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Sample records for structurally normal heart

  1. Integrated Transcriptome Map Highlights Structural and Functional Aspects of the Normal Human Heart.

    Science.gov (United States)

    Caracausi, Maria; Piovesan, Allison; Vitale, Lorenza; Pelleri, Maria Chiara

    2017-04-01

    A systematic meta-analysis of the available gene expression profiling datasets for the whole normal human heart generated a quantitative transcriptome reference map of this organ. Transcriptome Mapper (TRAM) software integrated 32 gene expression profile datasets from different sources returning a reference value of expression for each of the 43,360 known, mapped transcripts assayed by any of the experimental platforms used in this regard. Main findings include the visualization at the gene and chromosomal levels of the classical description of the basic histology and physiology of the heart, the identification of suitable housekeeping reference genes, the analysis of stoichiometry of gene products, and the focusing on chromosome 21 genes, which are present in one excess copy in Down syndrome subjects, presenting cardiovascular defects in 30-40% of cases. Independent in vitro validation showed an excellent correlation coefficient (r = 0.98) with the in silico data. Remarkably, heart/non-cardiac tissue expression ratio may also be used to anticipate that effects of mutations will most probably affect or not the heart. The quantitative reference global portrait of gene expression in the whole normal human heart illustrates the structural and functional aspects of the whole organ and is a general model to understand the mechanisms underlying heart pathophysiology. J. Cell. Physiol. 232: 759-770, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  2. Right ventricular wall abscess in structurally normal heart after leg osteomyelitis: First case.

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    Ahmad, Tanveer; Pasarad, Ashwini Kumar; Kishore, Kolkebaile Sadanand; Maheshwarappa, Nandakumar Neralakere

    2016-09-01

    A 3-year-old girl presented with fever and acute dyspnea for 4 days. She had suffered an injury to the left lower leg 3 weeks earlier, with abscess formation. Magnetic resonance imaging showed osteomyelitis of the lower tibia. Echocardiography showed a mass in the right ventricular wall. She underwent concomitant heart surgery for removal of the right ventricular mass and limb arthrotomy. We believe this is a first reported case in which a ventricular wall abscess developed in a structurally normal heart following leg osteomyelitis. © The Author(s) 2015.

  3. Anatomy of the pig heart: comparisons with normal human cardiac structure.

    Science.gov (United States)

    Crick, S J; Sheppard, M N; Ho, S Y; Gebstein, L; Anderson, R H

    1998-07-01

    Transgenic technology has potentially solved many of the immunological difficulties of using pig organs to support life in the human recipient. Nevertheless, other problems still remain. Knowledge of cardiac anatomy of the pig (Sus scrofa) is limited despite the general acceptance in the literature that it is similar to that of man. A qualitative analysis of porcine and human cardiac anatomy was achieved by gross examination and dissection of hearts with macrophotography. The porcine organ had a classic 'Valentine heart' shape, reflecting its location within the thorax and to the orientation of the pig's body (unguligrade stance). The human heart, in contrast, was trapezoidal in silhouette, reflecting man's orthograde posture. The morphologically right atrium of the pig was characterised by the tubular shape of its appendage (a feature observed on the left in the human heart). The porcine superior and inferior caval veins opened into the atrium at right angles to one another, whereas in man the orifices were directly in line. A prominent left azygous vein (comparable to the much reduced left superior caval or oblique vein in man) entered on the left side of the pig heart and drained via the coronary sinus. The porcine left atrium received only 2 pulmonary veins, whereas 4 orifices were generally observed in man. The sweep between the inlet and outlet components of the porcine right ventricle was less marked than in man, and a prominent muscular moderator band was situated in a much higher position within the porcine right ventricle compared with that of man. The apical components of both porcine ventricles possessed very coarse trabeculations, much broader than those observed in the human ventricles. In general, aortic-mitral fibrous continuity was reduced in the outlet component of the porcine left ventricle, with approximately two-thirds of the aortic valve being supported by left ventricular musculature. Several potentially significant differences exist between

  4. Reconstruction and Visualization of Fiber and Laminar Structure inthe Normal Human Heart from Ex Vivo DTMRI Data

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    Rohmer, Damien; Sitek, Arkadiusz; Gullberg, Grant T.

    2006-12-18

    Background - The human heart is composed of a helicalnetwork of muscle fibers. These fibers are organized to form sheets thatare separated by cleavage surfaces. This complex structure of fibers andsheets is responsible for the orthotropic mechanical properties ofcardiac muscle. The understanding of the configuration of the 3D fiberand sheet structure is important for modeling the mechanical andelectrical properties of the heart and changes in this configuration maybe of significant importance to understand the remodeling aftermyocardial infarction.Methods - Anisotropic least square filteringfollowed by fiber and sheet tracking techniques were applied to DiffusionTensor Magnetic Resonance Imaging (DTMRI) data of the excised humanheart. The fiber configuration was visualized by using thin tubes toincrease 3-dimensional visual perception of the complex structure. Thesheet structures were reconstructed from the DTMRI data, obtainingsurfaces that span the wall from the endo- to the epicardium. Allvisualizations were performed using the high-quality ray-tracing softwarePOV-Ray. Results - The fibers are shown to lie in sheets that haveconcave or convex transmural structure which correspond to histologicalstudies published in the literature. The fiber angles varied depending onthe position between the epi- and endocardium. The sheets had a complexstructure that depended on the location within the myocardium. In theapex region the sheets had more curvature. Conclusions - A high-qualityvisualization algorithm applied to demonstrated high quality DTMRI datais able to elicit the comprehension of the complex 3 dimensionalstructure of the fibers and sheets in the heart.

  5. Kodamaea ohmeri tricuspid valve endocarditis with right ventricular inflow obstruction in a neonate with structurally normal heart

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    Sundaram Ponnusamy

    2011-01-01

    Full Text Available The yeast Kodamaea (Pichia ohmeri is a rare human pathogen with infrequent report of neonatal infection. Native valve endocarditis by Kodamaea ohmeri is extremely rare. The current case report describes a case of fatal nosocomial native valve endocarditis without any structural heart defects in a 40dayold baby. The patient was referred to our institute after having ICU stay of 18 days in another hospital for necrotizing enterocolitis and was found to have obstructive tricuspid valve mass and fungemia with Kodamaea ohmeri. In spite of the treatment, patient developed sepsis with disseminated intravascular coagulation and could not be revived.

  6. Analysis of Morphological Characteristics and Origins of Idiopathic Premature Ventricular Contractions Under a 12-Lead Electrocardiogram in Children with Structurally Normal Hearts.

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    Jiang, Jianbin; He, Yuee; Qiu, Huixian; Zhang, Yuanhai; Chu, Maoping; Li, Yuechun; Chen, Qi

    2017-10-21

    Up to 40% of healthy children have premature ventricular complexes or contractions (PVCs) detected with 24-hour Holter monitoring. We aimed to investigate the morphological characteristics and origins of idiopathic PVCs under a 12-lead electrocardiogram in children with structurally normal hearts. All asymptomatic monomorphic PVC patients with structurally normal hearts under 18 years of age were included in this retrospective study. Characteristics of PVCs in lead V 1 under a 12-lead electrocardiogram were classified as left bundle branch block (PVC-LBBB) or right bundle branch block (PVC-RBBB). According to limb leads, PVC-LBBB or PVC-RBBB was divided into: PVCs-LBBB type I; PVCs-LBBB type II; PVCs-RBBB type I; PVCs-RBBB type II; and PVCs-RBBB type III. Out of 178 PVC patients, 94 cases of PVCs-LBBB (PVCs-LBBB type I = 60; PVCs-LBBB type II = 34) and 84 cases of PVCs-RBBB (PVCs-RBBB type I = 3; PVCs-RBBB type II = 55; PVCs-RBBB type III = 26) were identified. The frequency of PVCs-LBBB type I increased with age and the frequency of PVCs-RBBB type II and III decreased with age. Among the children monitor tested, from 1 years old to 18 years old, PVCs originating from the left or right ventricular outflow tract gradually increased with age, while PVCs originating from the branch sources decreased with age.

  7. Heart rate and heart rate variability in normal young adults.

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    Coumel, P; Maison-Blanche, P; Catuli, D

    1994-11-01

    The relationships between heart rate (HR) and HR variability (HRV) are not simple. Because both depend on the autonomic nervous system (ANS), they are not independent variables. Technically, the quantification of HRV is influenced by the duration of the cardiac cycles. The complexity of these relationships does not justify ignoring HR when studying HRV, as frequently occurs. Using spectral and nonspectral methods, the HR and various normalized and non-normalized indices of HRV were studied in 24-hour recordings of a homogeneous cohort of seventeen 20-year-old healthy males. The HR-HRV relationships were appraised by analyzing the same data in two different ways. The 24 mean hourly values provide consistent information on the circadian behavior of the indices, while the average 24-hour individual data show a wide spectrum of normality. Combined approaches allow assessment of the direct impact of RR interval on HRV evaluation. The correlations between HR and normalized indices of HRV are weaker in 24-hour individual data than in pooled hourly data of the same individuals. These correlations are close to 1 in the latter case, which does not mean that measuring HRV is simply another method of evaluating HR, but that normal physiology supposes a harmonious behavior of the various indices. When considered individually without normalization, the specific indices of vagal modulation (high-frequency band of the spectrum, short-term HR oscillations of the nonspectral analysis) consistently increase at night and diminish during the day. However, the low-frequency power, which supposedly reflects sympathetic influences, also increases at night, whereas more logically the longer HR oscillations would predominate during the day. Moreover, the selective analysis of HR oscillations during HR acceleration or decrease indicates that their behavior differs accordingly. We recommend that closer attention be paid to the complex relationships between HR and HRV. The strong correlations

  8. Tachyarrhythmias in structural heart disease

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    Kiès, Philippine

    2006-01-01

    Ventricular tachyarrhythmias, the major cause of sudden unexpected cardiac arrest, occur specifically in patients with structural heart disease. In general, all types of structural heart disease may lead to chronic heart failure, a severe condition with an additional high risk of atrial- and

  9. Is the normal heart rate ``chaotic'' due to respiration?

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    Wessel, Niels; Riedl, Maik; Kurths, Jürgen

    2009-06-01

    The incidence of cardiovascular diseases increases with the growth of the human population and an aging society, leading to very high expenses in the public health system. Therefore, it is challenging to develop sophisticated methods in order to improve medical diagnostics. The question whether the normal heart rate is chaotic or not is an attempt to elucidate the underlying mechanisms of cardiovascular dynamics and therefore a highly controversial topical challenge. In this contribution we demonstrate that linear and nonlinear parameters allow us to separate completely the data sets of the three groups provided for this controversial topic in nonlinear dynamics. The question whether these time series are chaotic or not cannot be answered satisfactorily without investigating the underlying mechanisms leading to them. We give an example of the dominant influence of respiration on heart beat dynamics, which shows that observed fluctuations can be mostly explained by respiratory modulations of heart rate and blood pressure (coefficient of determination: 96%). Therefore, we recommend reformulating the following initial question: "Is the normal heart rate chaotic?" We rather ask the following: "Is the normal heart rate `chaotic' due to respiration?"

  10. Myofibrillar disarray produced in normal hearts by chronic electrical pacing.

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    Adomian, G E; Beazell, J

    1986-07-01

    Myofibrillar disarray has been observed in various normal, experimental, and pathologic conditions of the heart. In order to elucidate the common denominator involved in the development of disarray, we undertook the present study to test the hypothesis that myofibrillar disarray can be produced in the normal heart as a result of altering myocardial stress vectors. In the heart, the vectors associated with the patterns of contraction are determined by the sequence of depolarization. In order to alter this sequence, the conduction system of 12 normal dogs was interrupted by the production of complete atrioventricular block. After 3 months of electronic pacing of the right ventricular apex at 70 bpm, myofibrillar disarray was observed in 9 out of 12 of these hearts. In matched tissue samples from 12 control dogs, myofibrillar disarray was not observed. We conclude that myofibrillar disarray may be produced by abnormal stress vectors resulting from alterations in the sequence of depolarization, and therefore the pattern of contraction. We believe this to represent a unifying concept to explain the development of myofibrillar disarray observed in a variety of conditions.

  11. General anesthesia suppresses normal heart rate variability in humans

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    Matchett, Gerald; Wood, Philip

    2014-06-01

    The human heart normally exhibits robust beat-to-beat heart rate variability (HRV). The loss of this variability is associated with pathology, including disease states such as congestive heart failure (CHF). The effect of general anesthesia on intrinsic HRV is unknown. In this prospective, observational study we enrolled 100 human subjects having elective major surgical procedures under general anesthesia. We recorded continuous heart rate data via continuous electrocardiogram before, during, and after anesthesia, and we assessed HRV of the R-R intervals. We assessed HRV using several common metrics including Detrended Fluctuation Analysis (DFA), Multifractal Analysis, and Multiscale Entropy Analysis. Each of these analyses was done in each of the four clinical phases for each study subject over the course of 24 h: Before anesthesia, during anesthesia, early recovery, and late recovery. On average, we observed a loss of variability on the aforementioned metrics that appeared to correspond to the state of general anesthesia. Following the conclusion of anesthesia, most study subjects appeared to regain their normal HRV, although this did not occur immediately. The resumption of normal HRV was especially delayed on DFA. Qualitatively, the reduction in HRV under anesthesia appears similar to the reduction in HRV observed in CHF. These observations will need to be validated in future studies, and the broader clinical implications of these observations, if any, are unknown.

  12. Cardiopulmonary Exercise Testing in Fontan Patients With and Without Isomerism (Heterotaxy) as Compared to Patients With Primary Ciliary Dyskinesia and Subjects With Structurally Normal Hearts

    DEFF Research Database (Denmark)

    Loomba, Rohit S; Danduran, Michael; Nielsen, Kim G

    2017-01-01

    Isomerism, also known as heterotaxy, is a clinical entity that impacts multiple organ systems both anatomically and functionally. The airways and lungs are involved in a great number of these patients, leading to increased sinopulmonary symptoms, increased need for oxygenation, and increased post...... isomerism. The results are likely limited by selection bias and highlight the need for multicentric efforts to characterize cardiopulmonary exercise testing in those patients with pulmonary isomerism.......Isomerism, also known as heterotaxy, is a clinical entity that impacts multiple organ systems both anatomically and functionally. The airways and lungs are involved in a great number of these patients, leading to increased sinopulmonary symptoms, increased need for oxygenation, and increased...... postoperative ventilatory support. Additionally, these patients often have congenital heart disease requiring Fontan palliation. What has not been previously described, and is the focus of this study, is the results of cardiopulmonary exercise testing in those who have undergone Fontan palliation...

  13. Genetic insights into normal and abnormal heart development.

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    Nemer, Mona

    2008-01-01

    Congenital heart defects (CHDs) affect 1-2% of newborn children and are the leading cause of death in infants under 1 year of age. CHDs represent the single largest class of birth defects and account for 25% of all human congenital abnormalities. Numerous epidemiologic studies have established the heritable nature of CHDs. However, despite the remarkable progress of the past decade, very few CHD-causing genes have been identified so far. Molecular and genetic analysis of heart development--which requires the execution of specific genetic programs--has led to the identification of essential cardiac regulators and mutations that are linked to human CHD. Elucidation of the mechanisms of action of these transcription factors has also provided a molecular framework that will continue to help furthering our understanding of the molecular basis of normal and abnormal heart growth. This review will summarize present knowledge of cardiac development and illustrate how analysis of heart development has helped understand the genetic basis of some CHDs and how these advances could translate into better prevention, diagnosis, and care of congenital heart disease.

  14. Three-Dimensional Mitral Valve Morphology and Age-Related Trends in Children and Young Adults with Structurally Normal Hearts Using Transthoracic Echocardiography.

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    Jolley, Matthew A; Ghelani, Sunil J; Adar, Adi; Harrild, David M

    2017-06-01

    The mitral valve has a complex three-dimensional (3D) morphology that is incompletely described by two-dimensional echocardiography (echo). Three-dimensional echo provides a more robust tool to analyze the mitral valve. The shape of the mitral annulus and leaflets, and differences with age, have not been described by 3D echo in normal children. Our objective was to characterize and quantify the 3D mitral valve morphology in children with normal transthoracic echocardiograms over a broad spectrum of age and to identify differences in valve shape with age. Three-dimensional midsystolic mitral valve models were constructed in 100 children and young adults with normal echocardiograms using 3D transthoracic images. Annular and leaflet metrics were quantified and regression equations were prepared. Interuser and intrauser variability was measured. Two hundred fifty patients, from neonate to young adult, were retrospectively reviewed to obtain 100 evaluable patients (40% evaluable). The annular height to commissural width ratio of the mitral valve ("saddle shape") was preserved across age (median 24.3, IQR 21.8-28.1). Three-dimensional mitral valve area, length, and volume parameters were linearly related to body surface area (P  0.87, P mitral valve morphology in children is possible in a modern clinical pediatric echocardiography laboratory using transthoracic images, although further optimization of imaging is needed. The saddle shape of the mitral annulus was preserved across age and size. Most mitral valve parameters increased linearly with patient size. Further investigation is warranted to explore changes in valve morphology in the pediatric population in health and with disease. Copyright © 2017 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.

  15. Mechanism of syncope without prodromes with normal heart and normal electrocardiogram.

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    Brignole, Michele; Guieu, Regis; Tomaino, Marco; Iori, Matteo; Ungar, Andrea; Bertolone, Cristina; Unterhuber, Matthias; Bottoni, Nicola; Tesi, Francesca; Claude Deharo, Jean

    2017-02-01

    "Unexplained syncope, no prodromes, and normal heart" has been described as a distinct clinical and biological entity. The purpose of this study was to assess the mechanism of syncope. In this prospective multicenter study, 58 patients presenting with unexplained syncope, no prodromes, and a normal heart received an implantable loop recorder (ILR) and were followed up until a diagnosis was established. Their outcomes were compared with those of 389 patients affected by reflex syncope with prodromes who received an ILR. During a mean observation period of 16 ± 13 months, a diagnostic event was documented by the ILR in 29 patients (50%); an asystolic pause of 11 ± 5 seconds (range 3.5-22 seconds) was present at the time of the diagnostic event in 19 patients (66%). Compared with patients affected by reflex syncope with prodromes, patients with unexplained syncope, no prodromes, and a normal heart more frequently had an asystolic syncope (66% vs 47%; P = .001), and this was more frequently due to idiopathic paroxysmal atrioventricular block (47% vs 21%; P = .04). Ten patients with asystolic pauses underwent cardiac pacing, and 8 patients underwent oral theophylline treatment. During the subsequent 17 ± 12 months of follow-up, syncope recurred in 1 patient on theophylline and presyncope occurred in 1 patient with pacemaker. A long asystolic pause, frequently due to idiopathic paroxysmal atrioventricular block, played a role in the mechanism of syncope in two-thirds of patients who had electrocardiographic documentation of a diagnostic event. When a specific therapy was administered in patients with asystolic syncope, the short outcome was favorable. Copyright © 2016 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  16. Relationship between age, radiographic normal heart size and ...

    African Journals Online (AJOL)

    Open Access DOWNLOAD FULL TEXT Subscription or Fee ... Background: Cardio-vascular disease (CVD) is now on the increase. The precise ... However, information on normal values for various cardio-vascular structures in Nigeria, a country with the highest population of blacks in the world is sparse. In this regard the ...

  17. Real-Time Three-Dimensional Echocardiography in the Evaluation of Left Atrial Structure and Function in Normal, Aging, Hypertensive and Heart Failure Patients: New Insights into Left Atrial Adaptation and Remodeling

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    Cheng-Ting Tsai

    2009-03-01

    Conclusion: Eight cut planes provided sufficient accuracy in LA volume quantification using the RT-3DE method. Compared with normal aging, LA volume tends to increase with higher pumping volume to compensate for impaired left ventricular relaxation in hypertension. Relatively preserved total LA pumping volume may exist in heart failure patients at the expense of further adaptive volume expansion with a subsequently reduced total emptying fraction.

  18. Polymorphic Ventricular Tachycardia/Ventricular Fibrillation and Sudden Cardiac Death in the Normal Heart.

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    Shah, Ashok J; Hocini, Meleze; Denis, Arnaud; Derval, Nicolas; Sacher, Frederic; Jais, Pierre; Haissaguerre, Michel

    2016-09-01

    Primary electrical diseases manifest with polymorphic ventricular tachycardia (PMVT) and ventricular fibrillation (VF) and along with idiopathic VF contribute to about 10% of sudden cardiac deaths (SCDs) overall. These disorders include long QT syndrome, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia, short QT syndrome, and early repolarization syndrome. This article reviews the clinical electrophysiological management of PMVT/VF in a structurally normal heart affected with these disorders. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. [Sudden cardiac death in individuals with normal hearts: an update].

