardiac thrombosis in children is uncommon. We report the case of a large left ventricular thrombus in an infant with ischemic cardiomyopathy secondary to anomalous origin of the left coronary artery from the pulmonary artery. Given its mobility and protrusion across the aortic valve, the patient underwent urgent thrombus removal through a transaortic approach. There were no embolic or neurologic complications. This case highlights that thrombectomy may be performed safely and successfully in critically ill pediatric patients.

  4. Left Ventricular Thrombus Formation After Repair of Anomalous Left Coronary Artery From the Pulmonary Artery

    Science.gov (United States)

    Freud, Lindsay R.; Koenig, Peter R.; Russell, Hyde M.; Patel, Angira

    2014-01-01

    Although thrombus formation following myocardial infarction in adults is well known, intracardiac thrombosis in children is uncommon. We report the case of a large left ventricular thrombus in an infant with ischemic cardiomyopathy secondary to anomalous origin of the left coronary artery from the pulmonary artery. Given its mobility and protrusion across the aortic valve, the patient underwent urgent thrombus removal through a transaortic approach. There were no embolic or neurologic complications. This case highlights that thrombectomy may be performed safely and successfully in critically ill pediatric patients. PMID:24668990

  5. Impact of the right ventricular lead position on clinical outcome and on the incidence of ventricular tachyarrhythmias in patients with CRT-D

    DEFF Research Database (Denmark)

    Kutyifa, Valentina; Bloch Thomsen, Poul Erik; Huang, David T.

    2013-01-01

    Data on the impact of right ventricular (RV) lead location on clinical outcome and ventricular tachyarrhythmias in cardiac resynchronization therapy with defibrillator (CRT-D) patients are limited.......Data on the impact of right ventricular (RV) lead location on clinical outcome and ventricular tachyarrhythmias in cardiac resynchronization therapy with defibrillator (CRT-D) patients are limited....

  6. Impact of the right ventricular lead position on clinical outcome and on the incidence of ventricular tachyarrhythmias in patients with CRT-D

    DEFF Research Database (Denmark)

    Kutyifa, Valentina; Bloch Thomsen, Poul Erik; Huang, David T.;

    2013-01-01

    Data on the impact of right ventricular (RV) lead location on clinical outcome and ventricular tachyarrhythmias in cardiac resynchronization therapy with defibrillator (CRT-D) patients are limited.......Data on the impact of right ventricular (RV) lead location on clinical outcome and ventricular tachyarrhythmias in cardiac resynchronization therapy with defibrillator (CRT-D) patients are limited....

  7. Epicardial radiofrequency ablation for left ventricular aneurysm related ventricular arrhythmias during off-pump coronary artery bypass surgery

    Institute of Scientific and Technical Information of China (English)

    YU Yang; GAO Ming-xin; LI Hai-tao; ZHANG Fan; GU Cheng-xiong

    2012-01-01

    Background Left ventricular aneurysm (LVA) is one of the serious complications after acute myocardial infarction.We attempted to evaluate the preliminary efficacy of LVA repair combined with epicardial radiofrequency ablation for ventricular arrhythmia during off-pump coronary artery bypass grafting (OPCAB).Methods From June 2009 to April 2011,31 patients with LVA had angina symptoms and ventricular arrhythmia.In all patients,circular and cross-shaped radiofrequency epicardial ablations were performed using unipolar ablation pen along the border between the aneurysm wall and normal cardiac tissue and in the central zone of the aneurysms,followed by a linear placation of ventricular aneurysms on beating heart.Results All the patients showed complete recovery.The average number of grafted vessels was 2.7±1.3.Intraoperative examinations revealed that the ventricular arrhythmia was effectively controlled by radiofrequency ablation.All cases had been followed up for one year.Holter monitoring revealed a significant reduction in ventricular arrhythmias (P <0.05).Echocardiography showed significant increase in left ventricular ejection fraction (P <0.05) and decrease in left ventricular end-diastolic diameter (P <0.05).Conclusions For patients with ventricular aneurysm and preoperative malignant arrhythmia,aneurysm repair plus epicardial radiofrequency ablation in OPCAB was found to be an effective and feasible therapeutic technique.However,medium-to long-term therapeutic efficacy of this method remains to be determined by future studies and observations.

  8. Dual Endothelin Receptor Blockade Abrogates Right Ventricular Remodeling and Biventricular Fibrosis in Isolated Elevated Right Ventricular Afterload.

    Directory of Open Access Journals (Sweden)

    Eva Amalie Nielsen

    Full Text Available Pulmonary arterial hypertension is usually fatal due to right ventricular failure and is frequently associated with co-existing left ventricular dysfunction. Endothelin-1 is a powerful pro-fibrotic mediator and vasoconstrictor that is elevated in pulmonary arterial hypertension. Endothelin receptor blockers are commonly used as pulmonary vasodilators, however their effect on biventricular injury, remodeling and function, despite elevated isolated right ventricular afterload is unknown.Elevated right ventricular afterload was induced by progressive pulmonary artery banding. Seven rabbits underwent pulmonary artery banding without macitentan; 13 received pulmonary artery banding + macitentan; and 5 did not undergo inflation of the pulmonary artery band (sham-operated controls.Right and left ventricular collagen content was increased with pulmonary artery banding compared to sham-operated controls and ameliorated by macitentan. Right ventricular fibrosis signaling (connective tissue growth factor and endothelin-1 protein levels; extra-cellular matrix remodeling (matrix-metalloproteinases 2 and 9, apoptosis and apoptosis-related peptides (caspases 3 and 8 were increased with pulmonary artery banding compared with sham-operated controls and decreased with macitentan.Isolated right ventricular afterload causes biventricular fibrosis, right ventricular apoptosis and extra cellular matrix remodeling, mediated by up-regulation of endothelin-1 and connective tissue growth factor signaling. These pathological changes are ameliorated by dual endothelin receptor blockade despite persistent elevated right ventricular afterload.

  9. Ventricular septal rupture and right ventricular intramyocardial dissection secondary to acute inferior myocardial infarction.

    Science.gov (United States)

    Bittencourt, Márcio Sommer; Seltmann, Martin; Muschiol, Gerd; Achenbach, Stephan

    2010-01-01

    A 61-year-old female patient presented with sub acute myocardial infarction with an occluded right coronary artery on invasive evaluation and a ventricular septal rupture on echocardiogram. Cardiac computed tomography (CT) was performed to better define the septal anatomy. As the anatomy on cardiac CT was considered unfavorable for percutaneous intervention, the patient underwent successful surgical repair.

  10. EXPERIMENTAL STUDY OF RIGHT VENTRICULAR ASSIST IN ACUTE RIGHT VENTRICULAR FAILING

    Institute of Scientific and Technical Information of China (English)

    刘明辉; 苏鸿熙; 李功宋; 王加利; 董超; 童健

    1996-01-01

    The efficacy of right atrial-pulmonary artery (RA-PA)bypass during acute right ventricular failure(RVF)produced by pulmonary artery constriction in dogs was examined in this study Control group (n=7)was supported with conventional volume loading and inotropic therapy.In the experimental animals (n=8),RA-PA bypass was initiated 5 min.after the onset of severe RVF.Three control animals died from refractory ventricular fibrillation within one hour of RVF.No animals in the experimental group died within two hours of RA-PA bypass,but the histological study of the lungs in these animals demonstrated peribronchial,preivascular and intraalveolar hemorrhage.Lighr microscopic and electron microscopic examination of the myocardial specimens of the right ventricular free wall displayed the myocardial structures and ultrastructues were maintained effectively with RA-PA bypass wile irreversible myocardial injuries occurred in the control animasls after two hours of RVF with conventional therapy.During the 2hours of RA-PA bypass,the hemodynamic indices were also maintained better when compared to the control animals.It may be concluded,a roller pump right ventricular assist device effectively unloads the acute faijing right ventricle,maintains systemic cardisc output,and significatly reverses the myocardial ischemia during right venrricular failure,but RA-PA bypass may induce pulmonary hypertension due to increased pulmonary vascular resistance secondary to pulmonary edeme and interstitial hemorrhage.

  11. Rare Complication of External Ventricular Drainage:Intra-ventricular Drain Section

    Institute of Scientific and Technical Information of China (English)

    Hanane Ezzouine; Abdellatif Benslama

    2014-01-01

    The external ventricular derivation is an invasive technique used to cure hydrocephalus.Sometimes,it may have infectiousand mechanical complications and needs specific cares.Very rarely, the drain line can be cut with an intraventricular section tip as in thecase reported.

  12. Taquicardia ventricular polimórfica catecolaminérgica Catecholaminergic polymorphic ventricular tachycardia

    Directory of Open Access Journals (Sweden)

    Alejandro Velasco

    2009-04-01

    Full Text Available Catecholaminergic Polymorphic Ventricular Tachycardia is an inherited heart rhythm disorder recently discovered by genetic and electrophysiological diagnostic advancements. It consists of an inherited disorder characterized by the induction of bi-directional ventricular tachycardia in the presence of catecholamines, without a structural cardiac abnormality. Mutations in the Ryanodine receptor gene RyR2, have been linked with an autosomic dominant form, while mutations in the Calsequestrin gene CASQ 2 have showed correlation with an autosomic recessive form. The average age of onset is between 7 and 9 years of age, and clinical symptoms vary from syncope to sudden cardiac death. The diagnosis is confirmed by inducting ventricular tachycardia through a stress test or during an infusion of sympathicomimetic drugs like Isoproterenol, aided by the identification of mutations in the RyR2 and CASQ2 genes through gene analysis. Implantable cardiodefibrillator devices remain a valid therapeutic option in many cases due to the fact that antiarrhythmic drugs have not shown efficacy. Sympathetic cardiac denervation can be useful in some special cases. Catecholaminergic Polymorphic Ventricular Tachycardia opens a wide field for the development of new antiarrhythmic drugs and the use of gene therapy for cardiac rhythm disorders.

  13. Gender Differences in Performance of Script Analysis by Older Adults

    Science.gov (United States)

    Helmes, E.; Bush, J. D.; Pike, D. L.; Drake, D. G.

    2006-01-01

    Script analysis as a test of executive functions is presumed sensitive to cognitive changes seen with increasing age. Two studies evaluated if gender differences exist in performance on scripts for familiar and unfamiliar tasks in groups of cognitively intact older adults. In Study 1, 26 older adults completed male and female stereotypical…

  14. Extracorporeal life support for refractory ventricular tachycardia

    Science.gov (United States)

    Joseph, Nicholas; Hofmann, James P.; Saranteas, Theodosios; Papadimos, Thomas J.

    2017-01-01

    Extracorporeal life support (ECLS) is a very effective bridging therapy in patients with refractory ventricular tachycardia (VT) associated with cardiogenic shock. A moribund patient in extremis, is not amenable to optimization by standard ACC/AHA guidelines. New approaches and novel salvage techniques are necessary to improve outcomes in patients with refractory clinical settings such as malignant ventricular arrhythmias, cardiac arrest, cardiogenic shock and/or pulmonary failure until further management options are explored. Data base searches were done using key words such as ECLS, VT, cardiac arrest, VT ablation, venoarterial extra-corporeal membrane oxygenation (VA-ECMO). The use of ECLS has been described in a few case reports to facilitate VT ablation for incessant VT refractory to medical therapy. For patients with, out-of- hospital ventricular fibrillation (VF) and VT, Minnesota Resuscitation Consortium has implemented emergent advanced perfusion and reperfusion strategy, followed by coronary angiography and primary coronary intervention to improve outcome. The major indications for ECLS are cardiogenic shock related to acute myocardial infarction, myocarditis, post embolic acute cor pulmonale, drug intoxication and post cardiac arrest syndrome with the threat of multi-organ failure. ECLS permits the use of negative inotropic antiarrhythmic drug therapy, facilitates the weaning of catecholamine administration, thereby ending the vicious cycle of catecholamine driven electric storm. ECLS provides hemodynamic support during ablation procedure, while mapping and induction of VT is undertaken. ECLS provides early access to cardiac catheterization laboratory in patients with cardiac arrest due to shockable rhythm. The current evidence from literature, supports the use of ECLS to ensure adequate vital organ perfusion in patients with refractory VT. ECLS is a safe, feasible and effective therapeutic option when conventional therapies are insufficient to support

  15. Echocardiographic evaluation of right ventricular function in congenital heart disease

    Institute of Scientific and Technical Information of China (English)

    Yiu-fai Cheung

    2014-01-01

    Objective This review aims to provide an overview of conventional and novel indices used in clinical and research arenas for evaluation of right ventricular (RV) function in congenital heart diseases with a dual-chambered circulation.Data sources Articles cited in this review were selected using PubMed search of publications in English with no date limits.The search terms included "echocardiography","right ventricle","RV function","cardiac function",and "congenital heart disease".Key references were also searched for additional publications.Study selection Articles related to description of echocardiographic techniques in the evaluation of subpulmonary or systemic RV function and their applications in congenital cardiac malformations were retrieved and reviewed.Results Three approaches have been used to evaluate subpulmonary and systemic RV function:(1) assessment of changes in RV size in the cardiac cycle,(2) determination of Doppler-derived velocities and systolic and diastolic time intervals,and (3) quantification of myocardial velocities and deformation.Conclusions Conventional and novel echocardiographic techniques enable the evaluation of subpulmonary and systemic RV function.Novel echocardiographic techniques have further allowed quantification of RV volumes and direct interrogation of myocardial deformation.These new techniques show promise in a more comprehensive evaluation beyond "eye-bailing" of RV function in the growing population of adolescent and adult congenital heart patients.

  16. Ventricular shunt infections: Immunopathogenesis and clinical management

    Science.gov (United States)

    Gutierrez-Murgas, Yenis; Snowden, Jessica N.

    2014-01-01

    Ventricular shunts are the most common neurosurgical procedure performed in the United States. This hydrocephalus treatment is often complicated by infection of the device with biofilm-forming bacteria. In this review, we discuss the pathogenesis of shunt infection, as well as the implications of the biofilm formation on treatment and prevention of these infections. Many questions remain, including the contribution of glia and the impact of inflammation on developmental outcomes following infection. Immune responses within the CNS must be carefully regulated to contain infection while minimizing bystander damage; further study is needed to design optimal treatment strategies for these patients. PMID:25156073

  17. Pseudo ventricular tachycardia: a case report.

    LENUS (Irish Health Repository)

    Riaz, A

    2012-02-01

    BACKGROUND: Dramatic artifacts of pseudo flutter have been reported in the past secondary to various factors including tremor (Handwerker and Raptopoulos in N Engl J Med 356:503, 2007) and dialysis machines (Kostis et al. in J Electrocardiol 40(4):316-318, 2007). METHODS: We present this unusual case where the artifact, produced by tremor, was so pronounced to be misdiagnosed and treated as ventricular tachycardia. CONCLUSION: This case highlights the importance of correlating ECG findings with history and clinical examination and of using 12 lead ECGs for rhythm interpretation especially to confirm consistence of arrhythmias in all leads.

  18. Mechanisms of neuronal chloride accumulation in intact mouse olfactory epithelium.

    Science.gov (United States)

    Nickell, William T; Kleene, Nancy K; Kleene, Steven J

    2007-09-15

    When olfactory receptor neurons respond to odours, a depolarizing Cl(-) efflux is a substantial part of the response. This requires that the resting neuron accumulate Cl(-) against an electrochemical gradient. In isolated olfactory receptor neurons, the Na(+)-K(+)-2Cl(-) cotransporter NKCC1 is essential for Cl(-) accumulation. However, in intact epithelium, a robust electrical olfactory response persists in mice lacking NKCC1. This response is largely due to a neuronal Cl(-) efflux. It thus appears that NKCC1 is an important part of a more complex system of Cl(-) accumulation. To identify the remaining transport proteins, we first screened by RT-PCR for 21 Cl(-) transporters in mouse nasal tissue containing olfactory mucosa. For most of the Cl(-) transporters, the presence of mRNA was demonstrated. We also investigated the effects of pharmacological block or genetic ablation of Cl(-) transporters on the olfactory field potential, the electroolfactogram (EOG). Mice lacking the common Cl(-)/HCO(3)(-) exchanger AE2 had normal EOGs. Block of NKCC cotransport with bumetanide reduced the EOG in epithelia from wild-type mice but had no effect in mice lacking NKCC1. Hydrochlorothiazide, a blocker of the Na(+)-Cl(-) cotransporter, had only a small effect. DIDS, a blocker of some KCC cotransporters and Cl(-)/HCO(3)(-) exchangers, reduced the EOG in epithelia from both wild-type and NKCC1 knockout mice. A combination of bumetanide and DIDS decreased the response more than either drug alone. However, no combination of drugs completely abolished the Cl(-) component of the response. These results support the involvement of both NKCC1 and one or more DIDS-sensitive transporters in Cl(-) accumulation in olfactory receptor neurons.

  19. Boron and Zinc Transport Through Intact Columns of Calcareous Soils

    Institute of Scientific and Technical Information of China (English)

    M. MAHMOOD-UL-HASSAN; M. S. AKHTAR; G. NABI

    2008-01-01

    Leaching of boron (B) and zinc (Zn) can be significant in some pedomorphic conditions, which can cause contamination of shallow groundwater and economic losses. Boron and Zn adsorption and transport was studied using 8.4 cm diameter ×28 cm long intact columns from two calcareous soil series with differing clay contents and vadose zone structures:Lyallpur soil series, clay loam (fine-silty, mixed, hyperthermic Ustalfic Haplargid), and Sultanpur soil series, sandy loam (coarse-silty, mixed, hyperthermic Ustollic Camborthid). The adsorption isotherms were developed by equilibrating soil with 0.01 mol L-1 CaCl2 aqueous solution containing varying amounts of B and Zn and were fitted to the Langmuir equation. The B and Zn breakthrough curves were fitted to the two-domain convective-dispersive equation. At the end of the leaching experiment, 0.11 L 10 g L-1 blue dye solution was also applied to each column to mark the flow paths.The Lyallpur soil columns had a slightly greater adsorption partition coefficient both for B and Zn than the Sultanpur soil columns. In the Lyallpur soil columns, B arrival was immediate but the peak concentration ratio (the concentration in solution at equilibrium/concentration applied) was lower than that in the Sultanpur soil columns. The breakthrough of B in the Sultanpur soil columns occurred after about 10 cm of cumulative drainage in both the columns; the rise in effluent concentration was fast and the peak concentration ratio was almost 1. Zinc leaching through the soil columns was very limited as only one column from the Lyallpur soil series showed Zn breakthrough in the effluent where the peak concentration ratio was only 0.05. This study demonstrates the effect of soil structure on B transport and has implications for the nutrient management in field soils.

  20. Raman mapping of intact biofilms on stainless steel surfaces

    Science.gov (United States)

    Nguyen, Julie K.; Heighton, Lynne; Xu, Yunfeng; Nou, Xiangwu; Schmidt, Walter F.

    2016-05-01

    Many issues occur when microbial bacteria contaminates human food or water; it can be dangerous to the public. Determining how the microbial are growing, it can help experts determine how to prevent the outbreaks. Biofilms are a tightly group of microbial cells that grow on living surfaces or surrounding themselves. Though biofilms are not necessarily uniform; when there are more than one type of microbial bacteria that are grown, Raman mapping is performed to determine the growth patterns. Depending on the type of microbial bacteria, they can grow in various patterns such as symmetrical or scattered on the surface. The biofilms need to be intact in order to preclude and potentially figuring out the relative intensity of different components in a biofilm mixture. In addition, it is important to determine whether one biofilms is a substrate for another biofilm to be detected. For example, it is possible if layer B appears above layer A, but layer A doesn't appear above layer B. In this case, three types of biofilms that are grown includes Listeria(L), Ralstonia(R), and a mixture of the two (LR). Since microbe deposits on metal surfaces are quite suitable, biofilms were grown on stainless steel surface slides. Each slide was viewed under a Raman Microscope at 100X and using a 532nm laser to provide great results and sharp peaks. The mapping of the laser helps determine how the bacteria growth, at which intensity the bacteria appeared in order to identify specific microbes to signature markers on biofilms.

  1. The effects of silver nanoparticles on intact wastewater biofilms

    Directory of Open Access Journals (Sweden)

    Zhiya eSheng

    2015-07-01

    Full Text Available Silver nanoparticles (Ag-NPs have strong antibacterial properties, which may adversely affect biological wastewater treatment processes. To determine the overall effect, intact biofilm samples were collected from the rotating biological contactor (RBC at the local wastewater treatment plant and treated with 200 mg Ag/L Ag-NPs for 24 h. The biofilm uptake of Ag-NPs was monitored with transmission electron microscopy (TEM. Forty-five min after Ag-NP application, Ag-NPs were seen in the biofilm extracellular polymeric substances (EPS. After 24 h, Ag-NPs had entered certain microbial cells, while other cells contained no observable Ag-NPs. Some cells were dying after the uptake of Ag-NPs. However, there was no significant reduction in cultivable bacteria in the biofilms, based on heterotrophic plate counts (HPC. While this may indicate that wastewater biofilms are highly resistant to Ag-NPs, the HPC represents only a small portion of the total microbial population. To further investigate the effects of Ag-NPs, a GeoChip microarray was used to directly detect changes in the functional gene structure of the microbial community in the biofilm. A clear decrease (34.6% decrease in gene number in gene diversity was evident in the GeoChip analysis. However, the complete loss of any specific gene was rare. Some gene families present in both treated and untreated biofilms. However, this doesn’t necessarily mean that there was no change in these families. Signal intensity decreased in certain variants in each family while other variants increased to compensate the effects of Ag-NPs. The results indicate that Ag-NP treatment decreased microbial community diversity but did not significantly affect the microbial community function. This provides direct evidence for the functional redundancy of microbial community in engineered ecosystems such as wastewater biofilms.

  2. LEFT VENTRICULAR SYSTOLIC FUNCTION DURING TREADMILL WALKING WITH LOAD CARRIAGE IN ADOLESCENTS

    Directory of Open Access Journals (Sweden)

    Moran Sagiv

    2006-06-01

    Full Text Available Backpack carriage occurs in day-to-day tasks and has applications in school, physical training, recreational activities and sports. Using metabolic cart and echocardiograph, this study determined and examined the effects of two different load carriages on left ventricular function during 30 min. of treadmill walking in healthy adolescent male subjects. Seventeen males (13.1 ± 0.5 yrs. walked on a treadmill at a speed of 4 km·h-1, each carrying a load relative to his body mass at 333 gr·kg-1 body weight during one session and without weight during the other session. Significant (p < 0.05 differences were noted between the 333 gr·kg-1 body weight and the no weights with regard to: VO2 13.6 ± 1.3 and 10.5 ± 1.1 ml·kg-1·min-1; heart rate: 133.2 ± 7.1 and 121.4 ± 5.6 beats·min-1; mean arterial blood pressure; 95. 4 ± 4.3 and 87.5 ± 3.8 mmHg and systolic blood pressure 147.7 ± 7.0 and 129.8 ± 7.1 mmHg respectively. No significant differences were noted between the two exercises with regard to left ventricular function variables. This study suggests that in adolescents as in adults, the vasodilatation mechanism dominates during combined dynamic and isometric exercises. Thus, the opposing force to the left ventricular ejection is reduced which in turn does not change the left ventricular global function. In addition, the vasodilatation mechanism enables oxygen supply to the contracting muscles via aerobic energy pathways

  3. Non-ventricular, Clinical, and Functional Features of the RyR2(R420Q) Mutation Causing Catecholaminergic Polymorphic Ventricular Tachycardia.