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    González-Melchor, Laila; Villarreal-Molina, Teresa; Iturralde-Torres, Pedro; Medeiros-Domingo, Argelia

    2014-01-01

    Sudden death (SD) is a tragic event and a world-wide health problem. Every year, near 4-5 million people experience SD. SD is defined as the death occurred in 1h after the onset of symptoms in a person without previous signs of fatality. It can be named "recovered SD" when the case received medical attention, cardiac reanimation effective defibrillation or both, surviving the fatal arrhythmia. Cardiac channelopathies are a group of diseases characterized by abnormal ion channel function due to genetic mutations in ion channel genes, providing increased susceptibility to develop cardiac arrhythmias and SD. Usually the death occurs before 40 years of age and in the autopsy the heart is normal. In this review we discuss the main cardiac channelopathies involved in sudden cardiac death along with current management of cases and family members that have experienced such tragic event. Copyright © 2014 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

  20. Biomarkers of heart failure with normal ejection fraction : a systematic review

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    Cheng, Jin M.; Akkerhuis, K. Martijn; Battes, Linda C.; van Vark, Laura C.; Hillege, Hans L.; Paulus, Walter J.; Boersma, Eric; Kardys, Isabella

    2013-01-01

    Heart failure with normal ejection fraction (HFNEF) is a major and growing public health problem, currently representing half of the heart failure burden. Although many studies have investigated the diagnostic and prognostic value of new biomarkers in heart failure, limited data are available on

  1. What Is a Total Artificial Heart?

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    ... Back To Health Topics / Total Artificial Heart Total Artificial Heart What Is a Total Artificial Heart? A ... outside power source. Normal Heart and CardioWest Total Artificial Heart Figure A shows the normal structure and ...

  2. Patient Experiences of Structured Heart Failure Programmes

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    Nuala E. Tully

    2010-01-01

    Full Text Available Objectives. Patient experiences of structured heart failure rehabilitation and their views on the important components of heart failure services were examined. Methods. Focus groups were conducted with fifteen participants (men, =12 attending one of two heart failure rehabilitation programmes. Sessions were guided by a semistructured interview schedule covering participants' experiences of the programme, maintenance, and GP role. Focus group transcripts were analysed qualitatively. Results. Participants indicated that rehabilitation programmes substantially met their needs. Supervised exercise sessions increased confidence to resume physical activity, while peer-group interaction and supportive medical staff improved morale. However, once the programme ended, some participants' self-care motivation lapsed, especially maintenance of an exercise routine. Patients doubted their GPs' ability to help them manage their condition. Conclusion. Structured rehabilitation programmes are effective in enabling patients to develop lifestyle skills to live with heart failure. However, postrehabilitation maintenance interventions are necessary to sustain patients' confidence in disease self-management.

  3. Early Embryonic Heart Rate in Normal Pregnancies In Memory of ...

    African Journals Online (AJOL)

    To determine the appearance and development of embryonic heart rate a total of n = 317 Nigerian pregnant women were studied in the very early pregnancy from 23 – 56 days from the onset of last menstrual period (LMP). All pregnancies had a subsequent successful outcome. Transvaginal ultrasonography was ...

  4. Predictive Models for Normal Fetal Cardiac Structures.

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    Krishnan, Anita; Pike, Jodi I; McCarter, Robert; Fulgium, Amanda L; Wilson, Emmanuel; Donofrio, Mary T; Sable, Craig A

    2016-12-01

    Clinicians rely on age- and size-specific measures of cardiac structures to diagnose cardiac disease. No universally accepted normative data exist for fetal cardiac structures, and most fetal cardiac centers do not use the same standards. The aim of this study was to derive predictive models for Z scores for 13 commonly evaluated fetal cardiac structures using a large heterogeneous population of fetuses without structural cardiac defects. The study used archived normal fetal echocardiograms in representative fetuses aged 12 to 39 weeks. Thirteen cardiac dimensions were remeasured by a blinded echocardiographer from digitally stored clips. Studies with inadequate imaging views were excluded. Regression models were developed to relate each dimension to estimated gestational age (EGA) by dates, biparietal diameter, femur length, and estimated fetal weight by the Hadlock formula. Dimension outcomes were transformed (e.g., using the logarithm or square root) as necessary to meet the normality assumption. Higher order terms, quadratic or cubic, were added as needed to improve model fit. Information criteria and adjusted R 2 values were used to guide final model selection. Each Z-score equation is based on measurements derived from 296 to 414 unique fetuses. EGA yielded the best predictive model for the majority of dimensions; adjusted R 2 values ranged from 0.72 to 0.893. However, each of the other highly correlated (r > 0.94) biometric parameters was an acceptable surrogate for EGA. In most cases, the best fitting model included squared and cubic terms to introduce curvilinearity. For each dimension, models based on EGA provided the best fit for determining normal measurements of fetal cardiac structures. Nevertheless, other biometric parameters, including femur length, biparietal diameter, and estimated fetal weight provided results that were nearly as good. Comprehensive Z-score results are available on the basis of highly predictive models derived from gestational

  5. Specific binding of nerve growth factor to normal and denervated canine heart.

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    Wells, D J; Strehlo, B L; Kaye, M P

    1981-11-01

    Preparations of membranes from normal and surgically denervated canine heart were tested for binding of radiolabeled nerve growth factor. Specific binding was detected in both normal and denervated hearts. Binding was nonsaturable and complex for normal atria and ventricles and denervated atria but appeared to be saturable for denervated ventricles. Nerve growth factor bound per microgram of protein was lower in denervated ventricles than normal ventricles, whereas slightly higher binding to denervated atria than normal atria was observed. This binding could not be displaced by cytochrome c, insulin, or epidermal growth factor. The data indicate that a large part of binding to normal ventricles could be due to nerve terminals attached to the heart, but specific binding detected in the denervated ventricles may be an intrinsic property of the tissue itself. These sites may serve as storage or uptake sites to direct sympathetic innervation in the developing or reinnervating myocardium.

  6. Evaluation of cardiac functions with Doppler echocardiography in children with Down syndrome and anatomically normal heart.

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    Al-Biltagi, Mohammed; Serag, Amany R; Hefidah, Mohammed M; Mabrouk, Maaly M

    2013-04-01

    To study the cardiac functions in Down syndrome children who did not have structural cardiac lesion by conventional and tissue Doppler echocardiography. A total of 85 children with Down syndrome without anatomic heart disease and 50 normal control children were subjected to the assessment of right and left ventricular functions by both two-dimensional and tissue Doppler echocardiography. Children with Down syndrome had significantly higher left ventricular ejection fraction detected by two-dimensional echocardiography and left ventricular diastolic dysfunction detected by tissue Doppler than observed in the controls. In addition, children with Down syndrome also had right ventricular systolic and diastolic dysfunctions. Children with Down syndrome had significantly higher pulmonary artery systolic pressure than the control children. There was no significant difference in the cardiac functions between children with non-disjunction Down syndrome and those with the translocation type. Despite an apparently normal heart, children with Down syndrome may have silent disturbed cardiac functions, which may be detected by two-dimensional or tissue Doppler echocardiography. This may have an important clinical implication, especially before involving Down syndrome children in surgery or strenuous exercise.

  7. Structural Bases of Postresuscitative Heart Failure

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    V. T. Dolgikh

    2005-01-01

    Full Text Available An experiment on 106 non-inbred male albino rats undergone 4-minute clinical death from acute blood loss has revealed that the first three days after resuscitation are marked by a concomitance of vascular disorders and cardiomyocytic dystrophic changes, the leading role being played by sludge, stasis, thrombosis, increased vascular permeability, perivascular edema, and hemorrhages. Cardiomyocytic destruction (various contractures, block-like myofibrillolysis, myocytoly-sis is a structural basis of postresuscitative heart failure. Three days later the heart displayed concomitant processes of recovery and damage. Three types of cardiac morphological changes have been identified in relation to the ratio of these processes.

  8. High-Normal Albuminuria and Risk of Heart Failure in the Community

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    Blecker, Saul; Matsushita, Kunihiro; Köttgen, Anna; Loehr, Laura R.; Bertoni, Alain G.; Boulware, L. Ebony; Coresh, Josef

    2011-01-01

    Background Albuminuria has been associated with cardiovascular risk, but the relationship of high-normal albuminuria to subsequent heart failure has not been well established. Study Design Prospective observational study, the Atherosclerosis Risk in Communities (ARIC) Study. Setting & Participants 10,975 individuals free from heart failure were followed up from the fourth ARIC Study visit (1996–1998) through January 2006. Predictor Urinary albumin-creatinine ratio (UACR), analyzed continuously and categorically as optimal (albuminuria was associated with a progressively increased risk of heart failure from intermediate-normal (adjusted HR, 1.54; 95% CI, 1.12–2.11) and high-normal UACR (adjusted HR, 1.91; 95% CI, 1.38–2.66) to microalbuminuria (adjusted HR, 2.49; 95% CI, 1.77–3.50) and macroalbuminuria (adjusted HR, 3.47; 95% CI, 2.10–5.72). Results were similar in secondary analyses of participants censored at the time of coronary heart disease event and along a range of eGFRs. Limitations UACR was measured as a single random sample. Conclusions Albuminuria is associated with subsequent heart failure, even in individuals with few cardiovascular risk factors and UACR within the normal range. Our results suggest that the association between albuminuria and heart failure may not be mediated fully by ischemic heart disease or kidney disease, measured using eGFR. PMID:21549463

  9. What to Expect After Total Artificial Heart Surgery

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    ... Back To Health Topics / Total Artificial Heart Total Artificial Heart A total artificial heart (TAH) is a pump that is surgically installed ... in a car. Normal Heart and a Total Artificial Heart Device Figure A shows the normal structure and ...

  10. The coronary arterioles in newborns, infants and children. A morphometric study of normal hearts and hearts with aortic atresia and complete transposition

    NARCIS (Netherlands)

    Kurosawa, S.; Kurosawa, H.; Becker, A. E.

    1986-01-01

    The state of development of the intramyocardial coronary arterioles in normal hearts and hearts with congenital malformations is unknown, although these vessels play an important role in regulating myocardial blood flow. To remedy the situation, we studied 64 normal hearts (ranging in age from 23

  11. Transcatheter cryothermal ablation of junctional ectopic tachycardia in the normal heart.

    Science.gov (United States)

    Law, Ian H; Von Bergen, Nicholas H; Gingerich, Jean C; Saarel, Elizabeth V; Fischbach, Peter S; Dick, Macdonald

    2006-08-01

    Junctional ectopic tachycardia in the normal heart is rare and often is resistant to pharmacologic management. Transcatheter ablation using radiofrequency energy places the AV node at risk. The purpose of this study was to report our experience with transcatheter cryothermal ablation using three-dimensional mapping in six patients with junctional ectopic tachycardia. A review of clinical and electrophysiologic data was performed on all patients with structurally normal hearts who underwent cryothermal ablation for treatment of junctional ectopic tachycardia at two institutions. Six patients (age 7.7-36.5 years) underwent attempted transcatheter cryothermal ablation using three-dimensional mapping. Only one patient had achieved arrhythmia suppression on medical management. Cryothermal mapping (-30 degrees C) localized the junctional focus while normal conduction was monitored. The junctional focus was high in the triangle of Koch in four patients and was low in one patient. The sixth patient had only one run of junctional ectopic tachycardia during the procedure and therefore received an empiric cryoablation (-70 degrees C) lesion. Subsequent cryoablation lesions were delivered at and around the junctional focus. In one patient, cryomapping eliminated the junctional focus but resulted in transient complete AV block; therefore, cryoablation was not performed. All patients who received the cryoablation lesions had elimination of their junctional ectopic tachycardia at 6-week follow-up. The patient who did not receive a cryoablation lesion remained in a slower junctional rhythm at follow-up. Cryoablation of junctional ectopic tachycardia is safe and effective. Nonetheless, proximity to the His-Purkinje system may preclude success. Empiric cryoablation can be effective; cryotherapy may not yield immediate success, but a delayed salutary effect can follow.

  12. Cardiac Extracellular Vesicles in Normal and Infarcted Heart

    Directory of Open Access Journals (Sweden)

    Dimitry A. Chistiakov

    2016-01-01

    Full Text Available Heart is a complex assembly of many cell types constituting myocardium, endocardium and epicardium that intensively communicate to each other in order to maintain the proper cardiac function. There are many types of intercellular intracardiac signals, with a prominent role of extracellular vesicles (EVs, such as exosomes and microvesicles, for long-distant delivering of complex messages. Cardiomyocytes release EVs, whose content could significantly vary depending on the stimulus. In stress, such as hypoxia, inflammation or injury, cardiomyocytes increase secretion of EVs. In hypoxic conditions, cardiac EVs are enriched with angiogenic and prosurvival factors. In acute myocardial infarction (AMI, damaged cardiac muscle cells produce EVs with increased content of angiogenic, anti-apoptotic, mitogenic and growth factors in order to induce repair and healing of the infarcted myocardium. Exosomal microRNAs play a central role in cardiac regeneration. In AMI, circulating cardiac EVs abundantly contain cardiac-specific miRNAs that serve as indicators of cardiac damage and have a big diagnostic potential as AMI biomarkers. Cardioprotective and regenerative properties of exosomes derived from cardiac and non-cardiac stem/progenitor cells are very helpful to be used in cell-free cardiotherapy and regeneration of post-infarct myocardium.

  13. Cardiac Extracellular Vesicles in Normal and Infarcted Heart.

    Science.gov (United States)

    Chistiakov, Dimitry A; Orekhov, Alexander N; Bobryshev, Yuri V

    2016-01-05

    Heart is a complex assembly of many cell types constituting myocardium, endocardium and epicardium that intensively communicate to each other in order to maintain the proper cardiac function. There are many types of intercellular intracardiac signals, with a prominent role of extracellular vesicles (EVs), such as exosomes and microvesicles, for long-distant delivering of complex messages. Cardiomyocytes release EVs, whose content could significantly vary depending on the stimulus. In stress, such as hypoxia, inflammation or injury, cardiomyocytes increase secretion of EVs. In hypoxic conditions, cardiac EVs are enriched with angiogenic and prosurvival factors. In acute myocardial infarction (AMI), damaged cardiac muscle cells produce EVs with increased content of angiogenic, anti-apoptotic, mitogenic and growth factors in order to induce repair and healing of the infarcted myocardium. Exosomal microRNAs play a central role in cardiac regeneration. In AMI, circulating cardiac EVs abundantly contain cardiac-specific miRNAs that serve as indicators of cardiac damage and have a big diagnostic potential as AMI biomarkers. Cardioprotective and regenerative properties of exosomes derived from cardiac and non-cardiac stem/progenitor cells are very helpful to be used in cell-free cardiotherapy and regeneration of post-infarct myocardium.

  14. Monitoring Heart Health and Structural Health: mDFA Quantification

    Directory of Open Access Journals (Sweden)

    Toru Yazawa

    2016-02-01

    Full Text Available The aim of this study was to make a method for an early detection of malfunction, e.g., abnormal vibration/fluctuation in recorded signals. We conducted experimentations of heart health and structural health monitoring. We collected natural signals, e.g., heartbeat fluctuation and mechanical vibration. For the analysis, we used modified detrended fluctuation analysis (mDFA method that we have made recently. mDFA calculated the scaling exponent (SI from the time series data, e.g., R-R interval time series obtained from electrocardiograms. In the present study, peaks were identified by our own method. In every single mDFA computation, we identified ~2000 consecutive peaks from a data: "2000" was necessary number to conduct mDFA. mDFA was able to distinguish between normal and abnormal behaviors: Normal healthy hearts exhibited an SI around 1.0, which is a phenomena comparable to 1/f fluctuation. Job-related stressful hearts and extrasystolic hearts both exhibited a low SI such as 0.7. Normally running car's vibration―recorded steering wheel vibration―exhibited an SI around 0.5, which is white noise like fluctuation. Normally spinning ball-bearings (BB exhibited an SI around 0.1, which belongs to the anti-correlation phenomena. A malfunctioning BB showed an increased SI. At an SI value over 0.2, an inspector must check BB's correct functioning. Here we propose that healthiness in various cyclic vibration behaviors can be quantitatively analyzed by mDFA.

  15. Hearts of dystonia musculorum mice display normal morphological and histological features but show signs of cardiac stress.

    Directory of Open Access Journals (Sweden)

    Justin G Boyer

    2010-03-01

    Full Text Available Dystonin is a giant cytoskeletal protein belonging to the plakin protein family and is believed to crosslink the major filament systems in contractile cells. Previous work has demonstrated skeletal muscle defects in dystonin-deficient dystonia musculorum (dt mice. In this study, we show that the dystonin muscle isoform is localized at the Z-disc, the H zone, the sarcolemma and intercalated discs in cardiac tissue. Based on this localization pattern, we tested whether dystonin-deficiency leads to structural defects in cardiac muscle. Desmin intermediate filament, microfilament, and microtubule subcellular organization appeared normal in dt hearts. Nevertheless, increased transcript levels of atrial natriuretic factor (ANF, 66% beta-myosin heavy chain (beta-MHC, 95% and decreased levels of sarcoplasmic reticulum calcium pump isoform 2A (SERCA2a, 26%, all signs of cardiac muscle stress, were noted in dt hearts. Hearts from two-week old dt mice were assessed for the presence of morphological and histological alterations. Heart to body weight ratios as well as left ventricular wall thickness and left chamber volume measurements were similar between dt and wild-type control mice. Hearts from dt mice also displayed no signs of fibrosis or calcification. Taken together, our data provide new insights into the intricate structure of the sarcomere by situating dystonin in cardiac muscle fibers and suggest that dystonin does not significantly influence the structural organization of cardiac muscle fibers during early postnatal development.

  16. THE EFFECT OF WAIST CIRCUMFERENCES MORE THAN NORMAL ON THE INCIDENT OF CORONARY HEART DISEASE

    Directory of Open Access Journals (Sweden)

    Pria Wahyu

    2017-07-01

    Full Text Available Introduction: Coronary heart disease is known as the most common disease that causes mortality in the world, one of the examination to identify the risks of coronary heart disease is measuring waist circumference. The purpose of this study was to identify correlation between large waist circumferences and the incident of coroner heart disease. Method: Design used in this study was analytic observational (retrospective with cross sectional approach. There were 63 respondents which sampling by simple random sampling. The independent variable was waist circumferences and the dependent variable was coronary heart disease. Data were collected by direct observation then analyzed by spearman correlation statistic test with significance level α≤0.05. Result: The result showed that waist circumferences more than normal had significant correlation with the incident of coronary heart disease (p=0.02. Analysis: It can be concluded that there was correlation between waist circumferences more than normal and the incident of coronary heart disease to the clients with coroner cardiac disease. Discussion: Earlier screening and detection is needed to prevent coronary heart disease.

  17. Normalization of cardiac substrate utilization and left ventricular hypertrophy precede functional recovery in heart failure regression.

    Science.gov (United States)

    Byrne, Nikole J; Levasseur, Jody; Sung, Miranda M; Masson, Grant; Boisvenue, Jamie; Young, Martin E; Dyck, Jason R B

    2016-05-15

    Impaired cardiac substrate metabolism plays an important role in heart failure (HF) pathogenesis. Since many of these metabolic changes occur at the transcriptional level of metabolic enzymes, it is possible that this loss of metabolic flexibility is permanent and thus contributes to worsening cardiac function and/or prevents the full regression of HF upon treatment. However, despite the importance of cardiac energetics in HF, it remains unclear whether these metabolic changes can be normalized. In the current study, we investigated whether a reversal of an elevated aortic afterload in mice with severe HF would result in the recovery of cardiac function, substrate metabolism, and transcriptional reprogramming as well as determined the temporal relationship of these changes. Male C57Bl/6 mice were subjected to either Sham or transverse aortic constriction (TAC) surgery to induce HF. After HF development, mice with severe HF (% ejection fraction hypertrophy/HF were returned to values observed in healthy controls. Interestingly, pressure-overload-induced left ventricular hypertrophy (LVH) and cardiac substrate metabolism were restored at 1-week post-DB, which preceded functional recovery. The regression of severe HF is associated with early and dramatic improvements in cardiac energy metabolism and LVH normalization that precede restored cardiac function, suggesting that metabolic and structural improvements may be critical determinants for functional recovery. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

  18. 3D imaging of the mitochondrial redox state of rat hearts under normal and fasting conditions

    Directory of Open Access Journals (Sweden)

    He N. Xu

    2014-03-01

    Full Text Available The heart requires continuous ATP availability that is generated in the mitochondria. Although studies using the cell culture and perfused organ models have been carried out to investigate the biochemistry in the mitochondria in response to a change in substrate supply, mitochondrial bioenergetics of heart under normal feed or fasting conditions has not been studied at the tissue level with a sub-millimeter spatial resolution either in vivo or ex vivo. Oxidation of many food-derived metabolites to generate ATP in the mitochondria is realized through the NADH/NAD+ couple acting as a central electron carrier. We employed the Chance redox scanner — the low-temperature fluorescence scanner to image the three-dimensional (3D spatial distribution of the mitochondrial redox states in heart tissues of rats under normal feeding or an overnight starvation for 14.5 h. Multiple consecutive sections of each heart were imaged to map three redox indices, i.e., NADH, oxidized flavoproteins (Fp, including flavin adenine dinucleotide (FAD and the redox ratio NADH/Fp. The imaging results revealed the micro-heterogeneity and the spatial distribution of these redox indices. The quantitative analysis showed that in the fasted hearts the standard deviation of both NADH and Fp, i.e., SD_NADH and SD_Fp, significantly decreased with a p value of 0.032 and 0.045, respectively, indicating that the hearts become relatively more homogeneous after fasting. The fasted hearts contained 28.6% less NADH (p = 0.038. No significant change in Fp was found (p = 0.4. The NADH/Fp ratio decreased with a marginal p value (0.076. The decreased NADH in the fasted hearts is consistent with the cardiac cells' reliance of fatty acids consumption for energy metabolism when glucose becomes scarce. The experimental observation of NADH decrease induced by dietary restriction in the heart at tissue level has not been reported to our best knowledge. The Chance redox scanner demonstrated the

  19. 3D IMAGING OF THE MITOCHONDRIAL REDOX STATE OF RAT HEARTS UNDER NORMAL AND FASTING CONDITIONS.

    Science.gov (United States)

    Xu, He N; Zhou, Rong; Moon, Lily; Feng, Min; Li, Lin Z

    2014-03-01

    The heart requires continuous ATP availability that is generated in the mitochondria. Although studies using the cell culture and perfused organ models have been carried out to investigate the biochemistry in the mitochondria in response to a change in substrate supply, mitochondrial bioenergetics of heart under normal feed or fasting conditions has not been studied at the tissue level with a sub-millimeter spatial resolution either in vivo or ex vivo. Oxidation of many food-derived metabolites to generate ATP in the mitochondria is realized through the NADH/NAD(+) couple acting as a central electron carrier. We employed the Chance redox scanner - the low-temperature fluorescence scanner to image the three-dimensional (3D) spatial distribution of the mitochondrial redox states in heart tissues of rats under normal feeding or an overnight starvation for 14.5 h. Multiple consecutive sections of each heart were imaged to map three redox indices, i.e., NADH, oxidized flavoproteins (Fp, including flavin adenine dinucleotide (FAD)) and the redox ratio NADH/Fp. The imaging results revealed the micro-heterogeneity and the spatial distribution of these redox indices. The quantitative analysis showed that in the fasted hearts the standard deviation of both NADH and Fp, i.e., SD_NADH and SD_Fp, significantly decreased with a p value of 0.032 and 0.045, respectively, indicating that the hearts become relatively more homogeneous after fasting. The fasted hearts contained 28.6% less NADH (p = 0.038). No significant change in Fp was found (p = 0.4). The NADH/Fp ratio decreased with a marginal p value (0.076). The decreased NADH in the fasted hearts is consistent with the cardiac cells' reliance of fatty acids consumption for energy metabolism when glucose becomes scarce. The experimental observation of NADH decrease induced by dietary restriction in the heart at tissue level has not been reported to our best knowledge. The Chance redox scanner demonstrated the feasibility of 3D

  20. Pulmonary veins in the normal lung and pulmonary hypertension due to left heart disease

    Science.gov (United States)

    Hunt, James M.; Bethea, Brian; Liu, Xiang; Gandjeva, Aneta; Mammen, Pradeep P. A.; Stacher, Elvira; Gandjeva, Marina R.; Parish, Elisabeth; Perez, Mario; Smith, Lynelle; Graham, Brian B.; Kuebler, Wolfgang M.

    2013-01-01

    Despite the importance of pulmonary veins in normal lung physiology and the pathobiology of pulmonary hypertension with left heart disease (PH-LHD), pulmonary veins remain largely understudied. Difficult to identify histologically, lung venous endothelium or smooth muscle cells display no unique characteristic functional and structural markers that distinguish them from pulmonary arteries. To address these challenges, we undertook a search for unique molecular markers in pulmonary veins. In addition, we addressed the expression pattern of a candidate molecular marker and analyzed the structural pattern of vascular remodeling of pulmonary veins in a rodent model of PH-LHD and in lung tissue of patients with PH-LHD obtained at time of placement on a left ventricular assist device. We detected urokinase plasminogen activator receptor (uPAR) expression preferentially in normal pulmonary veins of mice, rats, and human lungs. Expression of uPAR remained elevated in pulmonary veins of rats with PH-LHD; however, we also detected induction of uPAR expression in remodeled pulmonary arteries. These findings were validated in lungs of patients with PH-LHD. In selected patients with sequential lung biopsy at the time of removal of the left ventricular assist device, we present early data suggesting improvement in pulmonary hemodynamics and venous remodeling, indicating potential regression of venous remodeling in response to assist device treatment. Our data indicate that remodeling of pulmonary veins is an integral part of PH-LHD and that pulmonary veins share some key features present in remodeled yet not normotensive pulmonary arteries. PMID:24039255

  1. Pulmonary veins in the normal lung and pulmonary hypertension due to left heart disease.

    Science.gov (United States)

    Hunt, James M; Bethea, Brian; Liu, Xiang; Gandjeva, Aneta; Mammen, Pradeep P A; Stacher, Elvira; Gandjeva, Marina R; Parish, Elisabeth; Perez, Mario; Smith, Lynelle; Graham, Brian B; Kuebler, Wolfgang M; Tuder, Rubin M

    2013-11-15

    Despite the importance of pulmonary veins in normal lung physiology and the pathobiology of pulmonary hypertension with left heart disease (PH-LHD), pulmonary veins remain largely understudied. Difficult to identify histologically, lung venous endothelium or smooth muscle cells display no unique characteristic functional and structural markers that distinguish them from pulmonary arteries. To address these challenges, we undertook a search for unique molecular markers in pulmonary veins. In addition, we addressed the expression pattern of a candidate molecular marker and analyzed the structural pattern of vascular remodeling of pulmonary veins in a rodent model of PH-LHD and in lung tissue of patients with PH-LHD obtained at time of placement on a left ventricular assist device. We detected urokinase plasminogen activator receptor (uPAR) expression preferentially in normal pulmonary veins of mice, rats, and human lungs. Expression of uPAR remained elevated in pulmonary veins of rats with PH-LHD; however, we also detected induction of uPAR expression in remodeled pulmonary arteries. These findings were validated in lungs of patients with PH-LHD. In selected patients with sequential lung biopsy at the time of removal of the left ventricular assist device, we present early data suggesting improvement in pulmonary hemodynamics and venous remodeling, indicating potential regression of venous remodeling in response to assist device treatment. Our data indicate that remodeling of pulmonary veins is an integral part of PH-LHD and that pulmonary veins share some key features present in remodeled yet not normotensive pulmonary arteries.

  2. Discovering hierarchical structure in normal relational data

    DEFF Research Database (Denmark)

    Schmidt, Mikkel Nørgaard; Herlau, Tue; Mørup, Morten

    2014-01-01

    Hierarchical clustering is a widely used tool for structuring and visualizing complex data using similarity. Traditionally, hierarchical clustering is based on local heuristics that do not explicitly provide assessment of the statistical saliency of the extracted hierarchy. We propose a non......-parametric generative model for hierarchical clustering of similarity based on multifurcating Gibbs fragmentation trees. This allows us to infer and display the posterior distribution of hierarchical structures that comply with the data. We demonstrate the utility of our method on synthetic data and data of functional...

  3. Junctophilin-2 gene therapy rescues heart failure by normalizing RyR2-mediated Ca2+ release.

    Science.gov (United States)

    Reynolds, Julia O; Quick, Ann P; Wang, Qiongling; Beavers, David L; Philippen, Leonne E; Showell, Jordan; Barreto-Torres, Giselle; Thuerauf, Donna J; Doroudgar, Shirin; Glembotski, Christopher C; Wehrens, Xander H T

    2016-12-15

    Junctophilin-2 (JPH2) is the primary structural protein for the coupling of transverse (T)-tubule associated cardiac L-type Ca channels and type-2 ryanodine receptors on the sarcoplasmic reticulum within junctional membrane complexes (JMCs) in cardiomyocytes. Effective signaling between these channels ensures adequate Ca-induced Ca release required for normal cardiac contractility. Disruption of JMC subcellular domains, a common feature of failing hearts, has been attributed to JPH2 downregulation. Here, we tested the hypothesis that adeno-associated virus type 9 (AAV9) mediated overexpression of JPH2 could halt the development of heart failure in a mouse model of transverse aortic constriction (TAC). Following TAC, a progressive decrease in ejection fraction was paralleled by a progressive decrease of cardiac JPH2 levels. AAV9-mediated expression of JPH2 rescued cardiac contractility in mice subjected to TAC. AAV9-JPH2 also preserved T-tubule structure. Moreover, the Ca2+ spark frequency was reduced and the Ca2+ transient amplitude was increased in AAV9-JPH2 mice following TAC, consistent with JPH2-mediated normalization of SR Ca2+ handling. This study demonstrates that AAV9-mediated JPH2 gene therapy maintained cardiac function in mice with early stage heart failure. Moreover, restoration of JPH2 levels prevented loss of T-tubules and suppressed abnormal SR Ca2+ leak associated with contractile failure following TAC. These findings suggest that targeting JPH2 might be an attractive therapeutic approach for treating pathological cardiac remodeling during heart failure. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  4. Triggered intracellular calcium waves in dog and human left atrial myocytes from normal and failing hearts.

    Science.gov (United States)

    Aistrup, Gary L; Arora, Rishi; Grubb, Søren; Yoo, Shin; Toren, Benjamin; Kumar, Manvinder; Kunamalla, Aaron; Marszalec, William; Motiwala, Tej; Tai, Shannon; Yamakawa, Sean; Yerrabolu, Satya; Alvarado, Francisco J; Valdivia, Hector H; Cordeiro, Jonathan M; Shiferaw, Yohannes; Wasserstrom, John Andrew

    2017-11-01

    Abnormal intracellular Ca2+ cycling contributes to triggered activity and arrhythmias in the heart. We investigated the properties and underlying mechanisms for systolic triggered Ca2+ waves in left atria from normal and failing dog hearts. Intracellular Ca2+ cycling was studied using confocal microscopy during rapid pacing of atrial myocytes (36 °C) isolated from normal and failing canine hearts (ventricular tachypacing model). In normal atrial myocytes (NAMs), Ca2+ waves developed during rapid pacing at rates ≥ 3.3 Hz and immediately disappeared upon cessation of pacing despite high sarcoplasmic reticulum (SR) load. In heart failure atrial myocytes (HFAMs), triggered Ca2+ waves (TCWs) developed at a higher incidence at slower rates. Because of their timing, TCW development relies upon action potential (AP)-evoked Ca2+ entry. The distribution of Ca2+ wave latencies indicated two populations of waves, with early events representing TCWs and late events representing conventional spontaneous Ca2+ waves. Latency analysis also demonstrated that TCWs arise after junctional Ca2+ release has occurred and spread to non-junctional (cell core) SR. TCWs also occurred in intact dog atrium and in myocytes from humans and pigs. β-adrenergic stimulation increased Ca2+ release and abolished TCWs in NAMs but was ineffective in HFAMs making this a potentially effective adaptive mechanism in normals but potentially arrhythmogenic in HF. Block of Ca-calmodulin kinase II also abolished TCWs, suggesting a role in TCW formation. Pharmacological manoeuvres that increased Ca2+ release suppressed TCWs as did interventions that decreased Ca2+ release but these also severely reduced excitation-contraction coupling. TCWs develop during the atrial AP and thus could affect AP duration, producing repolarization gradients and creating a substrate for reentry, particularly in HF where they develop at slower rates and a higher incidence. TCWs may represent a mechanism for the initiation

  5. Cloning, chromosomal localization, and functional expression of the alpha 1 subunit of the L-type voltage-dependent calcium channel from normal human heart

    NARCIS (Netherlands)

    Schultz, D; Mikala, G; Yatani, A; Engle, D B; Iles, D E; Segers, B; Sinke, R J; Weghuis, D O; Klöckner, U; Wakamori, M

    1993-01-01

    A unique structural variant of the cardiac L-type voltage-dependent calcium channel alpha 1 subunit cDNA was isolated from libraries derived from normal human heart mRNA. The deduced amino acid sequence shows significant homology to other calcium channel alpha 1 subunits. However, differences from

  6. Crossed Andreev reflection in graphene normal-superconductor-normal structures with pseudo-diffusive interfaces

    Energy Technology Data Exchange (ETDEWEB)

    Mohammadpour, Hakimeh, E-mail: hpour@iasbs.ac.i [Institute for Advanced Studies in Basic Sciences, P.O. Box 45195-1159, 45195 Zanjan (Iran, Islamic Republic of); Asgari, Asghar, E-mail: asgari@tabrizu.ac.i [Research Institute for Applied Physics, University of Tabriz, 51665-163, Tabriz (Iran, Islamic Republic of); School of Electrical, Electronics and Computer Engineering, the University of Western Australia, Crawley, WA 6009 (Australia)

    2011-03-07

    In this Letter graphene normal-superconductor-normal heterostructures are modeled for studying the crossed Andreev reflection. A thin layer of undoped graphene with Fermi energy at the Dirac point at is assumed the interface between superconductor layer and each normal lead. The resulting contribution of the crossed Andreev reflection to the nonlocal conductance equals that of the electron elastic cotunneling. We explain this as another figure of merit for pseudodiffusive conduction at the Dirac point of the undoped layers. Also structures with only one undoped layer at the interface between the superconductor and one of the normal leads, as well as structures in which one of the leads is ferromagnetic, show pseudodiffusive conduction at the Dirac points.

  7. Galnt1 is required for normal heart valve development and cardiac function.

    Directory of Open Access Journals (Sweden)

    E Tian

    Full Text Available Congenital heart valve defects in humans occur in approximately 2% of live births and are a major source of compromised cardiac function. In this study we demonstrate that normal heart valve development and cardiac function are dependent upon Galnt1, the gene that encodes a member of the family of glycosyltransferases (GalNAc-Ts responsible for the initiation of mucin-type O-glycosylation. In the adult mouse, compromised cardiac function that mimics human congenital heart disease, including aortic and pulmonary valve stenosis and regurgitation; altered ejection fraction; and cardiac dilation, was observed in Galnt1 null animals. The underlying phenotype is aberrant valve formation caused by increased cell proliferation within the outflow tract cushion of developing hearts, which is first detected at developmental stage E11.5. Developing valves from Galnt1 deficient animals displayed reduced levels of the proteases ADAMTS1 and ADAMTS5, decreased cleavage of the proteoglycan versican and increased levels of other extracellular matrix proteins. We also observed increased BMP and MAPK signaling. Taken together, the ablation of Galnt1 appears to disrupt the formation/remodeling of the extracellular matrix and alters conserved signaling pathways that regulate cell proliferation. Our study provides insight into the role of this conserved protein modification in cardiac valve development and may represent a new model for idiopathic valve disease.

  8. Biomarkers of heart failure with normal ejection fraction: a systematic review.

    Science.gov (United States)

    Cheng, Jin M; Akkerhuis, K Martijn; Battes, Linda C; van Vark, Laura C; Hillege, Hans L; Paulus, Walter J; Boersma, Eric; Kardys, Isabella

    2013-12-01

    Heart failure with normal ejection fraction (HFNEF) is a major and growing public health problem, currently representing half of the heart failure burden. Although many studies have investigated the diagnostic and prognostic value of new biomarkers in heart failure, limited data are available on biomarkers other than natriuretic peptides in HFNEF. We performed a systematic review of epidemiological studies on the associations of biomarkers with the occurrence of HFNEF and with the prognosis of HFNEF patients. Biomarkers examined most extensively in HFNEF include biomarkers of myocyte stress, inflammation, and extracellular matrix remodelling. Some biomarkers have been shown to be increased to a different extent in HFNEF compared with heart failure with reduced ejection fraction (HFREF). Several biomarkers, including biomarkers of myocyte stress, inflammation, extracellular matrix remodelling, growth differentiation factor 15 (GDF-15), cystatin C, resistin, and galectin-3, were associated with development of HFNEF and with clinical outcomes of HFNEF patients in terms of morbidity and mortality. Several biomarkers, including biomarkers of myocyte stress, inflammation, extracellular matrix remodelling, GDF-15, cystatin C, resistin, and galectin-3, appeared to be promising diagnostic and prognostic tools in patients with HFNEF. Investigation of the incremental diagnostic and prognostic value of these biomarkers, or a combination thereof, over established clinical covariates and imaging techniques in large, prospective studies is warranted.

  9. Proximity effect in normal metal-multiband superconductor hybrid structures

    NARCIS (Netherlands)

    Brinkman, Alexander; Golubov, Alexandre Avraamovitch; Kupriyanov, M. Yu

    2004-01-01

    A theory of the proximity effect in normal metal¿multiband superconductor hybrid structures is formulated within the quasiclassical Green's function formalism. The quasiclassical boundary conditions for multiband hybrid structures are derived in the dirty limit. It is shown that the existence of

  10. Quantum transport in graphene normal-metal superconductor- normal-metal structures

    Directory of Open Access Journals (Sweden)

    H. Mohammadpour

    2008-06-01

    Full Text Available  We study the transport of electrons in a graphene NSN structure in which two normal regions are connected by a superconducting strip of thickness d. Within Dirac-Bogoliubov-de Gennes equations we describe the transmission through the contact in terms of different scattering processes consisting of quasiparticle cotunneling, local and crossed Andreev reflections. Compared to a fully normal structure we show that the angular dependence of the transmission probability is significantly modified by the presence of superconducting correlations. This modifation can be explained in terms of the interplay between Andreev reflection and Klein tunneling of chiral quasiparticles. We further analyze the energy dependence of the resulting differential conductance of the structure. The subgap differential conductance shows features of Andreev reflection and cotunelling processes, which tends to the values of an NS structure for large ds. Above the gap, the differential conductance shows an oscillatory behavior with energy even at very large ds.

  11. A computer heart model incorporating anisotropic propagation. I. Model construction and simulation of normal activation.

    Science.gov (United States)

    Lorange, M; Gulrajani, R M

    1993-10-01

    surface potential maps obtained with the new heart model properly positioned inside an inhomogeneous torso model were all within normal limits.

  12. Chamber-dependent expression of brain natriuretic peptide and its mRNA in normal and diabetic pig heart

    DEFF Research Database (Denmark)

    Christoffersen, Christina; Goetze, Jens P; Bartels, Emil D

    2002-01-01

    BNP mRNA transcript and a mature BNP mRNA transcript in normal porcine hearts. In normal pigs, the amount of precursor BNP mRNA was similar in atrial and ventricular myocardium, whereas the mature BNP transcript was 10- to 50-fold more abundant in atrial than in ventricular myocardium. Quantitation...... of proBNP in normal porcine hearts by radioimmunoassay disclosed abundant proBNP in the atria, whereas proBNP was undetectable in the ventricles. Laser confocal microscopy revealed proBNP in secretory granules of atrial but not in the ventricular myocardium of normal pigs. Mild streptozotocin...

  13. Basal and exercise-induced neuroendocrine activation in patients with heart failure and in normal subjects

    DEFF Research Database (Denmark)

    Kjaer, Andreas; Appel, Jon; Hildebrandt, Per

    2004-01-01

    : Twenty-three newly-diagnosed CHF patients and 18 age- and gender-matched healthy subjects were exercised at two workloads, which were calculated to correspond to 50 and 75% of each individual's heart rate response. RESULTS: In CHF patients, baseline levels of ANP, BNP, AVP, PRA and ET-1 were elevated...... compared to healthy subjects. Exercise induced an increase in ANP, A and NA in both CHF patients and in normal subjects, however BNP was only increased in CHF patients and not in normal subjects. CONCLUSION: When CHF patients exercise at the same relative and submaximal level as age-matched healthy...... subjects, the relative increases in ANP, A and NA were similar, however, BNP levels only increased in the CHF group....

  14. Profile of Cardiovascular Risk Factors in Patients with Coronary Heart Disease, Normal and Impaired Carbohydrate Metabolism

    Directory of Open Access Journals (Sweden)

    І.V. Cherniavska

    2015-11-01

    Full Text Available The aim of research was to conduct the comparative analysis of the profile of cardiovascular risk factors in patients with coronary heart disease (CHD and normal either impaired carbohydrate metabolism. Materials and methods. One hundred and forty two patients were observed. In order to estimate the rate of different forms of CHD depending on the state of carbohydrate metabolism such groups were formed: the first group consisted of 83 patients with type 2 diabetes mellitus (DM, the second group involved 34 patients with impaired glucose tolerance (IGT, the third group consisted of 25 patients with normal carbohydrate metabolism. The ischemic changes of myocardium were detected by ambulatory ECG monitoring with the obligatory achievement of submaximal heart rate during the research. Results. Silent myocardial ischemia was educed in 19 (22.9 % patients with type 2 DM, in 3 (8.8 % persons with IGT and in 2 (8.0 % patients with normal carbohydrate metabolism. Smoking, burdened heredity, violation in the haemostatic system more often occurred in the group of patients with type 2 DM and silent myocardial ischemia in comparison with the patients with type 2 DM without CHD. The profile of general population cardiovascular risk factors in patients with CHD and type 2 DM belongs to the most unfavorable. At the same time for patients with early violations of carbohydrate metabolism and normal carbohydrate metabolism such profile statistically does not differentiate meaningfully. Conclusions. Patients with type 2 DM and silent myocardial ischemia as compared to patients with type 2 DM without CHD have more expressed violations of indexes of general population cardiovascular risk factors for certain.

  15. Cardiac axis shift within the cardiac cycle of normal fetuses and fetuses with congenital heart defect.

    Science.gov (United States)

    Zhao, Y; Abuhamad, S; Sinkovskaya, E; Mlynarczyk, M; Romary, L; Abuhamad, A

    2015-11-01

    To investigate changes in the cardiac axis (CAx) within the cardiac cycle of normal fetuses and fetuses with congenital heart defects (CHD). This was a retrospective case-control study in which stored videoclips of four-chamber views from 527 prenatal ultrasound examinations performed at 18 + 0 to 36 + 6 weeks of gestation were reviewed. Among the ultrasound scans included, 287 were of normal fetuses (controls) and 240 were of fetuses with CHD. In each case, the CAx was measured at end systole (just before the atrioventricular (AV) valve opened) and at end diastole (just before the AV valve closed). CAx measurements of fetuses with CHD were compared to those of controls. The mean CAx in the control group was 45.9 ± 8.5° at end systole and 38.3 ± 8.4° at end diastole (P left heart syndrome and L-transposition of the great arteries, the CAx was greater at end diastole than at end systole, with a difference of more than 5°. In 21.3% of control fetuses, there was a CAx shift within the cardiac cycle of ≥ 10°. Abnormal CAx measured at end systole was strongly associated with CHD. Measurement of the CAx at end systole provides values that differ from those when measured at end diastole, in both normal fetuses and those with CHD. We recommend that the CAx be measured at end systole as a greater proportion of fetuses with CHD and fewer normal fetuses have an abnormal CAx at this stage compared to at end diastole. The occurrence of an abnormal CAx and the CAx shift within the fetal cardiac cycle depend on the type of CHD. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd.