    Science.gov (United States)

    Domingo, Diana; Neco, Patricia; Fernández-Pons, Elena; Zissimopoulos, Spyros; Molina, Pilar; Olagüe, José; Suárez-Mier, M Paz; Lai, F Anthony; Gómez, Ana M; Zorio, Esther

    2015-05-01

    Catecholaminergic polymorphic ventricular tachycardia is a malignant disease, due to mutations in proteins controlling Ca(2+) homeostasis. While the phenotype is characterized by polymorphic ventricular arrhythmias under stress, supraventricular arrhythmias may occur and are not fully characterized. Twenty-five relatives from a Spanish family with several sudden deaths were evaluated with electrocardiogram, exercise testing, and optional epinephrine challenge. Selective RyR2 sequencing in an affected individual and cascade screening in the rest of the family was offered. The RyR2(R420Q) mutation was generated in HEK-293 cells using site-directed mutagenesis to conduct in vitro functional studies. The exercise testing unmasked catecholaminergic polymorphic ventricular tachycardia in 8 relatives (sensitivity = 89%; positive predictive value = 100%; negative predictive value = 93%), all of them carrying the heterozygous RyR2(R420Q) mutation, which was also present in the proband and a young girl without exercise testing, a 91% penetrance at the end of the follow-up. Remarkably, sinus bradycardia, atrial and junctional arrhythmias, and/or giant post-effort U-waves were identified in patients. Upon permeabilization and in intact cells, the RyR2(R420Q) expressing cells showed a smaller peak of Ca(2+) release than RyR2 wild-type cells. However, at physiologic intracellular Ca(2+) concentration, equivalent to the diastolic cytosolic concentration, the RyR2(R420Q) released more Ca(2+) and oscillated faster than RyR2 wild-type cells. The missense RyR2(R420Q) mutation was identified in the N-terminus of the RyR2 gene in this highly symptomatic family. Remarkably, this mutation is associated with sinus bradycardia, atrial and junctional arrhythmias, and giant U-waves. Collectively, functional heterologous expression studies suggest that the RyR2(R420Q) behaves as an aberrant channel, as a loss- or gain-of-function mutation depending on cytosolic intracellular Ca(2

  4. Intact fetal ovarian cord formation promotes mouse oocyte survival and development

    Directory of Open Access Journals (Sweden)

    Pera Renee

    2010-01-01

    Full Text Available Abstract Background Female reproductive potential, or the ability to propagate life, is limited in mammals with the majority of oocytes lost before birth. In mice, surviving perinatal oocytes are enclosed in ovarian follicles for subsequent oocyte development and function in the adult. Before birth, fetal germ cells of both sexes develop in clusters, or germline cysts, in the undifferentiated gonad. Upon sex determination of the fetal gonad, germ cell cysts become organized into testicular or ovarian cord-like structures and begin to interact with gonadal somatic cells. Although germline cysts and testicular cords are required for spermatogenesis, the role of cyst and ovarian cord formation in mammalian oocyte development and female fertility has not been determined. Results Here, we examine whether intact fetal ovarian germ and somatic cell cord structures are required for oocyte development using mouse gonad re-aggregation and transplantation to disrupt gonadal organization. We observed that germ cells from disrupted female gonad prior to embryonic day e13.5 completed prophase I of meiosis but did not survive following transplantation. Furthermore, re-aggregated ovaries from e13.5 to e15.5 developed with a reduced number of oocytes. Oocyte loss occurred before follicle formation and was associated with an absence of ovarian cord structure and ovary disorganization. However, disrupted ovaries from e16.5 or later were resistant to the re-aggregation impairment and supported robust oocyte survival and development in follicles. Conclusions Thus, we demonstrate a critical window of oocyte development from e13.5 to e16.5 in the intact fetal mouse ovary, corresponding to the establishment of ovarian cord structure, which promotes oocyte interaction with neighboring ovarian somatic granulosa cells before birth and imparts oocytes with competence to survive and develop in follicles. Because germline cyst and ovarian cord structures are conserved in the

  5. Effects of hypokalemia on transmural dispersion of ventricular repolarization in left ventricular myocardium

    Institute of Scientific and Technical Information of China (English)

    Jiang-Hua Zhong; Shi-Juan Lu; Mo-Shui Chen; Zi-Bin Chen; Liu Wang; Ping-Sheng Wu

    2013-01-01

    Objective: To observe effects of hypokalemia on transmural heterogeneity of ventricular repolarization in left ventricular myocardium of rabbit, and explore the role of hypokalemia in malignant ventricular arrhythmia (MVA). Methods: A total of 20 rabbits were randomly divided into control group and hypokalemic group. Isolated hearts in the control group were simply perfused with modified Tyrode's solution, and were perfused with hypokalemic Tyrode's solution in hypokalemic group. Ventricular fibrillation threshold (VFT), 90% monophasic action potential repolarization duration (APD90) of subepicardial, midmyocardial and subendocardial myocardium, transmural dispersion of repolarization (TDR) and Cx43 protein expression in three layers of myocardium were measured in both groups. Results: VFT in the control group and the hypokalemic group were (13.40±2.95) V, and (7.00±1.49) V, respectively. There was a significant difference between two groups (P<0.01). APD90 of three myocardial layers in the hypokalemic group were significantly prolonged than those in the control group (P<0.01). APD90 in the hypokalemic group and the control group were (38.10±10.29) ms and (23.70±5.68) ms, and TDR were (52.90±14.55) ms and (36.10±12.44) ms, respectively. APD90 and TDR in the hypokalemic group were significantly higher than those in the control group (P<0.05), and the increase in APD90 of midmyocardium was more significant in the hypokalemic group. Cx43 protein expression of all three myocardial layers were decreased significantly in the hypokalemic group (P<0.01), and Cx43 was significantly increased (P<0.05). Reduction of Cx43 protein expression was more significant in the midmyocardium. Conclusions: Hypokalemic can increase transmural heterogeneity of Cx43 expression and repolarization in left ventricular myocardium of rabbit, and decrease VFT and can induce MVA more easily.

  6. Adenoviral-mediated Hath1-EGFP gene transfer into guinea pig cochlea through intact round window membrane

    Institute of Scientific and Technical Information of China (English)

    CHEN Wei; HU Yin-yan; YANG Shi-ming; GUO Wei; SUN Jian-he; HAN Dong-yi; ZHAI Suo-qiang; YANG Wei-yan; David Z.Z.He

    2008-01-01

    Objective To study expression of adenovira1-mediated Hathl-EGFP gene in the guinea pig cochlea after transfer through intact round window membrane (RWM), and to assess its effects on hearing. Methods Twenty adult guinea pigs were used, of which: 12 were surgically inoculated with AdHath1-EGFP in the bony groove of round window niche, and 8 with artificial perilymph. Auditory brainstem response(ABR) thresholds were determined in all animals before and 5 days after surgery. On post-surgery day 5 and day 14, animals were sacrificed and whole mounts of cochlea and fro zensections were examined. Results ABR tests showed no significant change of hearing after the surgery.Strong fluorescence staining in the cochleae was seen in Ad-Hathl-EGFP groups. The highest levels of gene expression were seen in the post-surgery day 5 group with tittle decrease on post-surgery day 14.The contralateral cochlea and those in the control groups were free of fluorescence staining. Conclusion The transgenic Hath1-EGFP can be effectively delivered into the inner ear through intact RWM, in an atraumatic manner.

  7. Communicating hydrocephalus in adult rats with kaolin obstruction of the basal cisterns or the cortical subarachnoid space.

    Science.gov (United States)

    Li, Jie; McAllister, James P; Shen, Yimin; Wagshul, Mark E; Miller, Janet M; Egnor, Michael R; Johnston, Miles G; Haacke, E Mark; Walker, Marion L

    2008-06-01

    Communicating hydrocephalus (CH) occurs frequently, but clinically-relevant animal models amenable to diagnostic imaging and cerebrospinal fluid shunting are not available. In order to develop and characterize models of subarachnoid space (SAS) obstruction at the basal cisterns (BC) or cerebral convexities (CX), 25% kaolin was injected in adult female Sprague-Dawley rats following halothane anesthesia; intact- or saline-injected animals served as controls. For BC animals (n=28 hydrocephalics, n=20 controls), an anterior approach to the C1-clivus interval was employed and 30 microl of kaolin or saline was injected. For CX injections (n=13 hydrocephalics, n=3 controls), 50-60 microl of kaolin was injected bilaterally after separating the partitions in the SAS. In BC-injected rats, kaolin was observed grossly in the basal cisterns but not in the cisterna magna or at the foramina of Luschka, indicating that communicating (or extra-ventricular)--not obstructive--hydrocephalus had been induced. Following ketamine/xylazine anesthesia, magnetic resonance imaging (MRI) of gadolinium injected into the lateral ventricle also demonstrated CSF flow from the foramina of Luschka. MRI also revealed that ventriculomegaly progressed steadily in BC animals and by 2 weeks post-kaolin the mean Evan's ratio (frontal horn) increased significantly (mean 0.45 compared to 0.31 in intact- and 0.34 in saline-injected controls; pkaolin deposits covering approximately 80% of the cerebral hemispheres and developed noticeable ventriculomegaly (mean Evan's ratio 0.40), which was significant relative to intact animals (p=0.011) but not saline-injected controls. Surprisingly, ventriculomegaly following CX injections was less severe and much more protracted, requiring 3-4 months to develop compared to ventriculomegaly produced by BC obstruction. No hydrocephalic animals demonstrated obvious neurological deficits, but BC-injected animals that subsequently developed more severe ventriculomegaly

  8. Ventricular rate control of atrial fibrillation in heart failure

    NARCIS (Netherlands)

    Rienstra, Michiel; Van Gelder, Isabelle C

    2013-01-01

    In the last few years, there has been a major shift in the treatment of atrial fibrillation (AF) in the setting of hear failure (HF), from rhythm to ventricular rate control in most patients with both conditions. In this article, the authors focus on ventricular rate control and discuss the indicati

  9. Bradyarrhythmias: first presentation of arrhythmogenic right ventricular cardiomyopathy?

    Science.gov (United States)

    Burghouwt, Danielle E; Kammeraad, Janneke Ae; Knops, Paul; du Plessis, Frederik A; de Groot, Natasja Ms

    2015-04-01

    Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a disorder characterized by progressive replacement of myocardial cells by fibro-fatty tissue giving rise to ventricular tachyarrhythmias. In this case report, we describe a pediatric patient with sinoatrial arrests and second degree atrioventricular conduction block several years before ARVC became apparent. These findings suggest that bradyarrhythmias can also be the first expression of ARVC.

  10. Acupuncture Treatment for 98 Cases of Ventricular Premature Beat

    Institute of Scientific and Technical Information of China (English)

    Han Baojie; Wang Feng; Wang Xinzhong

    2008-01-01

    @@ Ventricular premature beat is a commonly encountered arrhythmia,which can occur in patients with and without cardiac diseases.In TCM.ventricular premature beat fall into the category of palpitation and obstruction of qi in the chest.The authors treated it with acupuncture and obtained satisfactory thera-peutic effects.A summary follows.

  11. Patient's Guide to Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy

    Science.gov (United States)

    ... Page Patient’s Guide to Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy Past to Present Crystal Tichnell , Cynthia A. James , ... Info & Metrics eLetters Introduction Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is an inherited progressive disease of ...

  12. [Catecholaminergic polymorphic ventricular tachycardia is a rare inherited heart disease.