  16. Effects of local radiofrequency denervation on ventricular electrophysiological properties in normal and acute myocardial ischemia heart.

    Science.gov (United States)

    Huang, Y; Wang, D-N; Liu, P; Song, Y; Cui, H-M; Zhang, J-Y; Blackwell, J; Liao, D-N

    2016-06-01

    To observe the effects of local radiofrequency denervation on ventricular effective refractory periods, electrical alternans and ventricular arrhythmia susceptibility post myocardial infarction. Thirty-four mongrel dogs were randomly divided into the normal heart group (n = 16, 8 in sham and 8 in local sympathetic denervation - LSD) and the acute myocardial ischemia (AMI) group (n = 18, 9 in control and 9 in LSD). The left cardiac sympathetic nerve was denervated with irrigated catheter radiofrequency ablation. Left ventricular effective refractory periods (ERP), monophasic action potential duration at 90% (APD90) and APD alternans were measured at baseline and 2 hours after LSD in the normal heart group. AMI was induced by ligating the left anterior descending coronary artery 2 hours after LSD was performed. Then APD90, the occurrence of ventricular arrhythmias (VAs) were measured. Compared with baseline, LSD significantly prolonged ventricular ERP and APD90 at all sites (p LSD group, whereas no significant change was shown in the sham group. But their spatial dispersions did not change in both groups. APD alternans occurred at shorter pacing cycle length at each site after LAD→LSD when compared to the sham group (p LSD group than in the control group (p LSD may have a beneficial impact on ventricular arrhythmias induced by AMI through modulation of autonomic tone.

  17. RF Breakdown in Normal Conducting Single-cell Structures

    CERN Document Server

    Dolgashev, Valery A; Higo, Toshiyasu; Nantista, Christopher D; Tantawi, Sami G

    2005-01-01

    Operating accelerating gradient in normal conducting accelerating structures is often limited by rf breakdown. The limit depends on multiple parameters, including input rf power, rf circuit, cavity shape and material. Experimental and theoretical study of the effects of these parameters on the breakdown limit in full scale structures is difficult and costly. We use 11.4 GHz single-cell traveling wave and standing wave accelerating structures for experiments and modeling of rf breakdown behavior. These test structures are designed so that the electromagnetic fields in one cell mimic the fields in prototype multicell structures for the X-band linear collider. Fields elsewhere in the test structures are significantly lower than that of the single cell. The setup uses matched mode converters that launch the circular TM01 mode into short test structures. The test structures are connected to the mode launchers with vacuum rf flanges. This setup allows economic testing of different cell geometries, cell materials an...

  18. Imposed quasi-normality in covariance structure analysis

    NARCIS (Netherlands)

    Koning, Ruud H.; Neudecker, H.; Wansbeek, T.

    1993-01-01

    In the analysis of covariance structures, the distance between an observed covariance matrix S of order k x k and C(6) E(S) is minimized by searching over the 8-space. The criterion leading to a best asymptotically normal (BAN) estimator of 0 is found by minimizing the difference between vecS and

  19. Vibrational spectra and normal coordinate analysis on structure of ...

    Indian Academy of Sciences (India)

    journal of. December 2008 physics pp. 1291–1300. Vibrational spectra and normal coordinate analysis on structure of chlorambucil and thioguanine. S GUNASEKARAN1, S KUMARESAN2,∗, ... methoprexate are most effective in the treatment of leukemia [5–10] in children. Thioguanine interferes with the conversion of ...

  20. Image quality assessment based on textural structure and normalized noise

    Science.gov (United States)

    Zhang, Chun-e.; Qiu, Zhengding

    2006-01-01

    Traditional image quality assessments are mostly based on error analysis and the errors only stem from the absolute differences of pixel values or transform coefficients between the two compared images. With consideration of Human Vision System this paper proposes a quality assessment based on textural structure and normalized noise, SNPSNR. The time-frequency property of wavelet transform is utilized to represent images' textural structure and then the structural noise is figured as the difference between wavelet transform coefficients emphasized by textural structure. The noises on each level, i.e., each channel, are weighted by HVS. Due to the energy distribution property of wavelet transform, the noise quantity difference on each transform level is quite large and is not proportional to the influence caused by them. We normalize the structural noise on different levels by normalizing the coefficients on each level. SNPSNR computation adopting the PSNR form and the result data are fitted with Differential Mean Opinion Scores (DMOS) using logistic function. SNPSNR gains better performance when compared with MSSIM, HVSNR and PSNR.

  1. Mapping molecular agents distributions in whole mice hearts using born-normalized optical projection tomography.

    Directory of Open Access Journals (Sweden)

    Claudio Vinegoni

    Full Text Available To date there is a lack of tools to map the spatio-temporal dynamics of diverse cells in experimental heart models. Conventional histology is labor intensive with limited coverage, whereas many imaging techniques do not have sufficiently high enough spatial resolution to map cell distributions. We have designed and built a high resolution, dual channel Born-normalized near-infrared fluorescence optical projection tomography system to quantitatively and spatially resolve molecular agents distribution within whole murine heart. We validated the use of the system in a mouse model of monocytes/macrophages recruitment during myocardial infarction. While acquired, data were processed and reconstructed in real time. Tomographic analysis and visualization of the key inflammatory components were obtained via a mathematical formalism based on left ventricular modeling. We observed extensive monocyte recruitment within and around the infarcted areas and discovered that monocytes were also extensively recruited into non-ischemic myocardium, beyond that of injured tissue, such as the septum.

  2. Evaluation of shear stress accumulation on blood components in normal and dysfunctional bileaflet mechanical heart valves using smoothed particle hydrodynamics.

    Science.gov (United States)

    Shahriari, S; Maleki, H; Hassan, I; Kadem, L

    2012-10-11

    Evaluating shear induced hemodynamic complications is one of the major concerns in design of the mechanical heart valves (MHVs). The monitoring of these events relies on both numerical simulations and experimental measurements. Currently, numerical approaches are mainly based on a combined Eulerian-Lagrangian approach. A more straightforward evaluation can be based on the Lagrangian analysis of the whole blood. As a consequence, Lagrangian meshfree methods are more adapted to such evaluation. In this study, smoothed particle hydrodynamics (SPH), a fully meshfree particle method originated to simulate compressible astrophysical flows, is applied to study the flow through a normal and a dysfunctional bileaflet mechanical heart valves (BMHVs). The SPH results are compared with the reference data. The accumulation of shear stress patterns on blood components illustrates the important role played by non-physiological flow patterns and mainly vortical structures in this issue. The statistical distribution of particles with respect to shear stress loading history provides important information regarding the relative number of blood components that can be damaged. This can be used as a measure of the response of blood components to the presence of the valve implant or any implantable medical device. This work presents the first attempt to simulate pulsatile flow through BMHVs using SPH method. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. Cardiac sympathetic afferent reflex control of cardiac function in normal and chronic heart failure states.

    Science.gov (United States)

    Wang, Han-Jun; Rozanski, George J; Zucker, Irving H

    2017-04-15

    Cardiac sympathetic afferents are considered to be essential pathways for transmission of cardiac nociception to the central nervous system during myocardial ischaemia. However, a potential contribution of the CSAR control of cardiac dysfunction in both normal and chronic heart failure (CHF) states remains unknown. We found that activation of the CSAR evokes little increase in cardiac contractility with an exaggerated peripheral vasoconstriction in the CHF state. CSAR inhibition by epicardial lidocaine decreased cardiac contractility to a greater extent in CHF rats than sham rats. Furthermore, we also found that epicardial lidocaine paradoxically decreased left ventricular end-diastolic pressure (LVEDP) and left ventricular end-diastolic volume (preload) in CHF rats, which was not observed in sham rats. Chronic ablation of the CSAR by epicardial application of the afferent neurotoxin, RTX, selectively lowered diastolic blood pressure CHF rats. The observation suggests that CSAR has a differential effect on cardiac function in normal and CHF states. CSAR activation in normal state causes significant increase in cardiac contractility and cardiac output. The enhanced 'cardiac sympathetic afferent reflex' (CSAR) critically contributes to the exaggerated global sympathetic tone in chronic heart failure (CHF). However, a potential contribution of the cardio-cardiac reflex control of cardiac function in both normal and CHF states remains unknown. In this study, we evaluated the effects of direct activation or inhibition of the CSAR on cardiac function by pressure-volume (P-V) loop analysis in ∼12-week sham-operated and myocardial infarcted (MI) rats. In sham rats, acute CSAR activation by epicardial application of bradykinin (BK) increased heart rate (HR), left ventricular systolic pressure (LVSP), the maximum first derivative of left ventricular pressure (dp/dtmax ), and the slope of the end-systolic P-V relationship (ESPVR), suggesting that acute CSAR activation in

  4. American Heart Association's Life's Simple 7: Avoiding Heart Failure and Preserving Cardiac Structure and Function.

    Science.gov (United States)

    Folsom, Aaron R; Shah, Amil M; Lutsey, Pamela L; Roetker, Nicholas S; Alonso, Alvaro; Avery, Christy L; Miedema, Michael D; Konety, Suma; Chang, Patricia P; Solomon, Scott D

    2015-09-01

    Many people may underappreciate the role of lifestyle in avoiding heart failure. We estimated whether greater adherence in middle age to American Heart Association's Life's Simple 7 guidelines—on smoking, body mass, physical activity, diet, cholesterol, blood pressure, and glucose—is associated with lower lifetime risk of heart failure and greater preservation of cardiac structure and function in old age. We studied the population-based Atherosclerosis Risk in Communities Study cohort of 13,462 adults ages 45-64 years in 1987-1989. From the 1987-1989 risk factor measurements, we created a Life's Simple 7 score (range 0-14, giving 2 points for ideal, 1 point for intermediate, and 0 points for poor components). We identified 2218 incident heart failure events using surveillance of hospital discharge and death codes through 2011. In addition, in 4855 participants free of clinical cardiovascular disease in 2011-2013, we performed echocardiography from which we quantified left ventricular hypertrophy and diastolic dysfunction. One in four participants (25.5%) developed heart failure through age 85 years. Yet, this lifetime heart failure risk was 14.4% for those with a middle-age Life's Simple 7 score of 10-14 (optimal), 26.8% for a score of 5-9 (average), and 48.6% for a score of 0-4 (inadequate). Among those with no clinical cardiovascular event, the prevalence of left ventricular hypertrophy in late life was approximately 40% as common, and diastolic dysfunction was approximately 60% as common, among those with an optimal middle-age Life's Simple 7 score, compared with an inadequate score. Greater achievement of American Heart Association's Life's Simple 7 in middle age is associated with a lower lifetime occurrence of heart failure and greater preservation of cardiac structure and function. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. In vivo epicardial force and strain characterisation in normal and MLP-knockout murine hearts.

    Science.gov (United States)

    Michaelides, M; Georgiadou, S; Constantinides, C

    2015-07-01

    The study's objective is to quantify in vivo epicardial force and strain in the normal and transgenic myocardium using microsensors.Male mice (n = 39), including C57BL/6 (n = 26), 129/Sv (n = 5), wild-type (WT) C57  ×  129Sv (n = 5), and muscle LIM protein (MLP) knock-out (n = 3), were studied under 1.5% isoflurane anaesthesia. Microsurgery allowed the placement of two piezoelectric crystals at longitudinal epicardial loci at the basal, middle, and apical LV regions, and the independent (and/or concurrent) placement of a cantilever force sensor. The findings demonstrate longitudinal contractile and relaxation strains that ranged between 4.8-9.3% in the basal, middle, and apical regions of C57BL/6 mice, and in the mid-ventricular regions of 129/Sv, WT, and MLP mice. Measured forces ranged between 3.1-8.9 mN. The technique's feasibility is also demonstrated in normal mice following afterload, occlusion-reperfusion challenges.Furthermore, the total mid-ventricular forces developed in MLP mice were significantly reduced compared to the WT controls (5.9  ±  0.4 versus 8.9  ±  0.2 mN, p < 0.0001), possibly owing to the fibrotic and stiffer myocardium. No significant strain differences were noted between WT and MLP mice.The possibility of quantifying in vivo force and strain from the normal murine heart is demonstrated with a potential usefulness in the characterisation of transgenic and diseased mice, where regional myocardial function may be significantly altered.

  6. Effect of Nebivolol on MIBG Parameters and Exercise in Heart Failure with Normal Ejection Fraction

    Energy Technology Data Exchange (ETDEWEB)

    Messias, Leandro Rocha, E-mail: lmessias@cardiol.br; Ferreira, Aryanne Guimarães; Miranda, Sandra Marina Ribeiro de; Teixeira, José Antônio Caldas [Universidade Federal Fluminense, Rio de Janeiro, RJ (Brazil); Azevedo, Jader Cunha de [Universidade Federal Fluminense, Rio de Janeiro, RJ (Brazil); Hospital Procardíaco, Rio de Janeiro, RJ (Brazil); Messias, Ana Carolina Nader Vasconcelos [Hospital Federal dos Servidores do Estado do Rio de Janeiro, Rio de Janeiro, RJ (Brazil); Maróstica, Elisabeth [Universidade Federal Fluminense, Rio de Janeiro, RJ (Brazil); Mesquita, Claudio Tinoco [Universidade Federal Fluminense, Rio de Janeiro, RJ (Brazil); Hospital Procardíaco, Rio de Janeiro, RJ (Brazil)

    2016-05-15

    More than 50% of the patients with heart failure have normal ejection fraction (HFNEF). Iodine-123 metaiodobenzylguanidine (123I-MIBG) scintigraphy and cardiopulmonary exercise test (CPET) are prognostic markers in HFNEF. Nebivolol is a beta-blocker with vasodilating properties. To evaluate the impact of nebivolol therapy on CPET and123I-MIBG scintigraphic parameters in patients with HFNEF. Twenty-five patients underwent 123I-MIBG scintigraphy to determine the washout rate and early and late heart-to-mediastinum ratios. During the CPET, we analyzed the systolic blood pressure (SBP) response, heart rate (HR) during effort and recovery (HRR), and oxygen uptake (VO{sub 2}). After the initial evaluation, we divided our cohort into control and intervention groups. We then started nebivolol and repeated the tests after 3 months. After treatment, the intervention group showed improvement in rest SBP (149 mmHg [143.5-171 mmHg] versus 135 mmHg [125-151 mmHg, p = 0.016]), rest HR (78 bpm [65.5-84 bpm] versus 64.5 bpm [57.5-75.5 bpm, p = 0.028]), peak SBP (235 mmHg [216.5-249 mmHg] versus 198 mmHg [191-220.5 mmHg], p = 0.001), peak HR (124.5 bpm [115-142 bpm] versus 115 bpm [103.7-124 bpm], p= 0.043), HRR on the 1st minute (6.5 bpm [4.75-12.75 bpm] versus 14.5 bpm [6.7-22 bpm], p = 0.025) and HRR on the 2nd minute (15.5 bpm [13-21.75 bpm] versus 23.5 bpm [16-31.7 bpm], p = 0.005), but no change in peak VO{sub 2} and 123I-MIBG scintigraphic parameters. Despite a better control in SBP, HR during rest and exercise, and improvement in HRR, nebivolol failed to show a positive effect on peak VO2 and 123I-MIBG scintigraphic parameters. The lack of effect on adrenergic activity may be the cause of the lack of effect on functional capacity.

  7. Avoiding vacuum arcs in high gradient normal conducting RF structures

    CERN Document Server

    Sjøbæk, Kyrre Ness; Adli, Erik; Grudiev, Alexej; Wuensch, Walter

    In order to build the Compact LInear Collider (CLIC), accelerating structures reaching extremely high accelerating gradients are needed. Such structures have been built and tested using normal-conducting copper, powered by X-band RF power and reaching gradients of 100 MV/m and above. One phenomenon that must be avoided in order to reliably reach such gradients, is vacuum arcs or “breakdowns”. This can be accomplished by carefully designing the structure geometry such that high surface fields and large local power flows are avoided. The research presented in this thesis presents a method for optimizing the geometry of accelerating structures so that these breakdowns are made less likely, allowing the structure to operate reliably at high gradients. This was done primarily based on a phenomenological scaling model, which predicted the maximum gradient as a function of the break down rate, pulse length, and field distribution in the structure. The model is written in such a way that it allows direct comparis...

  8. The relationship between resting heart rate variability and erectile tumescence among men with normal erectile function

    Science.gov (United States)

    Harte, Christopher B.

    2013-01-01

    Introduction Individuals with erectile dysfunction have been shown to display lower heart rate variability (HRV), suggesting dysregulation of cardiac autonomic function. No studies have explored whether HRV is predictive of erectile response among men with clinically normal erectile function. Aim To examine associations between resting HRV and objective measures of genital response (i.e., resting penile circumference; erectile tumescence) and self-reported sexual function. Methods The sample comprised 59 male community volunteers (mean age = 20.15 years; SD = 2.52) selected from the control conditions of two previously published studies. Participants reported erectile function in the normal range (scoring ≥ 26 on the International Index of Erectile Function [IIEF]) and had no history of cardiovascular disease or myocardial infarct. During a laboratory visit, self-report, anthropometric, cardiovascular, and electrocardiographic data were assessed, as well as resting penile circumference and erectile tumescence in response to viewing an erotic film. Main Outcome Measures Resting penile responses, erectile tumescence (circumferential change via penile plethysmography), self-reported sexual function per the IIEF, and both time-domain (standard deviation of beat-to-beat [NN] intervals [SDNN], square root of the mean squared difference of successive NN intervals [RMSSD], and percent of NN intervals for which successive heartbeat intervals differed by at least 50 msec [pNN50]) and frequency-domain (low frequency [LF], high frequency [HF], LF/HF ratio) parameters of HRV were assessed. Results Higher resting HF power and lower resting LF/HF ratio were associated with greater erectile tumescence. There were marginally significant positive associations between mean NN interval and pNN50 and penile tumescence. HRV was not associated with self-reported sexual function or with resting penile circumference. Conclusions Results suggested that, among men without erectile

  9. Increased P-wave and QT dispersions necessitate long-term follow-up evaluation of Down syndrome patients with congenitally normal hearts.

    Science.gov (United States)

    Karadeniz, Cem; Ozdemir, Rahmi; Demir, Fikri; Yozgat, Yılmaz; Küçük, Mehmet; Oner, Talia; Karaarslan, Utku; Meşe, Timur; Unal, Nurettin

    2014-12-01

    Reports state that Down syndrome (DS) patients with congenitally normal hearts might experience the development of cardiac abnormalities such as cardiac autonomic dysfunction, valvular lesions, bradycardia, and atrioventricular block. However, the presence of any difference in terms of P-wave dispersion (PWd) and QT dispersion (QTd) was not evaluated previously. This study prospectively investigated 100 DS patients with structurally normal hearts and 100 age- and sex-matched healthy control subjects. Standard 12-lead electrocardiograms were used to assess and compare P-wave and QT durations together with PWd and QTd. The median age of the DS patients and control subjects was 48 months. Heart rates and P-wave and QT dispersions were significantly greater in the DS group than in the control group (113 ± 22.9 vs 98.8 ± 16.6 bpm, p < 0.001; 31.3 ± 9.5 vs 24 ± 8.6 ms, p < 0.001; and 46.6 ± 15.9 vs 26 ± 9.1 ms, p < 0.001, respectively). A positive correlation was found between PWd and age in the DS patients (p < 0.05; r = 0.2). All children with DS should be followed up carefully with electrocardiography in terms of increased P-wave and QT dispersions even in the absence of concomitant congenital heart disease for management of susceptibility to arryhthmias.

  10. Prognostic Value of Prothrombin Time International Normalized Ratio in Acute Decompensated Heart Failure – A Combined Marker of Hepatic Insufficiency and Hemostatic Abnormality

    National Research Council Canada - National Science Library

    Okada, Atsushi; Sugano, Yasuo; Nagai, Toshiyuki; Takashio, Seiji; Honda, Satoshi; Asaumi, Yasuhide; Aiba, Takeshi; Noguchi, Teruo; Kusano, Kengo F; Ogawa, Hisao; Yasuda, Satoshi; Anzai, Toshihisa

    2016-01-01

    .... The clinical significance of prothrombin time international normalized ratio (INR), a widely accepted marker assessing coagulation abnormalities, in acute decompensated heart failure (ADHF) remains unclear.Methods...

  11. Pulmonary function impairment in patients with chronic heart failure: Lower limit of normal versus conventional cutoff values

    NARCIS (Netherlands)

    Minasian, A.G.; Elshout, F.J.J. van den; Dekhuijzen, P.N.R.; Vos, P.J.E.; Willems, F.F.; Bergh, P.J.P.C. van den; Heijdra, Y.F.

    2014-01-01

    OBJECTIVE: To determine the prevalence of pulmonary function abnormalities in patients with chronic heart failure (HF) according to recent American Thoracic Society/European Respiratory Society (ATS/ERS) guidelines using the lower limit of normal (LLN) compared to conventional cutoff values.