    DEFF Research Database (Denmark)

    Holst, Anders Gaarsdal; Tfelt-Hansen, 1jacob; Olesen, Morten S

    2010-01-01

    Catecholaminergic polymorphic ventricular tachycardia is a rare inherited heart disease, which can lead to life-threatening ventricular arrhythmias in patients with a structurally normal heart. The age of onset is usually between two and 12 years and the initial symptom is frequently syncope...

  13. Ventricular tachycardia after administration of sildenafil citrate: a case report

    Directory of Open Access Journals (Sweden)

    Rasmussen Jeppe G

    2007-08-01

    Full Text Available Abstract Background It has not previously been reported that sildenafil citrate causes malignant arrhythmias in humans. Case presentation A 41-year-old man developed sustained ventricular tachycardia following sildenafil citrate administration. Conclusion It cannot be dismissed that this patient experienced ventricular tachycardia as an adverse effect of sildenafil citrate administration.

  14. Evaluation of left ventricular volumes measured by magnetic resonance imaging

    DEFF Research Database (Denmark)

    Møgelvang, J; Thomsen, C; Mehlsen, J

    1986-01-01

    Left ventricular end-diastolic and end-systolic volumes were determined in 17 patients with different levels of left ventricular function by magnetic resonance imaging (MRI). A 1.5 Tesla Magnet was used obtaining ECG triggered single and multiple slices. Calculated cardiac outputs were compared...

  15. Ventricular septal defect closure in a patient with achondroplasia.

    Science.gov (United States)

    Nakanishi, Keisuke; Kawasaki, Shiori; Amano, Atsushi

    2017-01-01

    Achondroplasia with co-morbid CHD is rare, as are reports of surgical treatment for such patients. We present the case of a 13-year-old girl with achondroplasia and ventricular septal defect. Her ventricular septal defect was surgically repaired focussing on the cardiopulmonary bypass flow, healing of the sternum, and her frail neck cartilage. The surgery and recovery were without complications.

  16. Ventricular rate control of atrial fibrillation in heart failure

    NARCIS (Netherlands)

    Rienstra, Michiel; Van Gelder, Isabelle C

    2013-01-01

    In the last few years, there has been a major shift in the treatment of atrial fibrillation (AF) in the setting of hear failure (HF), from rhythm to ventricular rate control in most patients with both conditions. In this article, the authors focus on ventricular rate control and discuss the

  17. Aortic coarctation, aneurysm, and ventricular dysfunction in an asymptomatic infant.

    Science.gov (United States)

    García, Ana I; Aguilar, Juan M; García, Enrique

    2016-06-01

    Aortic arch coarctation with post-coarctation aneurysm is rare in infants. We present the case of an asymptomatic 3-month-old infant with severe left ventricular dysfunction in this setting. The patient underwent surgical repair, and the left ventricular ejection fraction improved to recovery the 4th post-operative month.

  18. Right ventricular noncompacted cardiomyopathy-time for a new classification?

    Institute of Scientific and Technical Information of China (English)

    Marija Zdravkovic; Mirjana Krotin

    2009-01-01

    @@ To the Editor: We read with a great interest the recent article by Zhang et al,~1 in which they reported a rare case of isolated right ventricular noncompaction with normal left ventricular systolic function in a 23-year-old female.

  19. Intermittent′ restrictive ventricular septal defect in Tetralogy of Fallot

    Directory of Open Access Journals (Sweden)

    Sudhir S Shetkar

    2015-01-01

    Full Text Available Ventricular septal defect (VSD in Tetralogy of Fallot (TOF is usually large and non-restrictive with equalization of right and left ventricular pressures. Restrictive VSD in TOF is rare. We present an unusual case of TOF with restriction to VSD caused by accessory tricuspid valve tissue that varied with respiration.

  20. Muscular ventricular septal defects: A reappraisal of the anatomy

    NARCIS (Netherlands)

    Wenink, A.C.G.; Oppenheimer-Dekker, A.; Moulaert, A.J.

    1979-01-01

    Among 79 autopsy specimens of hearts with an isolated ventricular septal defect, there were 29 cases of muscular defect. Among 60 hearts with complete transposition of the great arteries and a ventricular septal defect, there were 13 cases with a muscular defect. All muscular defects could be classi

  1. Cardioverter-defibrillator implantation to treat cardiac fibroma-induced ventricular tachycardia in a 70-year-old woman.

    Science.gov (United States)

    Hakim, Fayaz Ahmad; Pandit, Anil; Mookadam, Farouk; Mamby, Sylvia

    2014-06-01

    Benign cardiac fibroma is rarely reported in adults. Its clinical symptoms are related to outflow obstruction or dysrhythmias. We present the case of a 70-year-old woman who had a syncopal episode from ventricular tachycardia caused by cardiac fibroma. Because of unfavorable tumor anatomy, the patient was not a candidate for surgical excision, and she declined orthotopic heart transplantation. To prevent sudden cardiac death, we placed an implantable cardioverter-defibrillator, and the patient remained well throughout the 2-year follow-up period. To our knowledge, this is the first report of implantable cardioverter-defibrillator therapy to treat an adult patient's unresectable cardiac fibroma.

  2. Genetic bases of arrhythmogenic right ventricular cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Alessandra Rampazzo

    2010-05-01

    Full Text Available Arrhythmogenic right ventricular cardiomyopathy (ARVC is a heart muscle disease in which the pathological substrate is a fibro-fatty replacement of the right ventricular myocardium. The major clinical features are different types of arrhythmias with a left branch block pattern. ARVC shows autosomal dominant inheritance with incomplete penetrance. Recessive forms were also described, although in association with skin disorders. Ten genetic loci have been discovered so far and mutations were reported in five different genes. ARVD1 was associated with regulatory mutations of transforming growth factor beta-3 (TGFβ3, whereas ARVD2, characterized by effort-induced polymorphic arrhythmias, was associated with mutations in cardiac ryanodine receptor-2 (RYR2. All other mutations identified to date have been detected in genes encoding desmosomal proteins: plakoglobin (JUP which causes Naxos disease (a recessive form of ARVC associated with palmoplantar keratosis and woolly hair; desmoplakin (DSP which causes the autosomal dominant ARVD8 and plakophilin-2 (PKP2 involved in ARVD9. Desmosomes are important cell-to-cell adhesion junctions predominantly found in epidermis and heart; they are believed to couple cytoskeletal elements to plasma membrane in cell-to-cell or cell-to-substrate adhesions.

  3. Phase statistics approach to human ventricular fibrillation

    Science.gov (United States)

    Wu, Ming-Chya; Watanabe, Eiichi; Struzik, Zbigniew R.; Hu, Chin-Kun; Yamamoto, Yoshiharu

    2009-11-01

    Ventricular fibrillation (VF) is known to be the most dangerous cardiac arrhythmia, frequently leading to sudden cardiac death (SCD). During VF, cardiac output drops to nil and, unless the fibrillation is promptly halted, death usually ensues within minutes. While delivering life saving electrical shocks is a method of preventing SCD, it has been recognized that some, though not many, VF episodes are self-terminating, and understanding the mechanism of spontaneous defibrillation might provide newer therapeutic options for treatment of this otherwise fatal arrhythmia. Using the phase statistics approach, recently developed to study financial and physiological time series, here, we reveal the timing characteristics of transient features of ventricular tachyarrhythmia (mostly VF) electrocardiogram (ECG) and find that there are three distinct types of probability density function (PDF) of phase distributions: uniform (UF), concave (CC), and convex (CV). Our data show that VF patients with UF or CC types of PDF have approximately the same probability of survival and nonsurvival, while VF patients with CV type PDF have zero probability of survival, implying that their VF episodes are never self-terminating. Our results suggest that detailed phase statistics of human ECG data may be a key to understanding the mechanism of spontaneous defibrillation of fatal VF.

  4. RADIOFREQUENCY ABLATION OF IDIOPATHIC RIGHT VENTRICULAR TACHYCARDIA

    Institute of Scientific and Technical Information of China (English)

    华伟; JituVohra

    1998-01-01

    This paper presents our experieaee with radioreqencey ablation (RFA) for idiopathic ventricular tschycardia (VT) arising from right ventricle in 12 patients(pts). The age range d patients was 21~50, with a mean of 38. 5 years. Ten out of 12 were females, 1 patient had eandia failure due to almost incessant VT while the rest had normal left ventricular function.Twelve pts had VT arising from the fight ventricle; of those, 9 were from the outflow truct, 2 from the RV apex, and l from the RV inflow. In all tats the diagnostic study and therapeutic RFA were combined in a single procedure, pacemapping and local aetlvition time were used to guide the site of RFA in Ors with VT arising froth the tight ventricle.RFA was successful in 11 of the 12 pts ( 91%). Ntmaher of RF applications were 1~27, mean 9. 6; fluoroscopy time were 4~75, mean 26. 9 minutes. RFA for idiopathic RV has a high success rate. This mode of treament should be considered as a nonphartaaeologieal curative treatment for symptomatic pts.

  5. ECG manifestations of left ventricular electrical remodeling.

    Science.gov (United States)

    Estes, E Harvey

    2012-01-01

    Research and thinking about the electrocardiographic manifestations of left ventricular hypertrophy has been constrained by a limited conceptual model of the process: heart disease produces chamber enlargement (increased mass), which in turn produces an altered electrocardiogram. The process is much more complex than can be represented in this simple model. A more robust and intricate model is proposed, in which heart (and vascular) disease causes structural changes, electrical changes, biochemical changes, and others, all of which interact to produce electrical remodeling of ventricular myocardium. This electrical remodeling results in a variety of ECG changes. All of these changes interact, leading to an altered clinical course, and to premature death. It is suggested that research, based on this model, can provide new clues to the processes involved, and improve the prediction of clinical outcomes. New directions in research, in recording equipment, and in organizational activities are suggested to test this new model, and to improve the usefulness of the electrocardiogram as a research and diagnostic tool.

  6. Left ventricular noncompaction: Clinical-echocardiographic study

    Directory of Open Access Journals (Sweden)

    Nikolić Aleksandra

    2012-01-01

    Full Text Available Background/Aim. Left ventricular noncompaction (LVNC is a disorder in endomyocardial morphogenesis, seen either isolated (in the absence of other cardiac anomalies or in association with congenital heart disease and some neuromuscular diseases. Intrauterine arrest of the compaction of myocardial fibers is postulated to be the reason of LVNC. Recognition of this condition is extremely important due to its high mortality and morbidity that lead to progressive heart failure, ventricular arrhythmias and thromboembolic events. The aim of this study was to determine the prevalence and clinical presentation of LVNC among consecutive outpatients according to clinical and echocardiographyic findings. Methode. A total of 3,854 consecutive patients examined at the Institute for Cardiovascular Diseases within a period January 2006 - January 2007 were included in the study. All the patients underwent echocardiographic examination using the same equipment (Vivid 7, GE Medical System. Echocardiographic parameters and clinical presentation in patients with echocardiographic criteria for LVNC were analyzed. Results. Analyzing 3,854 consecutive outpatients, using two-dimensional Color Doppler echocardiography from January 2006 to January 2007, 12 patients met the criteria for LVNC. Seven of them were male. The mean age at diagnosis was 45 ± 15 years. Analyzing clinical manifestation of LVNC it was found that seven patients had signs of heart failure, six had arrhythmias with no embolic events. Conclusion. Our results suggest that the real prevalence of LVNC may be higher than expected. New studies have to be done to solve this problem.

  7. Novel observations on the origin of ependymal cells in the ventricular zone of the rat spinal cord.

    Science.gov (United States)

    Sevc, Juraj; Daxnerová, Zuzana; Haňová, Viera; Koval', Ján

    2011-02-01

    Despite extensive investigations of gliogenesis, the time of origin of ependymal cells in the spinal cord has not yet been fully elucidated. Using a single dose of 5-bromo-2-deoxyuridine combined with various survival times we monitored: mitotic activity (short survival time), the presence of newly formed cells in the ventricular zone (intermediate survival time) and the formation of ependymal cells (long survival time) during the late embryonic and early postnatal development in the ventricular zone of the spinal cord of rats. In the period of study it was found that the ependymal cells populated this region in two waves. Most of the ependymal cells originated around embryonic day 18 and then between postnatal days 8 and 15. In addition, it was observed that in the ventricular zone of the spinal cord, proliferation and production of ependymal cells continues at the slower rate at least until day 36 of postnatal development. Elucidation of the relationship between progenitors in the embryonic ventricular zone and the relative quiescent ependymal lining of the central canal in adulthood could be important in the search for the adult neural stem cell niche.

  8. Myocardial performance is reduced immediately prior to ventricular ectopy

    DEFF Research Database (Denmark)

    Bloch Thomsen, Poul Erik; Hansen, Thomas Fritz; Jons, Christian;

    2012-01-01

    of impulse conduction would also lead to changes in the contractile performance of sinus beats preceding ventricular ectopy using Tissue Doppler echocardiography. Methods: Twenty-three consecutive patients with VPBs were examined in the apical 4-chamber view with a frame rate of 150 Hz (GE VIVID VII). Eleven......Background: We recently demonstrated local voltage potentials indicating conduction impairment and block in the sinus beats preceding ventricular premature beats (VPBs) originating in the ventricular outflow tracts. Objective: The purpose of this study was to test the hypothesis that impairment...... patients had no structural heart disease, 5 had dilated cardiomyopathy, 4 had ischemic heart disease, 2 had arrhythmogenic right ventricular dysplasia, and 1 had aortic stenosis. The ectopy originated in the ventricular outflow tracts in 15 patients and in the left ventricle 8. Eleven of the patients...

  9. Cardiac fibrosis as a determinant of ventricular tachyarrhythmias

    Directory of Open Access Journals (Sweden)

    Norishige Morita, MD, PhD

    2014-12-01

    Full Text Available Animal and emerging clinical studies have demonstrated that increased ventricular fibrosis in a setting of reduced repolarization reserve promotes early afterdepolarizations (EADs and triggered activity that can initiate ventricular tachycardia and ventricular fibrillation (VT/VF. Increased ventricular fibrosis plays a key facilitatory role in allowing oxidative and metabolic stress-induced EADs to manifest as triggered activity causing VT/VF. The lack of such an arrhythmogenic effect by the same stressors in normal non-fibrotic hearts highlights the importance of fibrosis in the initiation of VT/VF. These findings suggest that antifibrotic therapy combined with therapy designed to increase ventricular repolarization reserve may act synergistically to reduce the risk of sudden cardiac death.

  10. Malignant ventricular tachycardia in acromegaly: a case report

    Directory of Open Access Journals (Sweden)

    Zhe An

    Full Text Available CONTEXT: In patients with acromegaly, cardiovascular complications are the main cause of death; sudden death has been associated with ventricular tachyarrhythmias. In other patients with life-threatening malignant ventricular tachyarrhythmias, surgical placement of an implantable cardioverter-defibrillator (ICD has proved highly effective in reducing sudden death rates. CASE REPORT: The present article reports the case of a 50-year-old male acromegalic patient who presented symptoms of syncope induced by ventricular tachycardia. An ICD was surgically implanted and a pituitary adenoma, which was responsible for the acromegaly, was completely removed in the same procedure. The surgery was successful and the ventricular arrhythmias were effectively terminated. During six months of follow-up, no documented arrhythmic episodes occurred. CONCLUSION: In patients with acromegaly, malignant ventricular tachyarrhythmia might be effectively controlled by implantation of an ICD and surgical removal of the pituitary adenoma.

  11. Measurements and interpretations of light scattering from intact biological cells

    Science.gov (United States)

    Wilson, Jeremy D.

    Visible light interacts with biological cells primarily through elastic scattering. The details of how cells scatter light depend on their morphology and their substructures. In this thesis we first present a series of experiments and models to discern the specific contributions of certain sub-cellular constituents to whole-cell scattering. Exploiting the findings of those studies, we report on experiments within model systems of cell death that demonstrate the potential of light scattering measurements as a tool in modern biology. Instrumentation capable of exploiting the findings of this thesis from a biology-relevant microscopy platform is designed and developed. A Mie theory based interpretation of light scattering signals originating from a collection of particles with a broad size distribution is developed. Upon applying this model to scattering data from intact cells, we find that it robustly extracts the size scale of dominant light scattering particles, suggests that scattering measurements are sensitive primarily to mitochondrial and lysosomal morphology, and unites conflicting results in the literature. Using this model as a basis, we present a collection of studies in which we use various strategies of photodynamic therapy (PDT) as a biophysical tool to perturb mitochondria and lysosomes, and observe the effects of these perturbations on whole-cell scattering. Through these experiments, we are able to discern the individual contributions of mitochondria and lysosomes to whole-cell light scattering, and demonstrate that mitochondria are responsible for roughly 80% of the scattering signal. Results of experiments aimed at demonstrating the potential role that light scattering measurements have to play in future studies of cell death biology are presented. We first show that mitochondrial-PDT-induced morphology changes measured with light scattering map into the cell killing efficacy of the therapy. We next demonstrate that mitochondrial

  12. Left and right ventricular diastolic function in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Rudhani Ibrahim

    2010-01-01

    Full Text Available The aim of this prospective study was the assessment of left ventricular and right ventricular diastolic function in patients on hemodialysis (HD and the correlation of this func-tion with the duration of HD. The study included 42 patients (22 females and 20 males with chro-nic renal failure (CRF, treated with HD, and 40 healthy subjects (24 females and 16 males with no history of cardiovascular disease and with normal renal function, who constituted the control group. The groups were matched for age and sex. All study patients and control subjects under-went detailed history taking and physical examination. They also underwent electrocardiogram, echocardiography and biochemical and hematological blood analyses. Significant differences were noted between the two groups in the two-dimensional and M-mode echocardiography findings concerning aortic root dimension, transverse diameter of the left atrium, thickness of the inter-ventricular septum, thickness of the left ventricular posterior wall, left ventricular diastolic diameter, left ventricular systolic diameter, shortening fraction, ejection fraction as well as findings from the pulse Doppler study, including E wave, A wave, E/A ratio, deceleration time of E wave (DT-E, acceleration time of E wave (AT-E, tricuspid E and A waves (E tr and A tr and E tr /A tr , ratio. There were significant changes in HD patients without arterial hypertension as well in the control group subjects. Our study suggests that the left ventricular and left atrial dimensions as well as the left ventricular wall thickness are augmented in patients with CRF treated with HD compared with the control group. Additionally, the left and right ventricular diastolic function is also reduced in these patients. These differences were also noted in patients with CRF without arterial hypertension. Left ventricular diastolic dysfunction had no correlation with the duration of HD.

  13. Independent influences of excessive body weight and elevated blood pressure from childhood on left ventricular geometric remodeling in adulthood.

    Science.gov (United States)

    Yan, Yinkun; Liu, Junting; Wang, Liang; Hou, Dongqing; Zhao, Xiaoyuan; Cheng, Hong; Mi, Jie

    2017-09-15

    Obesity and hypertension are two risk factors of left ventricular hypertrophy (LVH) in adults. We aimed to examine the impacts of body weight and blood pressure (BP) from childhood on adult LV geometric remodeling. The study cohort consisted of 1256 adults aged 27-42years who had 2-10 measurements of body mass index (BMI) and BP from childhood in 1987 to adulthood in 2010. We calculated the cumulative and incremental values of BMI and BP from childhood to adulthood. In adulthood, four LV geometric patterns were defined based on the values of left ventricular mass index (g/m(2.7)) and relative wall thickness: normal geometry, concentric remodeling (CR), eccentric hypertrophy (EH) and concentric hypertrophy (CH). The prevalence of abnormal LV geometric patterns in adults was 26.4% for CR, 2.0% for EH and 2.5% for CH. For childhood values, systolic BP (Odds Ratio [OR]=1.26, 95% confidence interval [CI]=1.08-1.47) but not BMI (OR=1.06, 95%CI=0.93-1.18) was associated with adult CR, whereas BMI (OR=3.53, 95%CI=2.09-5.98) but not systolic BP (OR=1.04, 95%CI=0.65-1.66) was associated with adult EH. Both childhood BMI (OR=2.69, 95%CI=1.77-4.09) and systolic BP (OR=1.64, 95%CI=1.07-2.51) were independently associated with adult CH. For adulthood, cumulative and incremental values, BMI and systolic BP were independently associated with adult CR, EH and CH. Excessive body weight and elevated BP from childhood have independent influences on the development of adult LV geometric remodeling. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Hemodynamic improvement by right ventricular septal pacing in elderly patients with chronic atrial fibrillation and slow ventricular response

    Institute of Scientific and Technical Information of China (English)

    Wei HUA; Shidong GUO; Shu ZHANG; Fangzheng WANG; Lida ZHI; Hongxia NIU; Xin CHEN

    2005-01-01

    Background and objectives Right ventricular apical (RVA) pacing has been reported impairing left ventricular (LV)performance. Alternative pacing sites in right ventricle (RV) has been explored to obtain better cardiac function. Our study was designed to compare the hemodynamic effects of right ventricular septal (RVS) pacing with RVA pacing. Methods Ten elderly patients with chronic atrial fibrillation (AF) and long RR interval or slow ventricular response (VR) received VVI pacing. The hemodynamic difference between RVS and RVA pacing were examined by transthoracic echocardiography (TTE). Results Pacing leads were implanted successfully at the RVA and then RVS in all patients without complication. The left ventricular (LV) parameters,measured during RVA pacing including left ventricular ejection fraction (LVEF), FS, stroke volume (SV) and peak E wave velocity (EV) were decreased significantly compared to baseline data, while during RVS pacing, they were significantly better than those during RVA pacing. However, after 3-6 weeks there was no statistical significant difference between pre- and post- RVS pacing.Conclusions The LV hemodynamic parameters during RVA pacing were significantly worse than baseline data. The short term LV hemodynamic parameters of RVS pacing were significantly better than those of RVA pacing; RVS pacing could improve the hemodynamic effect through maintaining normal ventricular activation sequence and biventricular contraction synchrony in patients with chronic AF and slow ventricular response.

  15. Risk factors and predictors of Torsade de pointes ventricular tachycardia in patients with left ventricular systolic dysfunction receiving Dofetilide

    DEFF Research Database (Denmark)

    Pedersen, Henriette Sloth; Elming, Hanne; Seibaek, Marie

    2007-01-01

    The purpose of this study was to identify risk factors of Torsade de pointes (TdP) ventricular tachycardia in patients medicated with a class III antiarrhythmic drug (dofetilide) and left ventricular systolic dysfunction with heart failure (HF) or recent myocardial infarction (MI). The 2 Danish...

  16. Atrial Remodeling Is Directly Related to End-Diastolic Left Ventricular Pressure in a Mouse Model of Ventricular Pressure Overload

    NARCIS (Netherlands)

    De Jong, Anne Margreet; Van Gelder, Isabelle C.; Baudoin, Inge; Cannon, Megan V.; Van Gilst, Wiek H.; Maass, Alexander H.