  12. Normal Values for Heart Electrophysiology Parameters of Healthy Swine Determined on Electrophysiology Study.

    Science.gov (United States)

    Noszczyk-Nowak, Agnieszka; Cepiel, Alicja; Janiszewski, Adrian; Pasławski, Robert; Gajek, Jacek; Pasławska, Urszula; Nicpoń, Józef

    2016-01-01

    Swine are a well-recognized animal model for human cardiovascular diseases. Despite the widespread use of porcine model in experimental electrophysiology, still no reference values for intracardiac electrical activity and conduction parameters determined during an invasive electrophysiology study (EPS) have been developed in this species thus far. The aim of the study was to develop a set of normal values for intracardiac electrical activity and conduction parameters determined during an invasive EPS of swine. The study included 36 healthy domestic swine (24-40 kg body weight). EPS was performed under a general anesthesia with midazolam, propofol and isoflurane. The reference values for intracardiac electrical activity and conduction parameters were calculated as arithmetic means ± 2 standard deviations. The reference values were determined for AH, HV and PA intervals, interatrial conduction time at its own and imposed rhythm, sinus node recovery time (SNRT), corrected sinus node recovery time (CSNRT), anterograde and retrograde Wenckebach points, atrial, atrioventricular node and ventricular refractory periods. No significant correlations were found between body weight and heart rate of the examined pigs and their electrophysiological parameters. The hereby presented reference values can be helpful in comparing the results of various studies, as well as in more accurately estimating the values of electrophysiological parameters that can be expected in a given experiment.

  13. Impact of different breathing conditions on the dose to surrounding normal structures in tangential field breast radiotherapy

    Directory of Open Access Journals (Sweden)

    Prabhakar Ramachandran

    2007-01-01

    Full Text Available Cardiac toxicity is an important concern in tangential field breast radiotherapy. In this study, the impact of three different breathing conditions on the dose to surrounding normal structures such as heart, ipsilateral lung, liver and contralateral breast has been assessed. Thirteen patients with early breast cancer who underwent conservative surgery (nine left-sided and four right-sided breast cancer patients were selected in this study. Spiral CT scans were performed for all the three breathing conditions, viz., deep inspiration breath-hold (DIBH, normal breathing phase (NB and deep expiration breath-hold (DEBH. Conventional tangential fields were placed on the 3D-CT dataset, and the parameters such as V30 (volume covered by dose> 30 Gy for heart, V20 (volume covered by dose> 20 Gy for ipsilateral lung and V50 (volume receiving> 50% of the prescription dose for heart and liver were studied. The average reduction in cardiac dose due to DIBH was 64% (range: 26.5-100% and 74% (range: 37-100% as compared to NB and DEBH respectively. For right breast cancer, DIBH resulted in excellent liver sparing. Our results indicate that in patients with breast cancer, delivering radiation in deep inspiration breath-hold condition can considerably reduce the dose to the surrounding normal structures, particularly heart and liver.

  14. Impact of different breathing conditions on the dose to surrounding normal structures in tangential field breast radiotherapy.

    Science.gov (United States)

    Prabhakar, Ramachandran; Tharmar, Ganesh; Julka, Pramod K; Rath, Goura K; Joshi, Rakesh C; Bansal, Anil K; Bisht, R K; Gopishankar, N; Pant, G S; Thulkar, S

    2007-01-01

    Cardiac toxicity is an important concern in tangential field breast radiotherapy. In this study, the impact of three different breathing conditions on the dose to surrounding normal structures such as heart, ipsilateral lung, liver and contralateral breast has been assessed. Thirteen patients with early breast cancer who underwent conservative surgery (nine left-sided and four right-sided breast cancer patients) were selected in this study. Spiral CT scans were performed for all the three breathing conditions, viz., deep inspiration breath-hold (DIBH), normal breathing phase (NB) and deep expiration breath-hold (DEBH). Conventional tangential fields were placed on the 3D-CT dataset, and the parameters such as V30 (volume covered by dose >30 Gy) for heart, V20 (volume covered by dose >20 Gy) for ipsilateral lung and V(50) (volume receiving >50% of the prescription dose) for heart and liver were studied. The average reduction in cardiac dose due to DIBH was 64% (range: 26.5-100%) and 74% (range: 37-100%) as compared to NB and DEBH respectively. For right breast cancer, DIBH resulted in excellent liver sparing. Our results indicate that in patients with breast cancer, delivering radiation in deep inspiration breath-hold condition can considerably reduce the dose to the surrounding normal structures, particularly heart and liver.

  15. Normal Thyroid Structure and Function in Rhophilin 2-Deficient Mice

    Science.gov (United States)

    Behrends, Jens; Clément, Serge; Pajak, Bernard; Pohl, Viviane; Maenhaut, Carine; Dumont, Jacques E.; Schurmans, Stéphane

    2005-01-01

    Rhophilin 2 is a Rho GTPase binding protein initially isolated by differential screening of a chronically thyrotropin (TSH)-stimulated dog thyroid cDNA library. In thyroid cell culture, expression of rhophilin 2 mRNA and protein is enhanced following TSH stimulation of the cyclic AMP (cAMP) transduction cascade. Yeast two-hybrid screening and coimmunoprecipitation have revealed that the GTP-bound form of RhoB and components of the cytoskeleton are protein partners of rhophilin 2. These results led us to suggest that rhophilin 2 could play an important role downstream of RhoB in the control of endocytosis during the thyroid secretory process which follows stimulation of the TSH/cAMP pathway. To validate this hypothesis, we generated rhophilin 2-deficient mice and analyzed their thyroid structure and function. Mice lacking rhophilin 2 develop normally, have normal life spans, and are fertile. They have no visible goiter and no obvious clinical signs of hyper- or hypothyroidism. The morphology of thyroid cells and follicles in these mice were normal, as were the different biological tests performed to investigate thyroid function. Our results indicate that rhophilin 2 does not play an essential role in thyroid physiology. PMID:15767687

  16. A new MRI-based model of heart function with coupled hemodynamics and application to normal and diseased canine left ventricles

    Directory of Open Access Journals (Sweden)

    Young Joon Choi

    2015-09-01

    Full Text Available A methodology for the simulation of heart function that combines an MRI-based model of cardiac electromechanics (CE with a Navier-Stokes based hemodynamics (NSH model is presented. The cardiac electromechanics model consists of two coupled components that simulate the electrical and the mechanical functions of the heart. Accurate representations of ventricular geometry and fiber orientations are constructed from the structural magnetic resonance and the diffusion tensor MR images, respectively. The deformation of the ventricle obtained from the electromechanical model serves as input to the hemodynamics model in this one-way coupled approach via imposed kinematic wall-velocity boundary conditions and at the same time, governs the blood flow into and out of the ventricular volume. The time-dependent endocardial surfaces are registered using a diffeomorphic mapping algorithm while the intraventricular blood flow patterns are simulated using a sharp-interface immersed boundary method based flow solver. The utility of the combined heart function model is demonstrated by comparing the hemodynamic characteristics of a normal canine heart beating in sinus rhythm (SR against that of the dyssynchronously-beating failing heart. We also discuss the potential of coupled cardiac electromechanics and hemodynamics models for various clinical applications.

  17. 2D imaging of functional structures in perfused pig heart

    Science.gov (United States)

    Kessler, Manfred D.; Cristea, Paul D.; Hiller, Michael; Trinks, Tobias

    2002-06-01

    In 2000 by 2D-imaging we were able for the first time to visualize in subcellular space functional structures of myocardium. For these experiments we used hemoglobin-free perfused pig hearts in our lab. Step by step we learned to understand the meaning of subcellular structures. Principally, the experiment revealed that in subcellular space very fast changes of light scattering can occur. Furthermore, coefficients of different parameters were determined on the basis of multicomponent system theory.

  18. Morphology, topology and dimensions of the heart and arteries of genetically normal and mutant mouse embryos at stages S21-S23.

    Science.gov (United States)

    Geyer, Stefan H; Reissig, Lukas F; Hüsemann, Markus; Höfle, Cordula; Wilson, Robert; Prin, Fabrice; Szumska, Dorota; Galli, Antonella; Adams, David J; White, Jacqui; Mohun, Timothy J; Weninger, Wolfgang J

    2017-10-01

    Accurate identification of abnormalities in the mouse embryo depends not only on comparisons with appropriate, developmental stage-matched controls, but also on an appreciation of the range of anatomical variation that can be expected during normal development. Here we present a morphological, topological and metric analysis of the heart and arteries of mouse embryos harvested on embryonic day (E)14.5, based on digital volume data of whole embryos analysed by high-resolution episcopic microscopy (HREM). By comparing data from 206 genetically normal embryos, we have analysed the range and frequency of normal anatomical variations in the heart and major arteries across Theiler stages S21-S23. Using this, we have identified abnormalities in these structures among 298 embryos from mutant mouse lines carrying embryonic lethal gene mutations produced for the Deciphering the Mechanisms of Developmental Disorders (DMDD) programme. We present examples of both commonly occurring abnormal phenotypes and novel pathologies that most likely alter haemodynamics in these genetically altered mouse embryos. Our findings offer a reference baseline for identifying accurately abnormalities of the heart and arteries in embryos that have largely completed organogenesis. © 2017 The Authors. Journal of Anatomy published by John Wiley & Sons Ltd on behalf of Anatomical Society.

  19. Heart Failure Increases the Risk of Adverse Renal Outcomes in Patients With Normal Kidney Function.

    Science.gov (United States)

    George, Lekha K; Koshy, Santhosh K G; Molnar, Miklos Z; Thomas, Fridtjof; Lu, Jun L; Kalantar-Zadeh, Kamyar; Kovesdy, Csaba P

    2017-08-01

    Heart failure (HF) is associated with poor cardiac outcomes and mortality. It is not known whether HF leads to poor renal outcomes in patients with normal kidney function. We hypothesized that HF is associated with worse long-term renal outcomes. Among 3 570 865 US veterans with estimated glomerular filtration rate (eGFR) ≥60 mL min-1 1.73 m-2 during October 1, 2004 to September 30, 2006, we identified 156 743 with an International Classification of Diseases, Ninth Revision, diagnosis of HF. We examined the association of HF with incident chronic kidney disease (CKD), the composite of incident CKD or mortality, and rapid rate of eGFR decline (slopes steeper than -5 mL min-1 1.73 m-2 y-1) using Cox proportional hazard analyses and logistic regression. Adjustments were made for various confounders. The mean±standard deviation baseline age and eGFR of HF patients were 68±11 years and 78±14 mL min-1 1.73 m-2 and in patients without HF were 59±14 years and 84±16 mL min-1 1.73 m-2, respectively. HF patients had higher prevalence of hypertension, diabetes mellitus, cardiac, peripheral vascular and chronic lung diseases, stroke, and dementia. Incidence of CKD was 69.0/1000 patient-years in HF patients versus 14.5/1000 patient-years in patients without HF, and 22% of patients with HF had rapid decline in eGFR compared with 8.5% in patients without HF. HF patients had a 2.12-, 2.06-, and 2.13-fold higher multivariable-adjusted risk of incident CKD, composite of CKD or mortality, and rapid eGFR decline, respectively. HF is associated with significantly higher risk of incident CKD, incident CKD or mortality, and rapid eGFR decline. Early diagnosis and management of HF could help reduce the risk of long-term renal complications. © 2017 American Heart Association, Inc.

  20. Optical investigation of functional structures in isolated perfused pig heart

    Science.gov (United States)

    Rauh, Robert; Boehnert, Markus; Mahlke, Christine; Kessler, Manfred D.

    2000-11-01

    Light scattering in tissue of mammals and humans is affected by subcellular structures. Since these structures correlate well with the status of cells and tissue, light scattering seems to be ideal for monitoring of functional tissue state. By use of EMPHO SSK Oxyscan we investigated functional parameters in a novel kind of isolated perfused pig heart model. In this perfusion model we use organs obtained by the local slaughterhouse that are reanimated at our institute by application of a heart-lung machine. By creating 3D-images of tissue scattering we found an interesting relation between anatomical structures of myocardium and the 3D-images. Additionally, we detected coherence between backscattered light intensity and functional tissue status. Furthermore, we got a sight into the redox state of cytochrome aa3, b and c by creating difference spectra. We believe that this new kind of tissue imaging method will give us the opportunity to get new insights into myocardial function.

  1. Mortality risk of long-term amiodarone therapy for atrial fibrillation patients without structural heart disease.

    Science.gov (United States)

    Qin, Dingxin; Leef, George; Alam, Mian Bilal; Rattan, Rohit; Munir, Mohamad Bilal; Patel, Divyang; Khattak, Furqan; Adelstein, Evan; Jain, Sandeep K; Saba, Samir

    2015-01-01

    Amiodarone is often prescribed in the management of atrial fibrillation (AF) but is known to cause significant end-organ toxicities. In this study, we examined the impact of amiodarone on all-cause mortality in AF patients with structurally normal hearts. We performed a retrospective cohort analysis of all AF patients with structurally normal hearts who were prescribed antiarrhythmic drugs (AAD) for rhythm control of AF at our institution from 2006 to 2013 (n = 2,077). Baseline differences between the amiodarone (AMIO: n = 403) and other AADs (NON-AMIO: n = 1,674) groups were corrected for using propensity score matching. Amiodarone use as first-line therapy decreased significantly with a higher degree of prescriber specialization in arrhythmia management (31%, 22%, and 9% for primary care physicians, general cardiologists and cardiac electrophysiologists, respectively, p amiodarone was associated with increased all-cause (HR 2.41, p = 0.012) and non-cardiac (HR 3.55, p = 0.008) mortality, but not cardiac mortality. AF recurrence and cardiac hospitalizations were similar between the two study groups. Amiodarone treatment of AF is associated with increased mortality in patients without structural heart disease and therefore should be avoided or only used as a second-line therapy, when other AF therapies fail. Adherence to guideline recommendations in the management of AF patients impacts clinical outcome.

  2. In vitro cultured progenitors and precursors of cardiac cell lineages from human normal and post-ischemic hearts

    Directory of Open Access Journals (Sweden)

    F Di Meglio

    2009-08-01

    Full Text Available The demonstration of the presence of dividing primitive cells in damaged hearts has sparked increased interest about myocardium regenerative processes. We examined the rate and the differentiation of in vitro cultured resident cardiac primitive cells obtained from pathological and normal human hearts in order to evaluate the activation of progenitors and precursors of cardiac cell lineages in post-ischemic human hearts. The precursors and progenitors of cardiomyocyte, smooth muscle and endothelial lineage were identified by immunocytochemistry and the expression of characteristic markers was studied by western blot and RT-PCR. The amount of proteins characteristic for cardiac cells (a-SA and MHC, VEGFR-2 and FVIII, SMA for the precursors of cardiomyocytes, endothelial and smooth muscle cells, respectively inclines toward an increase in both a-SA and MHC. The increased levels of FVIII and VEGFR2 are statistically significant, suggesting an important re-activation of neoangiogenesis. At the same time, the augmented expression of mRNA for Nkx 2.5, the trascriptional factor for cardiomyocyte differentiation, confirms the persistence of differentiative processes in terminally injured hearts. Our study would appear to confirm the activation of human heart regeneration potential in pathological conditions and the ability of its primitive cells to maintain their proliferative capability in vitro. The cardiac cell isolation method we used could be useful in the future for studying modifications to the microenvironment that positively influence cardiac primitive cell differentiation or inhibit, or retard, the pathological remodeling and functional degradation of the heart.

  3. Lung and heart volumes by three-dimensional ultrasound in normal fetuses at 12-32 weeks' gestation.

    Science.gov (United States)

    Peralta, C F A; Cavoretto, P; Csapo, B; Falcon, O; Nicolaides, K H

    2006-02-01

    To establish reference intervals for the fetal right, left and total lung volumes and heart volume between 12 and 32 weeks of gestation. Fetal lung and heart volumes were measured using three-dimensional (3D) ultrasound in 650 normal singleton pregnancies at 12-32 weeks. The VOCAL (Virtual Organ Computer-aided AnaLysis) technique was used to obtain a sequence of six sections of each lung and the heart around a fixed axis, each after a 30 degrees rotation from the previous one. The rotation axis for the lungs extended from the apex to the upper limit of the diaphragm dome, and the rotation axis for the heart extended from its apex to its connection to the great vessels. The contour of each of these organs was drawn manually in the six different rotation planes to obtain the 3D volume measurement. In 60 cases the fetal lungs and heart volumes were measured by the same sonographer twice and also by a second sonographer once in order to compare the measurements and calculate intra- and interobserver agreement. The total lung volume and heart volume increased with gestation, from respective mean values of 1.6 and 0.6 mL at 12 weeks to 10.9 and 4.3 mL at 20 weeks and 49.3 and 26.6 mL at 32 weeks. The right to left lung volume ratio did not change significantly with gestation (median, 0.7), whereas the heart to total lung volume ratio increased with gestation from about 0.3 at 12 weeks to 0.5 at 32 weeks. In the Bland-Altman plot, the difference between paired measurements by two sonographers was, in 95% of the cases, less than 0.05, 0.5 and 1.9 mL for each lung at 12-13, 19-22 and 29-32 weeks, respectively, and the corresponding values for the heart volumes were 0.04, 0.4 and 2.3 mL. In normal fetuses the lung and heart volumes increase between 12 and 32 weeks of gestation. The extent to which in pathological pregnancies possible deviations in these measurements from normal prove to be useful in the prediction of outcome remains to be determined. Copyright (c) 2005 ISUOG.

  4. Patient experiences of recovery after heart valve replacement: suffering weakness, struggling to resume normality

    DEFF Research Database (Denmark)

    Kikkenborg Berg, Selina; Zwisler, Ann-Dorthe; Pedersen, Birthe D.

    2013-01-01

    Heart valve disease is becoming a public health problem due to increasing life expectancy and new treatment methods. Patients are at risk of developing depression, anxiety or post-traumatic stress disorder after heart valve surgery. To better plan proper care, describing and understanding patients...

  5. Physiological roles of the transient outward current Ito in normal and diseased hearts

    DEFF Research Database (Denmark)

    Cordeiro, Jonathan M.; Callø, Kirstine; Aschar-Sobbi, Roozbeh

    2016-01-01

    constituents are consistently reduced in cardiac hypertrophy and heart failure. In this review, we discuss the physiological role of Ito as well as the molecular basis of this current in human and canine hearts, in which Ito has been thoroughly studied. In particular, we discuss the role of Ito in the action...

  6. Longitudinal study of vascular structure and function during normal pregnancy.

    Science.gov (United States)

    Iacobaeus, C; Andolf, E; Thorsell, M; Bremme, K; Jörneskog, G; Östlund, E; Kahan, T

    2017-01-01

    To examine alterations in maternal vascular structure and function during normal pregnancy. We assessed brachial and central blood pressure, pulse-wave velocity and augmentation index (by pulse-wave analysis and applanation tonometry), common carotid artery structure (by ultrasonography) and endothelial function in the brachial artery (by postischemic hyperemia-induced flow-mediated vasodilatation by glyceryl trinitrate) and in the forearm skin microcirculation (by laser Doppler perfusion imaging during iontophoretic administration of acetylcholine and sodium nitroprusside) in 52 healthy nulliparous women at 14, 24 and 34 weeks' gestation, and at 9 months postpartum. During pregnancy, brachial and central systolic and diastolic blood pressures initially decreased but subsequently increased (all P pregnancy (P pregnancy (0.30 ± 0.18 in the non-pregnant state at 9 months postpartum and 0.51 ± 0.19, 0.61 ± 0.39 and 0.49 ± 0.30 in the first, second and third trimesters, respectively) (P reactivity to acetylcholine also increased (P pregnancy (5.88 ± 0.91 m/s in the non-pregnant state and 5.55 ± 0.67, 5.12 ± 0.66 and 5.62 ± 0.74 m/s in the first, second and third trimesters, respectively) (P pregnancy, the blood volume expansion necessary for sufficient fetal growth is accommodated by early and marked changes in the matvascular system. This seems to be dependent on normal adaptive endothelial and vascular function. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

  7. Gaussian fitting for carotid and radial artery pressure waveforms: comparison between normal subjects and heart failure patients.

    Science.gov (United States)

    Liu, Chengyu; Zheng, Dingchang; Zhao, Lina; Liu, Changchun

    2014-01-01

    It has been reported that Gaussian functions could accurately and reliably model both carotid and radial artery pressure waveforms (CAPW and RAPW). However, the physiological relevance of the characteristic features from the modeled Gaussian functions has been little investigated. This study thus aimed to determine characteristic features from the Gaussian functions and to make comparisons of them between normal subjects and heart failure patients. Fifty-six normal subjects and 51 patients with heart failure were studied with the CAPW and RAPW signals recorded simultaneously. The two signals were normalized first and then modeled by three positive Gaussian functions, with their peak amplitude, peak time, and half-width determined. Comparisons of these features were finally made between the two groups. Results indicated that the peak amplitude of the first Gaussian curve was significantly decreased in heart failure patients compared with normal subjects (PGaussian curves (PGaussian curves (both PGaussian modeling, which should provide essential tools for further understanding the underlying physiological mechanisms of the artery pressure waveform.

  8. Multiplane magnetic resonance imaging of the heart and major vessels: studies in normal volunteers

    Energy Technology Data Exchange (ETDEWEB)

    Higgins, C.B.; Stark, D.; McNamara, M.; Lanzer, P.; Crooks, L.E.; Kaufman, L.