    2013-01-01

    Background: Atrial fibrillation (AF) is often preceded by underlying cardiac diseases causing ventricular pressure overload. Objective: It was our aim to investigate the progression of atrial remodeling in a small animal model of ventricular pressure overload and its association with induction of

  17. The Effect and Mechanism of Forsinopril on Ventricular Hypertrophy of SHR and Left Ventricular Pressure overloading Rat

    Institute of Scientific and Technical Information of China (English)

    黄恺; 戴闺柱

    2002-01-01

    The effects and mechanism of long-term angiotensin converting enzyme inhibitor (ACEI)Forsinopril on left ventricular hypertrophy of spontaneous hypertension rat (SHR) and left ventricular pressure overloading rat were studied. The left ventricular index (left ventricle weight/body weight) was used to evaluate left ventricular hypertrophy and the in situ hybridization to investigate the TGF-β1 gene expression in left ventricle. The results showed that Forsinopril significantly decreased the left ventricular index of both SHR and left ventricle pressure overloading rat. Forsinopril reduced the integral photic density of TGF-β1 gene statement from 2. 836± 0. 314 to 1.91 ± 0. 217(P<0.01, n=8 ) of SHR rat and from 3. 071±0. 456 to 2. 37640. 379 (P<0.01, n=8) of left ventricular pressure overloading rat respectively. It was concluded that Forsinopril could prevent the occurrence of left ventricular hypertrophy and reduce the TGF-β1 gene expression in left ventricle of both SHR and left ventricular pressure overloading rat significantly.

  18. Relationship between right and left ventricular function in candidates for implantable cardioverter defibrillator with low left ventricular ejection fraction.

    Science.gov (United States)

    Jimenez-Juan, Laura; Karur, Gauri R; Connelly, Kim A; Deva, Djeven; Yan, Raymond T; Wald, Rachel M; Singh, Sheldon; Leung, General; Oikonomou, Anastasia; Dorian, Paul; Angaran, Paul; Yan, Andrew T

    2017-04-01

    Indications for the primary prevention of sudden death using an implantable cardioverter defibrillator (ICD) are based predominantly on left ventricular ejection fraction (LVEF). However, right ventricular ejection fraction (RVEF) is also a known prognostic factor in a variety of structural heart diseases that predispose to sudden cardiac death. We sought to investigate the relationship between right and left ventricular parameters (function and volume) measured by cardiovascular magnetic resonance (CMR) among a broad spectrum of patients considered for an ICD. In this retrospective, single tertiary-care center study, consecutive patients considered for ICD implantation who were referred for LVEF assessment by CMR were included. Right and left ventricular function and volumes were measured. In total, 102 patients (age 62±14 years; 23% women) had a mean LVEF of 28±11% and RVEF of 44±12%. The left ventricular and right ventricular end diastolic volume index was 140±42 mL/m(2) and 81±27 mL/m(2), respectively. Eighty-six (84%) patients had a LVEF right ventricular systolic dysfunction. Although there was a significant and moderate correlation between LVEF and RVEF (r=0.40, pright ventricular systolic dysfunction (Kappa=0.041). Among patients being considered for an ICD, there is a positive but moderate correlation between LVEF and RVEF. A considerable proportion of patients who qualify for an ICD based on low LVEF have preserved RVEF, and vice versa.

  19. Nipro extra-corporeal left ventricular assist device fitting after left ventricular reconstruction with mitral valve plasty.

    Science.gov (United States)

    Arakawa, Mamoru; Yamaguchi, Atsushi; Nishimura, Takashi; Itoh, Satoshi; Yuri, Koichi; Kyo, Shunei; Adachi, Hideo

    2015-12-01

    Both left ventricular assist device and left ventricular reconstruction are treatment choices for severe heart failure conditions. Our institution performed a left ventricular assist device installation following a left ventricular reconstruction procedure on a 42-year-old male patient who presented with dilated cardiomyopathy and low cardiac output syndrome. A mitral valve plasty was used to correct the acute mitral valve regurgitation and we performed a Nipro extra-corporeal left ventricular assist device installation on post-operative day 14. Due to the left ventricular reconstruction that the patient had in a previous operation, we needed to attach an apical cuff on posterior apex, insert the inflow cannula with a large curve, and shift the skin insertion site laterally to the left. We assessed the angle between the cardiac longitudinal axis and the inflow cannula using computed tomography. The patient did not complain of any subjective symptoms of heart failure. Although Nipro extra-corporeal left ventricular assist device installation after left ventricular reconstruction has several difficulties historically, we have experienced a successful case.

  20. Comparison of left ventricular function assessment between echocardiography and MRI in Duchenne muscular dystrophy

    Energy Technology Data Exchange (ETDEWEB)

    Buddhe, Sujatha; Lewin, Mark; Olson, Aaron; Soriano, Brian D. [University of Washington School of Medicine and Seattle Children' s Hospital, Division of Cardiology, Department of Pediatrics, Seattle, WA (United States); Ferguson, Mark [University of Washington School of Medicine and Seattle Children' s Hospital, Department of Radiology, Seattle, WA (United States)

    2016-09-15

    Cardiomyopathy in Duchenne muscular dystrophy (DMD) is associated with death in approximately 40% of patients. Echocardiography is routinely used to assess left ventricular (LV) function; however, it has limitations in these patients. We compared echocardiographic measures of cardiac function assessment to cardiac MRI. We included children and young adults with DMD who had MRI performed between January 2010 and July 2015. We measured echocardiographic and MRI parameters of function assessment, including strain. Presence of late gadolinium enhancement (LGE) was assessed by MRI. Subjects were divided into two groups based on MRI left ventricular ejection fraction (LVEF): group I, LVEF ≥55% and group II, LVEF <55%. We included 41 studies in 33 subjects, with 25 in group I and 16 in group II. Mean age of subjects was 13.6 ± 2.8 years and mean duration between echocardiogram and MRI was 7.6 ± 4.1 months. Only 8 of 16 (50%) patients in group II had diminished function on echocardiogram. Echocardiographic images were suboptimal in 16 subjects (39%). Overall, echocardiographic parameters had weak correlation with MRI-derived ejection fraction percentage. MRI-derived myocardial strain assessment has better correlation with MRI ejection fraction as compared to echocardiography-derived strain parameters. Echocardiography-based ventricular functional assessment has weak correlation with MRI parameters in children and young adults with Duchenne muscular dystrophy. While this correlation improves in the subset of subjects with adequate echocardiographic image quality, it remains modest and potentially suboptimal for clinical management. Accordingly, we conclude that MRI should be performed routinely and early in children with DMD, not only for LGE imaging but also for functional assessment. (orig.)

  1. Young Adult Children of Divorced Parents: Depression and the Perception of Loss.

    Science.gov (United States)

    Drill, Rebecca L.

    1986-01-01

    Examined long-term effects of divorce in young adult children by comparing young adults of divorce (N=104) and those of intact families (N=172). When non-custodial parent was perceived as "lost" the young adult was more depressed. After-divorce perception of non-custodial father changed negatively, while perception of mother remained…

  2. [Left ventricular function in hypertension without left ventricular hypertrophy: echographic study with modelisation of left ventricular-aortic coupling].

    Science.gov (United States)

    Bonnet, B; Jourdan, F; du Cailar, G; Mimran, A; Fesler, P

    2014-06-01

    Because the functional interaction between the LV and arterial systems, termed ventricular-arterial coupling, is recognized as a key determinant of LV performance, the objective of the present study was to assess the impact of uncomplicated HT without LVH on LV performance using simultaneously echocardiography and carotid tonometry. LV maximal power (PmaxVG), cardiac power output (CPO), LV efficiency (CPO/PmaxVG), input aortic and output LV elastance (Ea and Ees) were assessed in 20 normotensive control subjects (NT) and 10 patients with untreated HT. PmaxVG was calculated according to the integral of the product of LV wall stress with strain rate (as an index of gradient velocity). Cyclic variation of wall thickness and SR were measured by speckel-tracking. Ea and Ees were derived and modelized from the pressure-volume curve. No difference in age, BMI and sex ratio was observed between NT and HT. Systolic BP (160±18 vs. 119±10mmHg), LV mass (99±15 vs. 76±12g/m(2)), PWV (9.7±2 vs. 6.9±1m/s) were significantly higher (P<0.01) in HT when compared to NT. In HT increased of CPO and Ea was compensated by an increase of LV (15±4 vs. 12±3%, P<0.02) and Ees (5.5±2 vs. 4.5±1.5mmHg/mL), which are significantly elevated in HT (P<0.05). No difference was observed in Ea/Ees between NT and HT. In conclusion at the early phase of HT, in patients without LVH, LV performance and ventricular-arterial coupling were adapted to post-load elevation. This adaptation may be the result of an increased of LV contractility.

  3. FSI simulation of intra-ventricular flow in patient-specific ventricular model with both mitral and aortic valves.

    Science.gov (United States)

    Zhong, Liang; Su, Boyang; Zhang, Jun-Mei; Leo, Hwa Liang; Tan, Ru San

    2013-01-01

    Investigating the intra-ventricular flow is the most important to understand the left ventricular function. In this study, we proposed a fluid-structure interaction (FSI) approach to simulate the blood flow in patient-specific model by combining both mitral and aortic valves. To accommodate the large mesh deformation, moving arbitrary Lagrangian-Eulerian (ALE) meshes were used for moving ventricular wall and rotating leaflets of valves. The left ventricular wall was predescribed according to the points acquired from magnetic resonance image (MRI). Mitral and aortic valves were integrated into the model by assuming each leaflet as a rigid body. Fluid-structure interaction (FSI) approach was adopted to capture the rapid motion of leaflets. The simulation results were qualitatively similar to the measurements reported in literatures. To the best of our knowledge, this is the first to simulate the patient-specific ventricular flow with the presence of both mitral and aortic valves.

  4. Fast rate (≥ 250 beats/min) right ventricular burst stimulation is useful for ventricular tachycardia induction in arrhythmogenic right ventricular cardiomyopathy

    Institute of Scientific and Technical Information of China (English)

    Ling-Min WU; Jing-Ru BAO; Yan YAO; Bing-Bo HOU; Li-Hui ZHENG; Shu ZHANG

    2016-01-01

    Background One of the major challenges in arrhythmogenic right ventricular cardiomyopathy (ARVC) ablation is ventricular tachy-cardia (VT) non-inducibility. The study aimed to assess whether fast rate (≥ 250 beats/min) right ventricular burst stimulation was useful for VT induction in patients with ARVC.Methods Ninety-one consecutive ARVC patients with clinical sustained VT that underwent electro-physiological study were enrolled. The stimulation protocol was implemented at both right ventricular apex and outflow tract as follows: Step A, up to double extra-stimuli; Step B, incremental stimulation with low rate (< 250 beats/min); Step C, burst stimulation with fast rate (≥ 250 beats/min); Step D, repeated all steps above with intravenous infusion of isoproterenol.Results A total of 76 patients had inducible VT (83.5%), among which 49 were induced by Step C, 15 were induced by Step B, 8 and 4 by Step A and D, respectively. Clinical VTs were induced in 60 patients (65.9%). Only two spontaneously ceased ventricular fibrillations were induced by Step C. Multivariate analysis showed that a narrower baseline QRS duration under sinus rhythm was independently associated with VT non-inducibility (OR: 1.1; 95% CI: 1.0–1.1;P = 0.019).ConclusionFast rate (≥ 250 beats/min) right ventricular burst stimulation provides a useful supplemental method for VT induction in ARVC patients.

  5. Functional and structural regeneration in the axolotl heart (Ambystoma mexicanum) after partial ventricular amputation.

    Science.gov (United States)

    Cano-Martínez, Agustina; Vargas-González, Alvaro; Guarner-Lans, Verónica; Prado-Zayago, Esteban; León-Oleda, Martha; Nieto-Lima, Betzabé

    2010-01-01

    "In the present study we evaluated the effect of partial ventricular amputation (PVA) in the heart of the adult urodele amphibian (Ambystoma mexicanum) in vivo on spontaneous heart contractile activity recorded in vitro in association to the structural recovery at one, five, 30 and 90 days after injury. One day after PVA, ventricular-tension (VT) (16 ± 3%), atrium-tension (AT) (46 ± 4%) and heart rate (HR) (58+10%) resulted lower in comparison to control hearts. On days five, 30 and 90 after damage, values achieved a 61 ± 5, 93 ± 3, and 98 ± 5% (VT), 60 ± 4, 96 ± 3 and 99 ± 5% (AT) and 74 ± 5, 84 ± 10 and 95 ± 10% (HR) of the control values, respectively. Associated to contractile activity recovery we corroborated a gradual tissue restoration by cardiomyocyte proliferation. Our results represent the first quantitative evidence about the recovery of heart of A. mexicanum restores its functional capacity concomitantly to the structural recovery of the myocardium by proliferation of cardiomyocytes after PVA. These properties make the heart of A. mexicanum a potential model to study the mechanisms underlying heart regeneration in adult vertebrates in vivo.

  6. Serum vitamin D, intact parathyroid hormone, and Fetuin A concentrations were associated with geriatric sarcopenia and cardiac hypertrophy

    Science.gov (United States)

    Chang, Wei-Ting; Wu, Chih-Hsing; Hsu, Ling-Wei; Chen, Po-Wei; Yu, Jia-Rong; Chang, Chin-Sung; Tsai, Wei-Chuan; Liu, Ping-Yen

    2017-01-01

    With aging, intact parathyroid hormone (iPTH) increases. It plays a crucial role in left ventricular hypertrophy (LVH). Also, 25-hydroxy vitamin D (Vit-D) and iPTH have been observed to be determinants of muscle wasting known as sarcopenia. Fetuin A (FetA), a systemic calcification inhibitor, involves in the development of diastolic heart failure. Hence, we hypothesized that the interplay among FetA, Vit-D and iPTH may contribute to sarcopenic LVH among the elders. We analyzed a database from the Tianliao Old People study with 541 elders (≥65 years) in a Taiwan’s suburban community. After excluding patients with renal function impairment, 120/449 (26.7%) patients were diagnosed with sarcopenia. Sarcopenic patients had lower serum Vit-D levels but higher FetA as well as iPTH. Notably, sarcopenic patients with LVH had significantly lower FetA and higher iPTH levels. In multivariate logistic regression analysis, only the increase in iPTH was independently associated with sarcopenic LVH (Odds ratio: 1.05; confidence interval: 1.03–1.08, p = 0.005). Using iPTH >52.3 ng/l as a cutoff point, the sensitivity and specificity was 66% and 84%, respectively. In conclusion, FetA, Vit-D, and iPTH levels were all associated with sarcopenia in this geriatric population. Among them, iPTH specifically indicates patients with sarcopenic LVH. PMID:28112206

  7. Post craniotomy extra-ventricular drain (EVD) associated nosocomial meningitis: CSF diagnostic criteria.

    Science.gov (United States)

    Muñoz-Gómez, Sigridh; Wirkowski, Elizabeth; Cunha, Burke A

    2015-01-01

    Because external ventricular drains (EVDs) provide access to cerebrospinal fluid (CSF), there is potential for EVD associated acute bacterial meningitis (EVD-AM). Post-craniotomy, in patients with EVDs, one or more CSF abnormalities are commonly present making the diagnosis of EVD-AM problematic. EVD-AM was defined as elevated CSF lactic acid (>6 nmol/L), plus CSF marked pleocytosis (>50 WBCs/mm(3)), plus a positive Gram stain (same morphology as CSF isolate), plus a positive CSF culture of neuropathogen (same morphology as Gram stained organism). We reviewed 22 adults with EVDs to determine if our four CSF parameters combined accurately identified EVD-AM. No single or combination of <4 CSF parameters correctly diagnosed or ruled out EVD-AM. Combined our four CSF parameters clearly differentiated EVD-AM from one case of pseudomeningitis due to E. cloacae. We conclude that our four CSF criteria combined are useful in diagnosing EVD-AM in adults.

  8. Arrhythmia in Acute Right Ventricular Infarction

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    Azin Alizadeh Asl

    2007-09-01

    Full Text Available Acute inferior myocardial infarction (MI frequently involves the right ventricle (RV.1-3 We assessed the prognostic impact of RV myocardial involvement in patients with inferior MI. One hundred seventy patients were admitted to the cardiac care unit of Madani Heart Hospital (Tabriz-Iran with the diagnosis of inferior MI with (group1 or without (group2 the simultaneous involvement of RV during the study period (from 2005 to 2006. Patients presenting within 12h of symptom onset were eligible for inclusion. Patients with simultaneous anterior wall MI or renal impairment (creatinine > 2 mg/dl, as well as those undergoing primary percutaneous translational coronary angioplasty, were excluded. Eighty eight percent of the patients with RVMI and 75% of those with isolated inferior MI had some type of arrhythmia. Atrioventricular (AV block occurred in 42% of the infarctions with RV involvement and only in 29% of the control group. Intra-ventricular conduction disturbance (IVCD was also more frequent in RVMI (29.4% vs. 13.1%, p=0.021, especially right bundle branch block (RBBB (20% vs. 7.4%, P=0.003. There was, however, no meaningful difference in the incidence of left bundle branch block (LBBB between the two groups (3.5% vs. 2.35%, P=0.95. Ventricular fibrillation (VF was observed in 5.2% and 1.2% and ventricular tachycardia in 26% and 12.2% of the patients in groups 1 and 2, respectively. In 27% of patients with RVMI, it was necessary to implant a pacemaker as compared to 10% of those in the control group. Mortality was higher in the patients with inferior infarction extended to the RV (15.3% vs. 3.5%, P= 0.0001. Thus, the differences between the findings in the two groups in terms of the occurrence of post-MI arrhythmias and conduction disorders were quite significant, but there was no meaningful difference with respect to the incidence of LBBB between the two groups. Additionally, patients with inferior MI who also had RV myocardial involvement were

  9. Echocardiographic evaluation of ventricular septal defect haemodynamics

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    Miranović Vesna

    2007-01-01

    Full Text Available Introduction Ventricular septal defect (VSD is an opening in the interventricular septum. 30-50% of patients with congenital heart disease have VSD. Objective The aim of the study was to determine the dependence of the left ventricular diastolic dimension (LVD, left ventricular systolic dimension (LVS, shortening fraction (SF, left atrium (LA, pulmonary artery truncus (TPA on the body surface and compare their values among experimental, control and a group of healthy children. Values of maximal systolic gradient pressure (Pvsd of VSD were compared with children from one experimental and control group. Method Children were divided into three groups: experimental (32 children with VSD that were to go to surgery, control (20 children with VSD who did not require surgery and 40 healthy children. Measurements of LVD, LVS, SF, LA, TPA were performed in accordance to recommendations of the American Echocardiographic Association. The value of Pvsd was calculated from the maximal flow velocity (V in VSD using the following formula: Pvsd=4xVІ (mm Hg. Results For children from the experimental group, the relationship between the body surface and the variability of the LVD was explained with 56.85%, LVS with 66.15%, SF with 4.9%, TPA with 58.92%. For children from the control group, the relationship between the body surface and the variability of LVD was explained with 88.8%, LVS with 72.5%, SF with 0.42%, PA with 58.92%. For healthy children, the relationship between the body surface and the variabilitiy of the LVD was explained with 88.8%, LVS with 88.78%, SF with 5.25% and PA with 84.75%. There was a significant statistical difference between average values of Pvsd in the experimental and control group (p<0.02. Conclusion The presence of the large VSD has an influence on the enlargement of LVD, LVS, SF, TPA. The enlargement of the size of the pulmonary artery depends on the presence of VSD and there is a direct variation in the magnitude of the shunt

  10. Treating critical supraventricular and ventricular arrhythmias

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    Trappe Hans-Joachim

    2010-01-01

    Full Text Available Atrial fibrillation (AF, atrial flutter, AV-nodal reentry tachycardia with rapid ventricular response, atrial ectopic tachycardia and preexcitation syndromes combined with AF or ventricular tachyarrhythmias (VTA are typical arrhythmias in intensive care patients (pts. Most frequently, the diagnosis of the underlying arrhythmia is possible from the physical examination (PE, the response to maneuvers or drugs and the 12-lead surface electrocardiogram. In unstable hemodynamics, immediate DC-cardioversion is indicated. Conversion of AF to sinus rhythm (SR is possible using antiarrhythmic drugs. Amiodarone has a conversion rate in AF of up to 80%. Ibutilide represents a class III antiarrhythmic agent that has been reported to have conversion rates of 50-70%. Acute therapy of atrial flutter (Aflut in intensive care pts depends on the clinical presentation. Atrial flutter can most often be successfully cardioverted to SR with DC-energies < 50 joules. Ibutilide trials showed efficacy rates of 38-76% for conversion of Aflut to SR compared to conversion rates of 5-13% when intravenous flecainide, propafenone or verapamil was administered. In addition, high dose (2 mg of ibutilide was more effective than sotalol (1.5 mg/kg in conversion of Aflut to SR (70 versus 19%. Drugs like procainamide, sotalol, amiodarone or magnesium were recommended for treatment of VTA in intensive care pts. However, only amiodarone is today the drug of choice in VTA pts and also highly effective even in pts with defibrillation-resistant out-of-hospital cardiac arrest (CA. There is a general agreement that bystander first aid, defibrillation and advanced life support is essential for neurologic outcome in pts after cardiac arrest due to VTA. Public access defibrillation in the hands of trained laypersons seems to be an ideal approach in the treatment of ventricular fibrillation (VF. The use of automatic external defibrillators (AEDs by basic life support ambulance providers or

  11. Left Ventricular Hypertrophy Evaluation in Obese Hypertensive Patients: Effect of Left Ventricular Mass Index Criteria

    Directory of Open Access Journals (Sweden)

    Eduardo Cantoni Rosa

    2002-04-01

    Full Text Available PURPOSE: To evaluate left ventricular mass (LVM index in hypertensive and normotensive obese individuals. METHODS: Using M mode echocardiography, 544 essential hypertensive and 106 normotensive patients were evaluated, and LVM was indexed for body surface area (LVM/BSA and for height² (LVM/h². The 2 indexes were then compared in both populations, in subgroups stratified according to body mass index (BMI: or = 30kg/m². RESULTS: The BSA index does not allow identification of significant differences between BMI subgroups. Indexing by height² provides significantly increased values for high BMI subgroups in normotensive and hypertensive populations. CONCLUSION: Left ventricular hypertrophy (LVH has been underestimated in the obese with the use of LVM/BSA because this index considers obesity as a physiological variable. Indexing by height² allows differences between BMI subgroups to become apparent and seems to be more appropriate for detecting LVH in obese populations.

  12. Visual speech fills in both discrimination and identification of non-intact auditory speech in children.

    Science.gov (United States)

    Jerger, Susan; Damian, Markus F; McAlpine, Rachel P; Abdi, Hervé

    2017-07-20

    To communicate, children must discriminate and identify speech sounds. Because visual speech plays an important role in this process, we explored how visual speech influences phoneme discrimination and identification by children. Critical items had intact visual speech (e.g. bæz) coupled to non-intact (excised onsets) auditory speech (signified by /-b/æz). Children discriminated syllable pairs that differed in intactness (i.e. bæz:/-b/æz) and identified non-intact nonwords (/-b/æz). We predicted that visual speech would cause children to perceive the non-intact onsets as intact, resulting in more same responses for discrimination and more intact (i.e. bæz) responses for identification in the audiovisual than auditory mode. Visual speech for the easy-to-speechread /b/ but not for the difficult-to-speechread /g/ boosted discrimination and identification (about 35-45%) in children from four to fourteen years. The influence of visual speech on discrimination was uniquely associated with the influence of visual speech on identification and receptive vocabulary skills.