    1984-04-01

    The feasibility of magnetic resonance imaging for defining anatomy of internal cardiac structures and major blood vessels was assessed in 14 normal subjects. Both electrocardiogram-gated and standard spin-echo images were obtained. Gated images provided better visualization of internal cardiac morphology and of upper mediastinal vessels than did nongated images. Trabecular detail and components of the mitral valve could be resolved. All segments of the left ventricular wall could be evaluated by combining axial, coronal, and sagittal images. Gated acquisition of magnetic resonance images did not increase imaging time; five transverse slices of the left ventricle were obtained in 6.0-8.5 min. The good image quality, ease of gated acquisition, large field of view, capability of direct imaging in multiple planes, and noninvasiveness of the technique suggest that it will be an important imaging method in cardiovascular disease.

  9. Deletion of JAM-C, a candidate gene for heart defects in Jacobsen syndrome, results in a normal cardiac phenotype in mice.

    Science.gov (United States)

    Ye, Maoqing; Hamzeh, Rabih; Geddis, Amy; Varki, Nissi; Perryman, M Benjamin; Grossfeld, Paul

    2009-07-01

    The 11q terminal deletion disorder (11q-) is a rare chromosomal disorder caused by a deletion in distal 11q. Fifty-six percent of patients have clinically significant congenital heart defects. A cardiac "critical region" has been identified in distal 11q that contains over 40 annotated genes. In this study, we identify the distal breakpoint of a patient with a paracentric inversion in distal 11q who had hypoplastic left heart and congenital thrombocytopenia. The distal breakpoint mapped to JAM-3, a gene previously identified as a candidate gene for causing HLHS in 11q-. To determine the role of JAM-3 in cardiac development, we performed a comprehensive cardiac phenotypic assessment in which the mouse homolog for JAM-3, JAM-C, has been deleted. These mice have normal cardiac structure and function, indicating that haplo-insufficiency of JAM-3 is unlikely to cause the congenital heart defects that occur in 11q- patients. Notably, we identified a previously undescribed phenotype, jitteriness, in most of the sick or dying adult JAM-C knockout mice. These data provide further insights into the identification of the putative disease-causing cardiac gene(s) in distal 11q, as well as the functions of JAM-C in normal organ development.

  10. Acromegaly with Normal Insulin-Like Growth Factor-1 Levels and Congestive Heart Failure as the First Clinical Manifestation

    Directory of Open Access Journals (Sweden)

    Hyae Min Lee

    2015-09-01

    Full Text Available The leading cause of morbidity and mortality in patients with acromegaly is cardiovascular complications. Myocardial exposure to excessive growth hormone can cause ventricular hypertrophy, hypertension, arrhythmia, and diastolic dysfunction. However, congestive heart failure as a result of systolic dysfunction is observed only rarely in patients with acromegaly. Most cases of acromegaly exhibit high levels of serum insulin-like growth factor-1 (IGF-1. Acromegaly with normal IGF-1 levels is rare and difficult to diagnose. Here, we report a rare case of an acromegalic patient whose first clinical manifestation was severe congestive heart failure, despite normal IGF-1 levels. We diagnosed acromegaly using a glucose-loading growth hormone suppression test. Cardiac function and myocardial hypertrophy improved 6 months after transsphenoidal resection of a pituitary adenoma.

  11. Increased heart rate variability but normal resting metabolic rate in hypocretin/orexin-deficient human narcolepsy.

    NARCIS (Netherlands)

    Fronczek, R.; Overeem, S.; Reijntjes, R.; Lammers, G.J.; Dijk, J.G.M.; Pijl, H.

    2008-01-01

    STUDY OBJECTIVES: We investigated autonomic balance and resting metabolic rate to explore their possible involvement in obesity in hypocretin/orexin-deficient narcoleptic subjects. METHODS: Resting metabolic rate (using indirect calorimetry) and variability in heart rate and blood pressure were

  12. Evaluation of the Fetal Heart Rate during Amniocentesis in Fetuses with Normal and Abnormal Karyotype

    National Research Council Canada - National Science Library

    Marija Hadzi-Lega; Ana Daneva-Markova; Eva Sozovska

    2014-01-01

    Introduction. We monitored the fetal heart rate (FHR) during amniocentesis in fetuses at 16-22 weeks of gestation and investigated whether an abnormal FHR was associated with chromosomal abnormalities. Methods...

  13. Prostacyclins have no direct inotropic effect on isolated atrial strips from the normal and pressure-overloaded human right heart.

    Science.gov (United States)

    Holmboe, Sarah; Andersen, Asger; Jensen, Rebekka V; Kimose, Hans Henrik; Ilkjær, Lars B; Shen, Lei; Clapp, Lucie H; Nielsen-Kudsk, Jens Erik

    2017-01-01

    Prostacyclins are vasodilatory agents used in the treatment of pulmonary arterial hypertension. The direct effects of prostacyclins on right heart function are still not clarified. The aim of this study was to investigate the possible direct inotropic properties of clinical available prostacyclin mimetics in the normal and the pressure-overloaded human right atrium. Trabeculae from the right atrium were collected during surgery from chronic thromboembolic pulmonary hypertension (CTEPH) patients with pressure-overloaded right hearts, undergoing pulmonary thromboendarterectomy (n = 10) and from patients with normal right hearts operated by valve replacement or coronary bypass surgery (n = 9). The trabeculae were placed in an organ bath, continuously paced at 1 Hz. They were subjected to increasing concentrations of iloprost, treprostinil, epoprostenol, or MRE-269, followed by isoprenaline to elicit a reference inotropic response. The force of contraction was measured continuously. The expression of prostanoid receptors was explored through quantitative polymerase chain reaction (qPCR). Iloprost, treprostinil, epoprostenol, or MRE-269 did not alter force of contraction in any of the trabeculae. Isoprenaline showed a direct inotropic response in both trabeculae from the pressure-overloaded right atrium and from the normal right atrium. Control experiments on ventricular trabeculae from the pig failed to show an inotropic response to the prostacyclin mimetics. qPCR demonstrated varying expression of the different prostanoid receptors in the human atrium. In conclusion, prostacyclin mimetics did not increase the force of contraction of human atrial trabeculae from the normal or the pressure-overloaded right heart. These data suggest that prostacyclin mimetics have no direct inotropic effects in the human right atrium.

  14. Hierarchical Structure of Heart Rate Variability in Humans

    Science.gov (United States)

    Gao, X. Z.; Ching, E. S. C.; Lin, D. C.

    2004-03-01

    We show a hierarchical structure (HS) of the She-Leveque form in the beat-to-beat RR intervals of heart rate variability (HRV) in humans. This structure, first found as an empirical law in turbulent fluid flows, implies further details in the HRV multifractal scaling. We tested HS using daytime RRi data from healthy subjects and heart diseased patients with congestive heart failure and found a universal law C(b) where b characterizes the multifractality of HRV and C is related to a co-dimension parameter of the most violent events in the fluctuation. The potential of diagnosis is discussed based on the characteristics of this finding. To model the HRV phenomenology, we propose a local-feedback-global-cascade (LFGC) model based on the She-Waymire (SW) cascade solution to the HS in fluid turbulence. This model extends from the previous work in that it integrates additive law multiplicatively into the cascade structure. It is an attempt to relate to the cardiovascular physiology which consists of numerous feedback controls that function primarily on the principle of additive law. In particular, the model is based on the same philosophy as the SW cascade that its multifractal dynamics consists of a singular and a modulating component. In the LFGC model, we introduce local feedback to model the dynamics of the modulating effect. The novelty of our model is to incorporate the cascade structure in the scheduling for the feedback control. This model also represents an alternative solution to the HS. We will present the simulation results by the LFGC model and discuss its implication in physiology terms.

  15. Early fetal echocardiography: heart biometry and visualization of cardiac structures between 10 and 15 weeks' gestation.

    Science.gov (United States)

    Smrcek, Jan Michael; Berg, Christoph; Geipel, Annegret; Fimmers, Rolf; Diedrich, Klaus; Gembruch, Ulrich

    2006-02-01

    The purpose of this prospective cross-sectional study was to compile normative data about biometry of the fetal heart and great vessels between 10 and 15 weeks in 123 normal singleton pregnancies. Additionally, we investigated the different methods and the optimal examination time of early fetal echocardiography. The interrogated parameters included total heart diameter; heart area and circumference; right and left ventricular diameter; diameter, circumference, and area of the thorax; and diameter of the aorta and pulmonary trunk. Visualization of the 4-chamber view, 3-vessel view, origin and crossover of the great arteries, aortic arch, ductus arteriosus, superior and inferior venae cavae, and pulmonary veins was analyzed, and the success rates by transvaginal sonography (TVS) and transabdominal sonography (TAS) were calculated. Complete evaluation of the fetal heart was impossible at 10 weeks; the total success rate increased from 45% at 11 weeks to 90% between 12 and 14 weeks and 100% at 15 weeks. Between 10 and 13 weeks, TVS was superior to TAS. At 14 weeks, both methods were similar to each other, and at 15 weeks, TAS allowed adequate visualization of all structures. Linear regression analysis showed a significant correlation between the interrogated parameters and gestational age, crown-rump length, and biparietal diameter (P cardiac defects in early pregnancy.

  16. Prenatal exposure to thyroid hormone is necessary for normal postnatal development of murine heart and lungs

    NARCIS (Netherlands)

    van Tuyl, Minke; Blommaart, Pietjan E.; de Boer, Piet A. J.; Wert, Susan E.; Ruijter, Jan M.; Islam, Saleem; Schnitzer, Jay; Ellison, Aaron R.; Tibboel, Dick; Moorman, Antoon F. M.; Lamers, Wouter H.

    2004-01-01

    Maternal hypothyroxinemia during early pregnancy poses an increased risk for poor neuropsychological development of the fetus. We tested the hypothesis that maternal hypothyroidism before the onset of fetal thyroid function also affects postnatal development of heart and lungs. This question was

  17. Structural valve deterioration in the Mitroflow biological heart valve prosthesis

    DEFF Research Database (Denmark)

    Issa, Issa Farah; Poulsen, Steen Hvitfeldt; Waziri, Farhad

    2018-01-01

    OBJECTIVES: Concern has been raised regarding the long-term durability of the Mitroflow biological heart valve prosthesis. Our aim was to assess the incidence of structural valve degeneration (SVD) for the Mitroflow bioprosthesis in a nationwide study in Denmark including all patients alive...... in Denmark who had received a Mitroflow aortic bioprosthesis since 2000. METHODS: Patients alive in Denmark with a Mitroflow bioprosthesis implanted since January 2000 were invited to participate in a nationwide cross-sectional study with a predefined definition of SVD. Of 1552 patients, 861 patients had...

  18. Drug effects on functional structures in isolated perfused pig heart

    Science.gov (United States)

    Trinks, Tobias; Rauh, Robert; Hiller, Michael; Kessler, Manfred D.

    2002-06-01

    Until today monitoring of immediate drug tissue interaction in living organs is an unsolved problem. However, for the development of new drugs and the improvement of medical therapy outcome it would be helpful to get new tools to visualize drug effects on tissue directly. With the EMPHO II SSK and a 3D-scanning device we detected changes of functional structures in an isolated perfused pig heart model after adding commonly used drugs like verapamil, nitroglycerin and salviae miltiorrhizae (Chinese herbal drug). In the paper the results are presented.

  19. Recurrent Pneumonia and a Normal Heart: Late Complication after Repair of Hemianomalous Pulmonary Venous Drainage—A Cautionary Tale

    Directory of Open Access Journals (Sweden)

    Maryanne Caruana

    2010-01-01

    Full Text Available Hemianomalous pulmonary venous drainage with intact atrial septum is a rare congenital anomaly and reports of its surgical repair and the long-term complications related to the correction are only infrequently encountered in the literature. We report the case of a patient with hemianomalous pulmonary venous drainage and intact atrial septum who underwent surgical repair using a pericardial baffle and creation of an “atrial septal defect” aged 15 years. Dyspnoea and recurrent chest infections started 7 months after surgery when he was seen by a respiratory physician without cardiac followup. He presented again aged 28 years with a recurrent pneumonia investigated over 6 weeks and heart pronounced normal from examination and echocardiography. Correct diagnosis was made in Grown Up Congenital Heart (GUCH clinic stimulating review of data and catheterisation with pulmonary artery angiography which confirmed it. We feel that this case highlights the importance of specialist care and followup for GUCH patients.

  20. Comparison at Necropsy of Heart Weight in Women Aged 20 to 29 Years With Fatal Trauma or Chemical Intoxication Versus Fatal Natural Cause (A Search for the Normal Adult Heart Weight).

    Science.gov (United States)

    Blackbourne, Brian D; Vasudevan, Anupama; Roberts, William C

    2017-03-01

    The present obesity epidemic makes determining the normal heart weight in adults difficult. This study examines the heart weight at autopsy in 104 women aged 20 to 29 years who died in 1978 to 1980 before the overweight epidemic ensued. Of the 104 cases, the hearts weighed ≤300 g in 86 (83%) and >300 g in 18 (17%). Of the 67 cases dying from an unnatural cause (trauma or chemical intoxication), only 3 (4%) had hearts weighing >300 g; of the 37 patients dying from a variety of natural causes, 15 (41%) had hearts weighing >300 g (p hearts in them ranged from 120 to 400 g (mean 262 ± 51; median 257 g); of the 22 cases (21%) in whom the BMI was >25 kg/m2, the hearts ranged from 230 to 850 g (mean 351 ± 142; median 300 g). In conclusion, the cases dying from an unnatural cause had smaller mean heart weights than those women dying from a natural cause and those with a normal BMI (≤25 kg/m2) had smaller mean heart weights than those with a BMI >25 kg/m2. The normal heart weight in young women dying from an unnatural cause with few exceptions is <300 g. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. MRI cross sectional atlas of normal canine cervical musculoskeletal structure

    OpenAIRE

    Alizadeh, M.; Zindl, Claudia; Allen, Matthew James; Knapik, GG; FItzpatrick, N; Marras, WS

    2016-01-01

    Although magnetic resonance imaging (MRI) has been increasingly used as a diagnostic tool for cervical spine injuries in canines, a comprehensive normal MRI anatomy of the canine cervical spine muscles is lacking. Therefore, the purpose of this study was to build a magnetic resonance imaging atlas of the normal cross sectional anatomy of the muscles of the canine cervical spine. MRI scans were performed on a canine cadaver using a combination of T1 and T2-weighted images in the transverse, sa...

  2. Characterization of mitochondria isolated from normal and ischemic hearts in rats utilizing atomic force microscopy.

    Science.gov (United States)

    Lee, Gi-Ja; Chae, Su-Jin; Jeong, Jae Hoon; Lee, So-Ra; Ha, Sang-Jin; Pak, Youngmi Kim; Kim, Weon; Park, Hun-Kuk

    2011-04-01

    Mitochondria play critical roles in both the life and the death of cardiac myocytes. Various factors, such as the loss of ATP synthesis and increase of ATP hydrolysis, impairment in ionic homeostasis, formation of reactive oxygen species (ROS), and release of proapoptotic proteins are related to the generation of irreversible damage. It has been proposed that the release of cytochrome c is caused by a swelling of the mitochondrial matrix triggered by the apoptotic stimuli. However, there is a controversy about whether or not the mitochondria, indeed, swell during apoptosis. The major advantages of atomic force microscopy (AFM) over conventional optical and electron microscopes for bio-imaging include the fact that no special coating and vacuum are required and imaging can be done in all environments--air, vacuum or aqueous conditions. In addition, AFM force-distance curve measurements have become a fundamental tool in the fields of surface chemistry, biochemistry, and material science. In this study, we used AFM to observe the morphological and property changes in heart mitochondria that were isolated from a rat myocardial infarction model. From the shape parameters of the mitochondria in the AFM topographic image, it seemed that myocardial infarction caused the mitochondrial swelling. Also, the results of force-distance measurements showed that the adhesion force of heart mitochondria was significantly decreased by myocardial in infarction. Therefore, we suggested that myocardial infarction might be the cause of mitochondrial swelling and the changes in outer membrane of heart mitochondria. © 2010 Elsevier Ltd. All rights reserved.

  3. EFFECT OF MITRAL REGURGITATION ON CHRONIC HEART FAILURE COURSE AND STRUCTURE-FUNCTIONAL HEART STATE

    Directory of Open Access Journals (Sweden)

    V. N. Larina

    2016-01-01

    Full Text Available Aim. To evaluate chronic heart failure (CHF course, functional and structural heart changes in patients with functional mitral regurgitation (MR of various degrees.Material and methods. A total of 104 outpatients (60-85 y. o. with CHF of functional class II-IV by NYHA and functional MR of I-II degrees and MR of III-IV degrees were included into the study groups.Results: Patients in both groups were comparable in sex, age, CHF duration, body mass index, systolic and diastolic blood pressure, clinical state by the clinical state scale, quality of life, anxious and depressive status. The majority of patients with MR III had significant left ventricle (LV systolic dysfunction (p=0,029, severe CHF course (p=0,034, received furosemide (p=0.004 and digoxin (p=0,004. They had significant increase in end-diastolic dimension (p<0,001, end-systolic dimension (p<0,001, left atrium (p=0,004, end-diastolic volume (p<0,001, end-systolic volume (p<0,001, pulmonary artery pressure (p<0,001, decrease in LV relative wall thickness (p=0,021 and LV ejection fraction (p<0,001. Patients of this group were hospitalized because of CHF decompensation and ischemic heart disease exacerbation more often (p=0,045.Conclusion. MR can be considered as one of sensitive predictors of LV geometry and function alteration in CHF patients and play an important role in symptoms development.

  4. EFFECT OF MITRAL REGURGITATION ON CHRONIC HEART FAILURE COURSE AND STRUCTURE-FUNCTIONAL HEART STATE

    Directory of Open Access Journals (Sweden)

    V. N. Larina

    2009-01-01

    Full Text Available Aim. To evaluate chronic heart failure (CHF course, functional and structural heart changes in patients with functional mitral regurgitation (MR of various degrees.Material and methods. A total of 104 outpatients (60-85 y. o. with CHF of functional class II-IV by NYHA and functional MR of I-II degrees and MR of III-IV degrees were included into the study groups.Results: Patients in both groups were comparable in sex, age, CHF duration, body mass index, systolic and diastolic blood pressure, clinical state by the clinical state scale, quality of life, anxious and depressive status. The majority of patients with MR III had significant left ventricle (LV systolic dysfunction (p=0,029, severe CHF course (p=0,034, received furosemide (p=0.004 and digoxin (p=0,004. They had significant increase in end-diastolic dimension (p<0,001, end-systolic dimension (p<0,001, left atrium (p=0,004, end-diastolic volume (p<0,001, end-systolic volume (p<0,001, pulmonary artery pressure (p<0,001, decrease in LV relative wall thickness (p=0,021 and LV ejection fraction (p<0,001. Patients of this group were hospitalized because of CHF decompensation and ischemic heart disease exacerbation more often (p=0,045.Conclusion. MR can be considered as one of sensitive predictors of LV geometry and function alteration in CHF patients and play an important role in symptoms development.

  5. Polarized spatial frequency domain imaging of heart valve fiber structure

    Science.gov (United States)

    Goth, Will; Yang, Bin; Lesicko, John; Allen, Alicia; Sacks, Michael S.; Tunnell, James W.

    2016-03-01

    Our group previously introduced Polarized Spatial Frequency Domain Imaging (PSFDI), a wide-field, reflectance imaging technique which we used to empirically map fiber direction in porcine pulmonary heart valve leaflets (PHVL) without optical clearing or physical sectioning of the sample. Presented is an extended analysis of our PSFDI results using an inverse Mueller matrix model of polarized light scattering that allows additional maps of fiber orientation distribution, along with instrumentation permitting increased imaging speed for dynamic PHVL fiber measurements. We imaged electrospun fiber phantoms with PSFDI, and then compared these measurements to SEM data collected for the same phantoms. PHVL was then imaged and compared to results of the same leaflets optically cleared and imaged with small angle light scattering (SALS). The static PHVL images showed distinct regional variance of fiber orientation distribution, matching our SALS results. We used our improved imaging speed to observe bovine tendon subjected to dynamic loading using a biaxial stretching device. Our dynamic imaging experiment showed trackable changes in the fiber microstructure of biological tissue under loading. Our new PSFDI analysis model and instrumentation allows characterization of fiber structure within heart valve tissues (as validated with SALS measurements), along with imaging of dynamic fiber remodeling. The experimental data will be used as inputs to our constitutive models of PHVL tissue to fully characterize these tissues' elastic behavior, and has immediate application in determining the mechanisms of structural and functional failure in PHVLs used as bio-prosthetic implants.

  6. Target heart rate to determine the normal value of coronary flow reserve during dobutamine stress echocardiography

    Directory of Open Access Journals (Sweden)

    Rousse Maria G

    2011-04-01

    Full Text Available Abstract Background The determination of coronary flow reserve (CFR is an essential concept at the moment of decision-making in ischemic heart disease. There are several direct and indirect tests to evaluate this parameter. In this sense, dobutamine stress echocardiography is one of the pharmacological method most commonly used worldwide. It has been previously demonstrated that CFR can be determined by this technique. Despite our wide experience with dobutamine stress echocardiography, we ignored the necessary heart rate to consider sufficient the test for the analysis of CFR. For this reason, our main goal was to determine the velocity of coronary flow in each stage of dobutamine stress echocardiography and the heart rate value necessary to double the baseline values of coronary flow velocity in the territory of the left anterior descending (LAD coronary artery. Methods A total of 33 consecutive patients were analyzed. The patients included had low risk for coronary artery disease. All the participants underwent dobutamine stress echocardiography and coronary artery flow velocity was evaluated in the distal segment of LAD coronary artery using transthoracic color-Doppler echocardiography. Results The feasibility of determining CFR in the territory of the LAD during dobutamine stress echocardiography was high: 31/33 patients (94%. Mean CFR was 2.67 at de end of dobutamine test. There was an excellent concordance between delta HR (difference between baseline HR and maximum HR and the increase in the CFR (correlation coefficient 0.84. In this sense, we found that when HR increased by 50 beats, CFR was ≥ 2 (CI 93-99.2%. In addition, 96.4% of patients reached a CFR ≥ 2 (IC 91.1 - 99% at 75% of their predicted maximum heart rate. Conclusions We found that the feasibility of dobutamine stress echocardiography to determine CFR in the territory of the LAD coronary artery was high. In this study, it was necessary to achieve a difference of 50 bpm

  7. Electrophysiological and structural remodeling in heart failure modulate arrhythmogenesis. 2D simulation study.

    Directory of Open Access Journals (Sweden)

    Juan F Gomez

    Full Text Available Heart failure is operationally defined as the inability of the heart to maintain blood flow to meet the needs of the body and it is the final common pathway of various cardiac pathologies. Electrophysiological remodeling, intercellular uncoupling and a pro-fibrotic response have been identified as major arrhythmogenic factors in heart failure.In this study we investigate vulnerability to reentry under heart failure conditions by incorporating established electrophysiological and anatomical remodeling using computer simulations.The electrical activity of human transmural ventricular tissue (5 cm × 5 cm was simulated using the human ventricular action potential model Grandi et al. under control and heart failure conditions. The MacCannell et al. model was used to model fibroblast electrical activity, and their electrotonic interactions with myocytes. Selected degrees of diffuse fibrosis and variations in intercellular coupling were considered and the vulnerable window (VW for reentry was evaluated following cross-field stimulation.No reentry was observed in normal conditions or in the presence of HF ionic remodeling. However, defined amount of fibrosis and/or cellular uncoupling were sufficient to elicit reentrant activity. Under conditions where reentry was generated, HF electrophysiological remodeling did not alter the width of the VW. However, intermediate fibrosis and cellular uncoupling significantly widened the VW. In addition, biphasic behavior was observed, as very high fibrotic content or very low tissue conductivity hampered the development of reentry. Detailed phase analysis of reentry dynamics revealed an increase of phase singularities with progressive fibrotic components.Structural remodeling is a key factor in the genesis of vulnerability to reentry. A range of intermediate levels of fibrosis and intercellular uncoupling can combine to favor reentrant activity.

  8. Prenatal exposure to thyroid hormone is necessary for normal postnatal development of murine heart and lungs.

    Science.gov (United States)

    van Tuyl, Minke; Blommaart, Pietjan E; de Boer, Piet A J; Wert, Susan E; Ruijter, Jan M; Islam, Saleem; Schnitzer, Jay; Ellison, Aaron R; Tibboel, Dick; Moorman, Antoon F M; Lamers, Wouter H

    2004-08-01

    Maternal hypothyroxinemia during early pregnancy poses an increased risk for poor neuropsychological development of the fetus. We tested the hypothesis that maternal hypothyroidism before the onset of fetal thyroid function also affects postnatal development of heart and lungs. This question was addressed in transgenic mice that express herpes simplex virus thymidine kinase in their thyroidal follicle cells. Treatment with ganciclovir rendered these mice severely hypothyroid because viral thymidine kinase converts ganciclovir into a cytotoxic nucleoside analog. Since ganciclovir crosses the placenta, it also destroyed the thyroid of transgenic embryos while leaving the thyroids of nontransgenic littermates unaffected. Hypothyroidism of both mother and fetus did not affect prenatal heart and lung development. However, the postnatal switch from beta- to alpha-myosin heavy chain (beta- and alpha-MHC, respectively) gene expression and the increase of SERCA-2a mRNA expression did not occur in the ventricular myocardium of either the transgenic (thyroid destroyed) or nontransgenic (intact thyroid) offspring of hypothyroid mothers. Similarly, postnatal animals of the latter two groups retained elevated surfactant protein (SP) A, B, and C mRNA levels in their alveolar epithelium. In hypothyroid pups from hypothyroid mothers, these changes were accompanied by decreased alveolar septation. Our study shows that these effects of maternal hypothyroidism become manifest after birth and are aggravated by the concomitant existence of neonatal hypothyroidism.

  9. Normal 123 I-MIBG uptake areas may be associated with hyperinnervation and arrhythmia risk in phenol model rabbit hearts.

    Science.gov (United States)

    Amino, Mari; Yoshioka, Koichiro; Tanaka, Sachie; Kawabe, Noboru; Kurosawa, Hiroyuki; Uchida, Keisuke; Oshikiri, Shinobu; Hashida, Tadashi; Kanda, Shigetaka; Inokuchi, Sadaki; Ikari, Yuji

    2017-10-01

    Iodine-123 metaiodobenzylguanidine (123 I-MIBG) is useful for detecting sympathetic innervation in the heart, and has been closely associated with fatal arrhythmias. However, such imaging is typically calibrated to the area of highest uptake and thus is unable to identify areas of hyperinnervation. We hypothesized that normal 123 I-MIBG uptake regions in the denervated heart would demonstrate nerve sprouting and correlate with the potential for arrhythmogenesis. Twenty New Zealand white rabbits treated with phenol or sham were prepared under anesthesia. Sympathetic innervation was quantified using autoradiography and immunostaining 4 weeks after phenol application, and electrophysiological study was performed. 123 I-MIBG revealed maximal local differences in isotope uptake in the border zone between areas with attenuated and abundant MIBG compared with that seen between adjacent regions within the lowest uptake areas. On immunostaining, heterogeneous and decreased expressions of growth-associated protein 43 signal were observed in the MIBG-attenuated areas; however, abundant signals were recognized in the MIBG-abundant areas. Upregulation of the tyrosine hydroxylase signal was observed at the part of the MIBG-abundant area. In electrophysiological study, the dispersion of activation recovery interval (ARI) was increased in the phenol-applied areas by norepinephrine infusion. Stellate stimulation exacerbated the ARI dispersion in both the phenol-applied and nonapplied areas, and was associated with increased inducibility of ventricular tachycardia and ventricular fibrillation. The presence of hyperinnervation in the nondenervated regions of denervated rabbit hearts suggests that heterogeneous neural remodeling occurs in regions with seemingly normal 123 I-MIBG uptake and contributes to electrical instability. © 2017 Wiley Periodicals, Inc.

  10. Vascular endothelium derived endothelin-1 is required for normal heart function after chronic pressure overload in mice.

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    Susi Heiden

    Full Text Available BACKGROUND: Endothelin-1 participates in the pathophysiology of heart failure. The reasons for the lack of beneficial effect of endothelin antagonists in heart failure patients remain however speculative. The anti-apoptotic properties of ET-1 on cardiomyocytes could be a reasonable explanation. We therefore hypothesized that blocking the pro-apoptotic TNF-α pathway using pentoxifylline could prevent the deleterious effect of the lack of ET-1 in a model for heart failure. METHODS: We performed transaortic constriction (TAC in vascular endothelial cells specific ET-1 deficient (VEETKO and wild type (WT mice (n = 5-9 and treated them with pentoxifylline for twelve weeks. RESULTS: TAC induced a cardiac hypertrophy in VEETKO and WT mice but a reduction of fractional shortening could be detected by echocardiography in VEETKO mice only. Cardiomyocyte diameter was significantly increased by TAC in VEETKO mice only. Pentoxifylline treatment prevented cardiac hypertrophy and reduction of fractional shortening in VEETKO mice but decreased fractional shortening in WT mice. Collagen deposition and number of apoptotic cells remained stable between the groups as did TNF-α, caspase-3 and caspase-8 messenger RNA expression levels. TAC surgery enhanced ANP, BNP and bcl2 expression. Pentoxifylline treatment reduced expression levels of BNP, bcl2 and bax. CONCLUSIONS: Lack of endothelial ET-1 worsened the impact of TAC-induced pressure overload on cardiac function, indicating the crucial role of ET-1 for normal cardiac function under stress. Moreover, we put in light a TNF-α-independent beneficial effect of pentoxifylline in the VEETKO mice suggesting a therapeutic potential for pentoxifylline in a subpopulation of heart failure patients at higher risk.

  11. Thyroid Function Within the Normal Range and Risk of Coronary Heart Disease

    DEFF Research Database (Denmark)

    Åsvold, Bjørn O; Vatten, Lars J; Bjøro, Trine

    2015-01-01

    documented, but conflicting evidence suggests that thyrotropin levels in the upper part of the reference range may be associated with an increased risk of coronary heart disease (CHD). OBJECTIVE: To assess the association between differences in thyroid function within the reference range and CHD risk. DESIGN...... known thyroid or cardiovascular disease at baseline. EXPOSURES: Thyroid function as expressed by serum thyrotropin levels at baseline. MAIN OUTCOMES AND MEASURES: Hazard ratios (HRs) of CHD mortality and CHD events according to thyrotropin levels after adjustment for age, sex, and smoking status....... RESULTS: Among 55 412 individuals, 1813 people (3.3%) died of CHD during 643 183 person-years of follow-up. In 10 cohorts with information on both nonfatal and fatal CHD events, 4666 of 48 875 individuals (9.5%) experienced a first-time CHD event during 533 408 person-years of follow-up. For each 1-m...

  12. Preconditioning Filter Bank Decomposition Using Structured Normalized Tight Frames

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    Martin Ehler

    2015-01-01

    Full Text Available We turn a given filter bank into a filtering scheme that provides perfect reconstruction, synthesis is the adjoint of the analysis part (so-called unitary filter banks, all filters have equal norm, and the essential features of the original filter bank are preserved. Unitary filter banks providing perfect reconstruction are induced by tight generalized frames, which enable signal decomposition using a set of linear operators. If, in addition, frame elements have equal norm, then the signal energy is spread through the various filter bank channels in some uniform fashion, which is often more suitable for further signal processing. We start with a given generalized frame whose elements allow for fast matrix vector multiplication, as, for instance, convolution operators, and compute a normalized tight frame, for which signal analysis and synthesis still preserve those fast algorithmic schemes.

  13. Echocardiography of the normal camel (Camelus dromedaries heart: technique and cardiac dimensions

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    Tharwat Mohamed

    2012-08-01

    Full Text Available Abstract Background Echocardiography and intra-cardiac dimensions have not previously been reported in adult camels despite its potential application for medical purpose. The aim of this study was to describe the results of a prospective study, aiming to report normal cardiac appearance and normal chamber dimensions in adult camels (Camelus dromedarius. Results On the right side, when the probe was placed in the 5th or 4th intercostal space (ICS, the caudal long-axis four-chamber view of the ventricles, atria, and the interventricular septum was obtained. Placing the probe slightly more cranially in the 4th ICS, the caudal long-axis four-chamber view and the caudal long-axis view of the left ventricular outflow tract (LVOT were imaged. In 7 camels, a hybrid view between a “four-chamber” and “LVOT view” was imaged from the same position. The short-axis view of the ventricles was obtained in the 4th ICS where the transducer was rotated between 0° and 25°. Placement of the transducer in the 3rd ICS allowed visualisation of the right ventricular outflow tract (RVOT. On the left side, when the probe was placed in the 5th or 4th ICS, a four-chamber view was obtained. The LVOT is imaged in the 4th ICS and the RVOT was seen from the 3rd ICS. Conclusions This study showed that it is possible to obtain good-quality echocardiograms in adult camels and provide normal cardiac dimensions. This study could be used as a reference for further studies concerning camels with cardiac diseases.

  14. Effects of GUASHA on Heart Rate Variability in Healthy Male Volunteers under Normal Condition and Weightlifters after Weightlifting Training Sessions

    Directory of Open Access Journals (Sweden)

    Xingze Wang

    2015-01-01

    Full Text Available Objectives. This paper aims at exploring the effects of GUASHA on heart rate variability between healthy volunteers under normal condition and weightlifters after training sessions. Methods. Ten healthy male volunteers under normal condition and 15 male weightlifters after weightlifting training sessions were recruited into two groups. Electrocardiography was recorded before and immediately after 20-minute GUASHA. HRV was calculated in both the time domain and the frequency domain. Results. Stress index was reduced, while standard deviation of N-N intervals (SDNN, proportion derived by dividing the number of interval differences of successive N-N intervals greater than 50 ms, and root mean square of successive differences (RMSSD were enhanced after GUASHA therapy in the two groups. The changes in SDNN and RMSSD were higher in the healthy men group than in the weightlifters group. In addition, low frequency was decreased whereas high frequency was significantly increased in healthy men after the GUASHA session. Conclusions. GUASHA therapy facilitates the parasympathetic nervous activity and modulates the balance between parasympathetic and sympathetic activities in both healthy men under normal condition and weightlifters after training sessions as indicated. Although the changes of the HRV parameters were similar in both groups, the responsiveness was more pronounced in healthy men than in male weightlifters.

  15. Clinical Updates in Women's Health Care Summary: Structural Heart Disease: Primary and Preventive Care Review.

    Science.gov (United States)

    Frisoli, Tiberio; Voeltz, Michele Doughty

    2017-03-01

    Reproductive-aged women with structural heart disease who become pregnant as well as postreproductive-aged women with this condition represent a significant proportion of patients seen by obstetrician- gynecologists. Usually, their conditions are complex, and a basic knowledge of the anatomy and physiology of the heart is required. Additionally, understanding the effect of pregnancy on women with structural heart disease is critically important to optimizing maternal and fetal outcomes. This monograph addresses the pathophysiology, signs and symptoms, screening and diagnosis, basic management, and suggested counseling for an obstetric-gynecologic patient with structural heart disease.

  16. Israel: coronary and structural heart interventions from 2010 to 2015.

    Science.gov (United States)

    Finkelstein, Ariel; Minha, Saar; Kornowski, Ran; Danenberg, Haim; Banai, Shmuel; Lotan, Haim; Segev, Amit; Barbash, Israel M

    2017-05-15

    The Israel Heart Society is a member of the European Society of Cardiology, and the Israeli Working Group of Interventional Cardiology is an active participant in EAPCI. The aim of this manuscript is to provide a snapshot of cardiac interventions performed in the State of Israel during the period 2010-2015. Data for this manuscript were collected via collaboration with the National Diseases Registries Unit of the Israel Center for Disease Control. During the survey period, the Israeli population increased by 7% but only one additional hospital with an active cardiac catheterisation laboratory was opened. The vast majority of the percutaneous procedures are performed in public hospital settings. Total coronary angiography procedures remained stable throughout the survey period, and the percentage of PCI out of total coronary angiography procedures remained approximately 50% throughout the survey period. More than 90% of the PCI procedures were performed using stent deployment, and the use of drug-eluting stents increased significantly during the survey period from 46% in 2010 to 92% in 2015. The number of TAVI procedures increased dramatically, by more than sixfold, from 130 procedures in 2010 to 851 procedures in 2015 (with 130 implants/million population at Q4 of 2015). The vast majority of interventional cardiology procedures are funded by the governmental healthcare providers, and all the citizens of the country have access to the most advanced cardiac interventions. If corrected for the increase in the population, the volumes of coronary interventions are decreasing throughout the country. However, structural heart disease interventions, and specifically valvular interventions, are growing rapidly and this trend is expected to continue in the near future.

  17. Comparative normal/failing rat myocardium cell membrane chromatographic analysis system for screening specific components that counteract doxorubicin-induced heart failure from Acontium carmichaeli.

    Science.gov (United States)

    Chen, Xiaofei; Cao, Yan; Zhang, Hai; Zhu, Zhenyu; Liu, Min; Liu, Haibin; Ding, Xuan; Hong, Zhanying; Li, Wuhong; Lv, Diya; Wang, Lirong; Zhuo, Xianyi; Zhang, Junping; Xie, Xiang-Qun; Chai, Yifeng

    2014-05-20

    Cell membrane chromatography (CMC) derived from pathological tissues is ideal for screening specific components acting on specific diseases from complex medicines owing to the maximum simulation of in vivo drug-receptor interactions. However, there are no pathological tissue-derived CMC models that have ever been developed, as well as no visualized affinity comparison of potential active components between normal and pathological CMC columns. In this study, a novel comparative normal/failing rat myocardium CMC analysis system based on online column selection and comprehensive two-dimensional (2D) chromatography/monolithic column/time-of-flight mass spectrometry was developed for parallel comparison of the chromatographic behaviors on both normal and pathological CMC columns, as well as rapid screening of the specific therapeutic agents that counteract doxorubicin (DOX)-induced heart failure from Acontium carmichaeli (Fuzi). In total, 16 potential active alkaloid components with similar structures in Fuzi were retained on both normal and failing myocardium CMC models. Most of them had obvious decreases of affinities on failing myocardium CMC compared with normal CMC model except for four components, talatizamine (TALA), 14-acetyl-TALA, hetisine, and 14-benzoylneoline. One compound TALA with the highest affinity was isolated for further in vitro pharmacodynamic validation and target identification to validate the screen results. Voltage-dependent K(+) channel was confirmed as a binding target of TALA and 14-acetyl-TALA with high affinities. The online high throughput comparative CMC analysis method is suitable for screening specific active components from herbal medicines by increasing the specificity of screened results and can also be applied to other biological chromatography models.

  18. American Heart Association’s Life’s Simple 7: Avoiding Heart Failure and Preserving Cardiac Structure and Function

    Science.gov (United States)

    Folsom, Aaron R.; Shah, Amil M.; Lutsey, Pamela L.; Roetker, Nicholas S.; Alonso, Alvaro; Avery, Christy L.; Miedema, Michael D.; Konety, Suma; Chang, Patricia P.; Solomon, Scott D.

    2015-01-01

    BACKGROUND Many people may underappreciate the role of lifestyle in avoiding heart failure. We estimated whether greater adherence in middle age to American Heart Association’s Life’s Simple 7 guidelines -- on smoking, body mass, physical activity, diet, cholesterol, blood pressure, and glucose -- is associated with lower lifetime risk of heart failure and greater preservation of cardiac structure and function in old age. METHODS We studied the population-based Atherosclerosis Risk in Communities Study cohort of 13,462 adults aged 45-64 years in 1987-89. From the 1987-89 risk factor measurements, we created a Life’s Simple 7 score (range 0-14, giving 2 points for ideal, 1 point for intermediate, and 0 points for poor components). We identified 2,218 incident heart failure events using surveillance of hospital discharge and death codes through 2011. In addition, in 4,855 participants free of clinical cardiovascular disease in 2011-13, we performed echocardiography from which we quantified left ventricular hypertrophy and diastolic dysfunction. RESULTS One in four participants (25.5%) developed heart failure through age 85. Yet, this lifetime heart failure risk was 14.4% for those with a middle-age Life’s Simple 7 score of 10-14 (optimal), 26.8% for a score of 5-9 (average), and 48.6% for a score of 0-4 (inadequate). Among those with no clinical cardiovascular event, the prevalence of left ventricular hypertrophy in late life was approximately 40% as common, and diastolic dysfunction was approximately 60% as common, among those with an optimal middle-age Life’s Simple 7 score compared with an inadequate score. CONCLUSIONS Greater achievement of American Heart Association’s Life’s Simple 7 in middle-age is associated with a lower lifetime occurrence of heart failure and greater preservation of cardiac structure and function. PMID:25908393

  19. Normal dose of pilsicainide showed marked negative inotropic effects in a patient who had no underlying heart disease

    Directory of Open Access Journals (Sweden)

    Masayoshi Yoshida, MD

    2014-02-01

    Full Text Available We report the case of an otherwise healthy 64-year-old female who developed cardiopulmonary arrest after the administration of pilsicainide for treatment of paroxysmal atrial fibrillation. She had had an episode of paroxysmal atrial fibrillation, but no liver dysfunction, renal dysfunction, or echocardiographic abnormality before her admission. On the day of admission and the following day, 50 mg of pilsicainide was administered intravenously over 10 min (total 100 mg. Shortly after the second injection, she developed marked bradycardia and hypotension and eventually fell into a state of pulseless electrical activity. Immediate cardiopulmonary resuscitation was started. Although application of a temporary pacemaker restored her heart rate, echocardiography revealed no left ventricular contraction. We started percutaneous cardiopulmonary support (PCPS and intra-aortic balloon pumping (IABP. Her cardiac contraction gradually recovered and returned to completely normality 3 days after the onset. The patient was discharged in an ambulatory condition.

  20. Long-term effect of continuing sports activity in competitive athletes with frequent ventricular premature complexes and apparently normal heart.

    Science.gov (United States)

    Delise, Pietro; Sitta, Nadir; Lanari, Emanuela; Berton, Giuseppe; Centa, Monica; Allocca, Giuseppe; Cati, Arianna; Biffi, Alessandro

    2013-11-01

    The long-term outcome of athletes with frequent ventricular premature complexes (VPCs) and apparently normal heart has not been fully clarified. To evaluate the clinical and prognostic significance of VPCs and the influence of continuing sports activity during follow-up, we studied 120 healthy athletes (96 men; median age 16 years) in whom frequent VPCs (>100 VPCs/24 hours) were discovered by chance during preparticipation screening. All athletes were followed up for a median of 84 months. During follow-up, 96 underwent serial 24-hour Holter recording and 62 underwent serial echocardiography. The median number of VPCs/24 hours on basal Holter was 3,760. During follow-up, 81 athletes continued sports activity, whereas 39 did not. No athlete died or developed overt heart disease. The median number of VPCs/24 hours decreased in both athletes who continued sports activity and those who did not (from 3,805 to 1,124, p sporting activity does not modify this benign outcome, (3) during follow-up, the burden of VPCs decreases whether or not subjects continue sports activity, and (4) in 14.5% of athletes, ejection fraction slightly decreases over time. Copyright © 2013 The Authors. Published by Elsevier Inc. All rights reserved.