  13. Brine Inclusions Migration in Intact Salt Crystals under Thermal Gradient

    Science.gov (United States)

    Caporuscio, F.; Boukhalfa, H.

    2013-12-01

    The behavior of water contained in rock salt under the influence of thermal gradients is critical to the performance of salt as a medium for the disposal of nuclear waste. Water contained in salt can be present as discrete inclusions within intact salt crystals, at the interface between salt crystals and aggregates, and also as hydration water and structural water present in accessory minerals present in salt. Water content in pure halite salt usually rages from 0.1 to 0.5 wt. % but is significantly higher in clay rich salt, for which water content can be up to several wt. %. Under the influence of thermal gradients brine inclusions and water associated to the accessory mineral is mobilized. Previous investigations have shown brine inclusions tend to move towards the heat source through a mechanism that involves the dissolution of salt at the hot face of the brine inclusion and its precipitation at the colder side of the inclusion. Uncertainties remain on the exact parameters that define the rate of brine migration and whether it truly migrates to towards the heat source. We performed studies under controlled thermal gradients to examine the behavior of brine inclusions in single salt crystals obtained from the underground salt mine at the Waste Isolation Power Plant (WIPP). We found that the behavior of the brine inclusions under thermal gradients is dependent on the thermal gradient magnitude and the nature of the inclusion. Full inclusions (liquid only) migrate predominantly towards the heat source, but when the inclusions are large and close to the surface they fracture the salt and release water near the surface. Inclusions that migrate towards the heat source migrate through a mechanism that involves the dissolution of salt at the hot side of the inclusion and its deposition along the migration path. SEM analysis of the migration pathways shows that brine migrates through the creation of a network of square shaped hollow channels of about 10 micron diameter

  14. An Experimental Model Using Cultured Cardiac Myocytes for a Study of the Generation of Premature Ventricular Contractions Under Ultrasound Exposure

    Science.gov (United States)

    Kudo, Nobuki; Yamamoto, Masaya

    2011-09-01

    It is known that use of a contrast agents in echocardiography increases the probability of generation of premature ventricular contractions (PVCs). As a basic study to elucidate the mechanisms and to reduce adverse effects, the generation of PVCs was investigated using cultured cardiac myocytes instead of the intact heart in vivo. Cardiac myocytes were isolated from neonatal rats and cultured on a cover slip. The myocyte sample was exposed to pulsed ultrasound with microbubbles adjacent to the myocytes, and generation of PVCs was examined with ultrasound exposure at various delay times after onset of myocyte contraction. The experimental results showed that generation of PVCs had a stable threshold delay time and that PVCs were generated only when myocytes were exposed to ultrasound with delay times longer than the threshold. The results indicate that the model used in this study is useful for revealing the mechanisms by which PVCs are induced by ultrasound exposure.

  15. Applications of 3D finite element modeling to the study of ventricular physiology

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    Moulton, Michael J.; Creswell, Lawrence L.; Hu, Ning S.; Actis, Ricardo L.; Myers, Kent W.; Szabo, Barna A.; Pasque, Michael K.

    1995-05-01

    A 3D, nonlinear finite element (FE) model of the diastolic canine heart was constructed from multislice magnetic resonance images (MRI). The model was solved using the p-version of the FE method to predict stress and deformation in diastole. Finite element models were employed in an 'inverse' problem to estimate the nonlinear material properties of intact diastolic myocardium. Additionally, FE models were employed to examine the effects of RV pressure overload on LV pressure-volume (P- V) relationships in the pathologic heart. A 3D, nonlinear FE model had 1,704 degrees of freedom and 8 elements, it had a maximum principal stress value of 429,127 dynes/cm2 and a minimum principal stress of -344,599 dynes/cm2 at p equals 6. Average nonlinear material parameters estimated for 6 dogs were E equals 28,722 +/- 15,984 dynes/cm2 and c equals 0.00182 +/- 0.00232 cm2/dyne. Examination of the effects of RV pressure increase on LV P-V relationships indicated substantially different effects of RV pressure overload on the different pathologic conditions (p < 0.005 by ANOVA) with increasing RV pressure having a more pronounced effect on the dilated heart than the hypertrophied heart. When the mechanical effects of the pericardium were included in the model, at higher RV pressures, all of the pressure-volume (P-V) curves became similar indicating that at higher RV pressures, the P-V curves were independent of ventricular shape and material properties and depended only on the RV pressure. In conclusion, FE models of the heart were constructed from MRI images of the heart and were employed to study diastolic ventricular function in the normal and pathologic heart.

  16. Case report: paradoxical ventricular septal motion in the setting of primary right ventricular myocardial failure.

    Science.gov (United States)

    Maslow, Andrew; Schwartz, Carl; Mahmood, Feroze; Singh, Arun; Heerdt, Paul M

    2009-07-01

    In this report, a case of right ventricular (RV) failure, hemodynamic instability, and systemic organ failure is described to highlight how paradoxical ventricular systolic septal motion (PVSM), or a rightward systolic displacement of the interventricular septum, may contribute to RV ejection. Multiple inotropic medications and vasopressors were administered to treat right heart failure and systemic hypotension in a patient following combined aortic and mitral valve replacement. In the early postoperative period, echocardiographic evaluation revealed adequate left ventricular systolic function, akinesis of the RV myocardial tissues, and PVSM. In the presence of PVSM, RV fractional area of contraction was > or =35% despite akinesis of the primary RV myocardial walls. The PVSM appeared to contribute toward RV ejection. As a result, the need for multiple inotropes was re-evaluated, in considering that end-organ dysfunction was the result of systemic hypotension and prolonged vasopressor administration. After discontinuation of phosphodiesterase inhibitors, native vascular tone returned and the need for vasopressors declined. This was followed by recovery of systemic organ function. Echocardiographic re-evaluation two years later, revealed persistent akinesis of the RV myocardial tissues and PVSM, the latter appearing to contribute toward RV ejection. This case highlights the importance of left to RV interactions, and how PVSM may mediate these hemodynamic interactions.

  17. [Long-term effect of polystan monocusp ventricular outflow patch after right ventricular outflow tract reconstruction].

    Science.gov (United States)

    Sugita, T; Matsumoto, M; Ogino, H; Nishizawa, J; Matsuyama, K; Yoshimura, S; Yoshioka, T; Tokuda, Y; Matsumura, M; Suda, K; Ueda, Y

    2000-09-01

    Forty-eight patients who underwent right ventricular outflow tract reconstruction with Monocusp Ventricular Outflow Patch (MVOP) fifty-five times and survived surgery, were reviewed in this study. Mean age at surgery was 6.4 years-old and mean follow-up interval was 75.2 months. There was no late death, however reoperation was performed 7 times. Freedom from reoperation rate was 97.2% and 80.7% after 5 and 10 years after surgery, respectively. The main cause for reoperation were right ventricular outflow obstruction RVOTO (5 cases). All of the RVOTO occurred at the distal end of the anastomosis. However, there was no RVOTO in patients who underwent RVOTR with MVOP during the past ten years. So, we considered the cause of RVOTO a technical problem. Pulmonary regurgitation was one to two degree early after surgery, and had worsened by almost two or three degrees more than 5 years after surgery. Moreover, five of six patients who underwent cardiac catheterization more than 10 years after surgery had three degrees of pulmonary regurgitation as well as a large CTR. In conclusion, according to long-term results, especially more than 10 years post operatively, pulmonary regurgitation was the most important problem.

  18. Reverse ventricular remodeling and improved ventricular compliance after heart transplantation in infants and young children.

    Science.gov (United States)

    Farooqi, Kanwal M; Lopez, Leo; Pass, Robert H; Hsu, Daphne T; Lamour, Jacqueline M

    2014-08-01

    After heart transplantation (HT) in infants and young children, environmental and intrinsic factors may lead to changes in the geometry and compliance of the donor heart. Serial demographic, clinical, hemodynamic, and echocardiographic data were obtained from HT recipients younger than 4 years of age. Echocardiographic chamber measurement z-scores were compared using recipient body surface area from the time of HT to 1 week, 3 months, and last follow-up visit. Left ventricular end-diastolic volume (LVEDV) z-scores were correlated with pulmonary capillary wedge pressure (PCWP) at each time point. Heart transplantation was performed for 13 children between March 2009 and December 2012, 9 of whom (69%) were boys. The median age at HT was 8 months (range, 4-43 months), and the mean follow-up period was 13 ± 7 months. Left ventricular end-diastolic dimension z-scores decreased significantly (p = 0.03) between HT and 1 week, then increased from 1 week to 3 and 12 months. (-1.32 ± 1.7, -0.71 ± 1.8, 0.41 ± 2.1, 0.79 ± 2.3, respectively). A positive relationship (R(2) = 0.48) between the LVEDV z-score and PCPW was present at the last follow-up visit. For infants and young children, the allograft demonstrates appropriate growth by 1 year after HT. Left ventricular compliance improves over time.

  19. Right Ventricular Function and Left Ventricular Assist Device Placement: Clinical Considerations and Outcomes

    Science.gov (United States)

    Lainez, Romeo; Parrino, Gene; Bates, Michael

    2010-01-01

    The HeartMate II is an axial-flow left ventricular assist device that is approved for the treatment of advanced heart failure as a bridge to transplant or destination therapy. Despite the success of this device, right ventricular failure remains a persistent problem in most studies. Right ventricular dysfunction is usually defined as the need for right heart mechanical support or the persistent requirement for inotropes to support right heart function beyond 14 days. Over 21 months, 45 patients with end-stage heart disease underwent placement of the HeartMate II at our institution. This continuous cohort of patients underwent a retrospective review to evaluate the incidence of right heart failure. The perioperative survival was 91% with no incidents of mechanical support for the right ventricle and no requirements for inotropes beyond 14 days. This survival was consistent to beyond 1 year at the time of the study, and 18% of patients underwent heart transplant with 100% survival. PMID:21603391

  20. Delayed efficacy of radiofrequency catheter ablation on ventricular arrhythmias originating from the left ventricular anterobasal wall.

    Science.gov (United States)

    Ding, Ligang; Hou, Bingbo; Wu, Lingmin; Qiao, Yu; Sun, Wei; Guo, Jinrui; Zheng, Lihui; Chen, Gang; Zhang, Linfeng; Zhang, Shu; Yao, Yan

    2017-03-01

    Ventricular arrhythmias (VAs) originating from the left ventricular anterobasal wall (LV-ABW) may represent a therapeutic challenge. The purpose of this study was to investigate the delayed efficacy of radiofrequency catheter (RFCA) ablation without an epicardial approach on VAs originating from the LV-ABW. Eighty patients (mean age 46.9 ± 14.9 years; 47 male) with VAs originating from the LV-ABW were enrolled. After systematic mapping of the right ventricular outflow tract, aortic root, adjacent LV endocardium, and coronary venous system, 3-4 ablation attempts were made at the earliest activation sites and/or best pace-mapping sites. Delayed efficacy was evaluated in patients with acute failure. During mean follow-up of 23.8 ± 21.9 months (range 3-72 months), complete elimination of all VAs was achieved in 47 patients (59%) and partial success in 19 (24%), for an overall success rate of 83%. In 25 of 37 patients (68%) with acute failure, VAs were eliminated or significantly reduced (>80% VA burden) by the delayed effect of RFCA during follow-up. Logistic regression analysis revealed that response time to ablation was a predictor of occurrence of delayed efficacy. No complications occurred during follow-up. Instead of extensive ablation, waiting for delayed efficacy of RFCA may be a reasonable choice for patients with VAs arising from the LV-ABW. Copyright © 2016 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.