  1. Classification of caesarean section and normal vaginal deliveries using foetal heart rate signals and advanced machine learning algorithms.

    Science.gov (United States)

    Fergus, Paul; Hussain, Abir; Al-Jumeily, Dhiya; Huang, De-Shuang; Bouguila, Nizar

    2017-07-06

    Visual inspection of cardiotocography traces by obstetricians and midwives is the gold standard for monitoring the wellbeing of the foetus during antenatal care. However, inter- and intra-observer variability is high with only a 30% positive predictive value for the classification of pathological outcomes. This has a significant negative impact on the perinatal foetus and often results in cardio-pulmonary arrest, brain and vital organ damage, cerebral palsy, hearing, visual and cognitive defects and in severe cases, death. This paper shows that using machine learning and foetal heart rate signals provides direct information about the foetal state and helps to filter the subjective opinions of medical practitioners when used as a decision support tool. The primary aim is to provide a proof-of-concept that demonstrates how machine learning can be used to objectively determine when medical intervention, such as caesarean section, is required and help avoid preventable perinatal deaths. This is evidenced using an open dataset that comprises 506 controls (normal virginal deliveries) and 46 cases (caesarean due to pH ≤ 7.20-acidosis, n = 18; pH > 7.20 and pH machine-learning algorithms are trained, and validated, using binary classifier performance measures. The findings show that deep learning classification achieves sensitivity = 94%, specificity = 91%, Area under the curve = 99%, F-score = 100%, and mean square error = 1%. The results demonstrate that machine learning significantly improves the efficiency for the detection of caesarean section and normal vaginal deliveries using foetal heart rate signals compared with obstetrician and midwife predictions and systems reported in previous studies.

  2. Decrease in heart rate variability response to task is related to anxiety and depressiveness in normal subjects.

    Science.gov (United States)

    Shinba, Toshikazu; Kariya, Nobutoshi; Matsui, Yasue; Ozawa, Nobuyuki; Matsuda, Yoshiki; Yamamoto, Ken-Ichi

    2008-10-01

    Previous studies have shown that heart rate variability (HRV) measurement is useful in investigating the pathophysiology of various psychiatric disorders. The present study further examined its usefulness in evaluating the mental health of normal subjects with respect to anxiety and depressiveness. Heart rate (HR) and HRV were measured tonometrically at the wrist in 43 normal subjects not only in the resting condition but also during a task (random number generation) to assess the responsiveness. For HRV measurement, high-frequency (HF; 0.15-0.4 Hz) and low-frequency (LF; 0.04-0.15 Hz) components of HRV were obtained using MemCalc, a time series analysis technique that combines a non-linear least square method with maximum entropy method. For psychological evaluation of anxiety and depressiveness, two self-report questionnaires were used: State-Trait Anxiety Inventory (STAI) and Self-Rating Depression Scale (SDS). No significant relation was observed between HR and HRV indices, and the psychological scores both in the resting and task conditions. By task application, HF decreased, and LF/HF and HR increased, and significant correlation with psychological scores was found in the responsiveness to task measured by the ratio of HRV and HR indices during the task to that at rest (task/rest ratio). A positive relationship was found between task/rest ratio for HF, and STAI and SDS scores. Task/rest ratio of HR was negatively correlated with STAI-state score. Decreased HRV response to task application is related to anxiety and depressiveness. Decreased autonomic responsiveness could serve as a sign of psychological dysfunction.

  3. Overexpression of neurofilament H disrupts normal cell structure and function

    Science.gov (United States)

    Szebenyi, Gyorgyi; Smith, George M.; Li, Ping; Brady, Scott T.

    2002-01-01

    Studying exogenously expressed tagged proteins in live cells has become a standard technique for evaluating protein distribution and function. Typically, expression levels of experimentally introduced proteins are not regulated, and high levels are often preferred to facilitate detection. However, overexpression of many proteins leads to mislocalization and pathologies. Therefore, for normative studies, moderate levels of expression may be more suitable. To understand better the dynamics of intermediate filament formation, transport, and stability in a healthy, living cell, we inserted neurofilament heavy chain (NFH)-green fluorescent protein (GFP) fusion constructs in adenoviral vectors with tetracycline (tet)-regulated promoters. This system allows for turning on or off the synthesis of NFH-GFP at a selected time, for a defined period, in a dose-dependent manner. We used this inducible system for live cell imaging of changes in filament structure and cell shape, motility, and transport associated with increasing NFH-GFP expression. Cells with low to intermediate levels of NFH-GFP were structurally and functionally similar to neighboring, nonexpressing cells. In contrast, overexpression led to pathological alterations in both filament organization and cell function. Copyright 2002 Wiley-Liss, Inc.

  4. Alteration in left ventricular normal and shear strains evaluated by 2D-strain echocardiography in the athlete's heart

    Science.gov (United States)

    Nottin, S; Doucende, G; Schuster-Beck, I; Dauzat, M; Obert, P

    2008-01-01

    The contraction of cardiomyocytes induces a systolic increase in left ventricular (LV) normal (radial, circumferential and longitudinal) and shear strains, whose functional consequences have not been evaluated, so far, in athletes. We used 2D ultrasound speckle tracking imaging (STI) to evaluate LV regional strain in high-level cyclists compared to sedentary controls. Sixteen male elite cyclists and 23 sedentary controls underwent conventional, tissue Doppler, and STI echocardiography at rest. We assessed LV long and short axis normal strains and shear strains. We evaluated circumferential–longitudinal shear strain from LV torsion, and circumferential–radial shear strain from the difference between subendocardial and subepicardial torsion. Apical radial strain (42.7 ± 10.5%versus 52.2 ± 14.3%, P subendocardial than in the subepicardial region in sedentary controls, but not in cyclists. Haemodynamic and tissue Doppler based indexes of global LV diastolic and systolic functions were not different between cyclists and controls. Athlete's heart is associated with specific LV adaptation including lower apical strain and lower myocardial shear strains, with no change in global LV diastolic and systolic function. These mechanical alterations could improve the cardiovascular adjustments to exercise by increasing the radial strain and torsional (and thus untwisting) response to exercise, a key element of diastolic filling and thus of cardiac performance in athletes. PMID:18687717

  5. Variations in height of jugular "a" wave in relation to heart rate in normal subjects and in patients with atrial septal defect.

    OpenAIRE

    Thiron, J M; Cribier, A.; Cazor, J L; Letac, B

    1980-01-01

    Analysis of jugular tracings in seven normal subjects in sinus rhythm whose heart rate varied spontaneously from one moment to another during expiratory apnoea, showed that a pronounced variation occurred in the size of the "a" waves in relation to that of the "v" waves and in accordance with the corresponding RR interval. In the 53 measurements which were carried out, the "a/v" ratio had a mean value of 0.9 for a heart rate above 87, 1.4 for a heart rate between 87 and 68, and 1.1 for a hear...

  6. Serbia: coronary and structural heart interventions from 2010 to 2015.

    Science.gov (United States)

    Stojkovic, Sinisa; Milasinovic, Dejan; Bozinovic, Nenad; Davidovic, Aleksandar; Debeljacki, Dragan; Djenic, Nemanja; Hinic, Sasa; Jagic, Nikola; Micic, Olivera; Mitov, Vladimir; Neskovic, Aleksandar N; Nikolic, Milan; Sagic, Dragan; Stankovic, Goran

    2017-05-15

    Serbia's interventional community has been facing the multifaceted challenge of an ageing population with cardiovascular diseases as the primary cause of death nationwide, coronary artery disease (CAD) being the most prevalent subset. The following two fields of activity have marked the trajectory of progress in the field of interventional cardiology in Serbia: first, the expansion of the infrastructure, mainly through the opening of new catheterisation laboratories across all of the country's administrative regions, which has resulted in better accessibility to coronary interventions for the general population; second, the creation of national platforms for continuous education, training and the promotion of clinical research in interventional cardiology, with close programmatic links to European Association of Percutaneous Cardiovascular Interventions (EAPCI)-based educational initiatives, including the curriculum for interventional cardiology. As growth seems to be inherent to the concept of progress, we report here on the expanding numbers of coronary interventions in the period between January 2010 and December 2015, and the early experiences with structural heart interventions in Serbia.

  7. Normal cardiac diameters in cine-MRI of the heart; Normalwerte der Herzdurchmesser in der Cine-MRT

    Energy Technology Data Exchange (ETDEWEB)

    Hergan, K.; Schuster, A.; Mair, M.; Burger, R.; Toepker, M. [Zentrales Inst. fuer Radiologie, Landeskrankenhaus Feldkirch (Austria)

    2004-11-01

    Purpose: To measure the normal diameters of cardiac cavities in standard cardiac views using cine MRI. Materials and Methods: Fifty-six volunteers were examined (27 male, 29 female) on a 1.5 T MR unit with ECG-triggered single shot free precision (SSFP) cine MR sequences and parallel image acquisition. Standardized echocardiographic planes were used to depict the heart of all volunteers (short axis, 4-chamber view, left and right 2-chamber views). The different diameters of the cardiac cavities were measured using a fixed protocol. Results: For the estimation of ventricular dilatation, the important female/male cross diameters of the left ventricle are 45.2{+-}3.4/51.6{+-}4.6 mm diastolic and 30.5{+-}3.5/33.8{+-}3.6 mm systolic, and of the right ventricle 30.7{+-}3.8/37.1{+-}5.9 mm diastolic and 22.3{+-}3.8/28.1{+-}4.4 mm systolic. For the determination of a left ventricular hypertrophy, relevant septal wall thickness measured in the short axis of the left ventricle of female/male volunteers are 8.0{+-}1.0/9.9{+-}1.2 mm diastolic and 10.9{+-}1.4/13.6{+-}1.9 mm systolic. The measured normal values of male volunteers were generally higher than those of female volunteers. The thickness of the ventricular septum correlated well when measured in the short axis and 4-chamber view. When measured in the 4-chamber view, the longitudinal diameter of the ventricles had a higher value in diastole and a lower value in systole, compared to the 2-chamber views of the right and left cardiac cavities. The atrial longitudinal diameters were higher in the 4-chamber view compared to the 2-chamber views, without any difference in systole or diastole. Conclusion: Diameters of cardiac cavities are easily and quickly measured. Using the tables with the normal values published here, it is simple to estimate an abnormal size of the heart. (orig.)

  8. Intact Imaging of Human Heart Structure Using X-ray Phase-Contrast Tomography.

    Science.gov (United States)

    Kaneko, Yukihiro; Shinohara, Gen; Hoshino, Masato; Morishita, Hiroyuki; Morita, Kiyozo; Oshima, Yoshihiro; Takahashi, Masashi; Yagi, Naoto; Okita, Yutaka; Tsukube, Takuro

    2017-02-01

    Structural examination of human heart specimens at the microscopic level is a prerequisite for understanding congenital heart diseases. It is desirable not to destroy or alter the properties of such specimens because of their scarcity. However, many of the currently available imaging techniques either destroy the specimen through sectioning or alter the chemical and mechanical properties of the specimen through staining and contrast agent injection. As a result, subsequent studies may not be possible. X-ray phase-contrast tomography is an imaging modality for biological soft tissues that does not destroy or alter the properties of the specimen. The feasibility of X-ray phase-contrast tomography for the structural examination of heart specimens was tested using infantile and fetal heart specimens without congenital diseases. X-ray phase-contrast tomography was carried out at the SPring-8 synchrotron radiation facility using the Talbot grating interferometer at the bending magnet beamline BL20B2 to visualize the structure of five non-pretreated whole heart specimens obtained by autopsy. High-resolution, three-dimensional images were obtained for all specimens. The images clearly showed the myocardial structure, coronary vessels, and conduction bundle. X-ray phase-contrast tomography allows high-resolution, three-dimensional imaging of human heart specimens. Intact imaging using X-ray phase-contrast tomography can contribute to further structural investigation of heart specimens with congenital heart diseases.

  9. Assessment of myocardial washout of Tc-99m-sestamibi in patients with chronic heart failure. Comparison with normal control

    Energy Technology Data Exchange (ETDEWEB)

    Kumita, Shin-ichiro; Seino, Yoshihiko; Cho, Keiichi; Nakajo, Hidenobu; Toba, Masahiro; Fukushima, Yoshimitsu; Takano, Teruo; Kumazaki, Tatsuo [Nippon Medical School, Tokyo (Japan); Okamoto, Noriake [Bristol-Myers Squibb K.K., Tokyo (Japan)

    2002-06-01

    In contrast to {sup 201}TlCl, {sup 99m}Tc-sestamibi shows very slow myocardial clearance after its initial myocardial uptake. In the present study, myocardial washout of {sup 99m}Tc-sestamibi was calculated in patients with non-ischemic chronic heart failure (CHF) and compared with biventricular parameters obtained from first-pass and ECG-gated myocardial perfusion SPECT data. After administration of {sup 99m}Tc-sestamibi, 25 patients with CHF and 8 normal controls (NC) were examined by ECG-gated myocardial perfusion SPECT and planar data acquisition in the early and delayed (interval of 3 hours) phase. Left ventricular ejection fraction (LVEF, %), peak filling rate (PFR, sec{sup -1}), end-diastolic volume (LVEDV, ml) and end-systolic volume (LVESV, ml) were automatically calculated from the ECG-gated SPECT data. Myocardial washout rates over 3 hours were calculated from the early and delayed planar images. Myocardial washout rates in the CHF group (39.6{+-}5.2%) were significantly higher than those in the NC group (31.2{+-}5.5%, p<0.01). The myocardial washout rates for the 33 subjects showed significant correlations with LVEF (r=-0.61, p<0.001), PFR (r=-0.47, p<0.01), LVEDV (r=0.45, p<0.01) and LVESV (r=0.48, p<0.01). The myocardial washout rate of {sup 99m}Tc-sestamibi is considered to be a novel marker for the diagnosis of myocardial damage in patients with chronic heart failure. (author)

  10. Regional differences in systolic active stress profiles in the normal beating heart. Assessment using an ultrasound based mathematical model.

    Science.gov (United States)

    McLaughlin, M; Langeland, S; Streb, W; Marciniak, M; D'Hooge, J; Bijnens, B; Claus, P

    2004-01-01

    Active stress (sigmaA) developed by cardiac muscle has been measured in isolated muscle preparations, under physiological loading conditions, by subtracting the passive stress (sigmaP) from the total stress (sigmaT). We previously developed a mechanical model based on M-mode ultrasound imaging to calculate these stresses in beating hearts. However, this model was based on one-dimensional imaging information and could not estimate regional differences in sigmaA. In the current study this model was improved by including two-dimensional B-mode echocardiographic data. In a porcine model a micro-manometer tipped catheter was used to measure left-ventricular pressure (LVP) and B-mode ultrasound images were recorded in a short-axis view. On the ultrasound image points in the mid-wall were selected and tracked to completely define the deformation of the myocardium. A kinematic model of the LV was then constructed from the displacement vectors of these points. sigmaT was calculated from the LVP. The material parameters for an exponential stress/strain relation were estimated during the diastolic E-wave when it was assumed that sigmaA = 0. These parameters were used to calculate sigmaP during systole and by subtracting this from sigmaT, sigmaA was calculated. The timing and shape of sigmaA profiles match those obtained from isolated muscle experiments. SigmaA was higher and peaked sooner in the posterior wall than in the anterior wall. Regional active stress estimation is possible in normal beating hearts.

  11. Features of structural and functional state of the heart in patients with chronic heart failure with comorbid hypertension

    Directory of Open Access Journals (Sweden)

    I. V. Drozdova

    2017-06-01

    Full Text Available The aim - to identify structural and functional features of cardiac remodeling in patients with chronic heart failure associated with hypertension. Materials and Methods. Hemodynamic, structural and functional changes have been studied in 77 patients (21 women and 56 men with chronic heart failure with preserved left ventricular ejection fraction using echocardiography. The first group consisted of 46 patients with heart failure and hypertension, the second group included 31 patients with CHF without hypertension. All groups were comparable to age and sex. Results. In patients with heart failure and a history of hypertension remodeling processes were characterized by increase in LAV (17.8%, p<0.05, LVPWd (16.3%, p<0.05, IVSd (12.7%, p<0.05, RWT (22.4%, p<0.05 and ejection fraction (13.3%, p<0.05, compared with patients without hypertension, with a predominance of eccentric and concentric hypertrophy and diastolic dysfunction by type of abnormal relaxation. Conclusions. In CHF patients with hypertension remodeling processes are characterized by walls thickening, increase in left atrium volume, left ventricular myocardial mass, left ventricular ejection fraction with a predominance of eccentric and concentric hypertrophy and diastolic dysfunction by type of abnormal relaxation that are reasonable to use in practice of medical and social expertise.

  12. Impaired isotonic contractility and structural abnormalities in the diaphragm of congestive heart failure rats.

    NARCIS (Netherlands)

    Hees, H.W.H. van; Heijden, H.F.M. van der; Hafmans, T.G.M.; Ennen, L.; Heunks, L.M.A.; Verheugt, F.W.A.; Dekhuijzen, P.N.R.

    2008-01-01

    BACKGROUND: Metabolic alterations and decreased isometric force generation have been demonstrated in different animal models for congestive heart failure (CHF). However, as few morphological examinations have been performed on the CHF diaphragm, it is unknown if structural abnormalities comprise a

  13. CARDIOTHORACIC RATIO AND VERTEBRAL HEART SCALE IN CLINICALLY NORMAL BLACK-RUMPED AGOUTIS (DASYPROCTA PRYMNOLOPHA, WAGLER 1831).

    Science.gov (United States)

    de Moura, Charlys Rhands Coelho; das Neves Diniz, Anaemilia; da Silva Moura, Laecio; das Chagas Araújo Sousa, Francisco; Baltazar, Pollyana Irene; Freire, Larisse Danielle; Guerra, Porfírio Candanedo; de Sousa, João Macedo; Giglio, Robson Fortes; Pessoa, Gerson Tavares; de Sá, Renan Paraguassu; Alves, Flávio Ribeiro

    2015-06-01

    Wild rodents, such as the lowland paca (Cuniculus paca), capybara (Hydrochoerus hydrochaeris), rock cavy (Kerodon rupestris), guinea pig (Cavia aperea), and black-rumped agouti (Dasyprocta prymnolopha) are intensely hunted throughout Amazonia and at the semiarid regions of northeastern Brazil. To contribute to the preservation of these species, more information about their anatomy, physiology and pathophysiology is needed. The aim of this study was to standardize the vertebral heart scale (VHS) and cardiothoracic ratio (CTR) in clinically normal black-rumped agouti, as well as to compare the results of these two methods, which are commonly used to evaluate the cardiac silhouette in domestic animals. Twelve healthy black-rumped agoutis, divided into two groups (six males and six females), obtained from the Nucleus for Wild Animal Studies and Conservation at the Federal University of Piauí, were radiographed in right and left lateral and dorsoventral projections. The values of the VHS were 8.00±0.31v (the number of thoracic vertebral length spanned by each dimension, starting at T4) for males and 8.11±0.41v for females, and there was no statistical difference between the decubitus (right and left) or between males and females (P>0.05). The CTR mean values obtained were 0.51±0.03 for males, and 0.52±0.02 for females, and there was no statistical difference between the genders (P>0.05). However, there was positive correlation between VHS and CTR (r=0.77 right decubitus and r=0.82 left decubitus). The thoracic and heart diameter had mean values of 6.72±0.61 and 3.48±0.30 cm (males), and for the females, it was 6.61±0.51 and 3.5±0.30 cm, respectively, and there was statistical difference between the genders. The results demonstrated high correlation between the VHS and CTR producing similar results, indicating similar clinical precision for assessing the size of the cardiac silhouette in the black-rumped agoutis.

  14. Applicability of structured telephone monitoring to follow up heart ...

    African Journals Online (AJOL)

    Pilly Chillo

    compared to other cardiovascular diseases, its incidence, prevalence as well as ... related to discharge planning, which emphasizes on medication review ... asked to note for development or worsening of lower limbs swelling, .... During the follow-up period, 25 (19.1%) patients were re-admitted back .... chronic heart failure.

  15. Applicability of structured telephone monitoring to follow up heart ...

    African Journals Online (AJOL)

    Background: Studies from developed countries have shown that home monitoring and follow up of heart failure (HF) patients by use of phone calls is cost-effective as it reduces re-admission and improves patients' clinical status. This intervention has however not been tested in resource poor countries including Tanzania, ...

  16. Cardiac Fibroblast-Derived Extracellular Matrix (Biomatrix as a Model for the Studies of Cardiac Primitive Cell Biological Properties in Normal and Pathological Adult Human Heart

    Directory of Open Access Journals (Sweden)

    Clotilde Castaldo

    2013-01-01

    Full Text Available Cardiac tissue regeneration is guided by stem cells and their microenvironment. It has been recently described that both cardiac stem/primitive cells and extracellular matrix (ECM change in pathological conditions. This study describes the method for the production of ECM typical of adult human heart in the normal and pathological conditions (ischemic heart disease and highlights the potential use of cardiac fibroblast-derived ECM for in vitro studies of the interactions between ECM components and cardiac primitive cells responsible for tissue regeneration. Fibroblasts isolated from adult human normal and pathological heart with ischemic cardiomyopathy were cultured to obtain extracellular matrix (biomatrix, composed of typical extracellular matrix proteins, such as collagen and fibronectin, and matricellular proteins, laminin, and tenascin. After decellularization, this substrate was used to assess biological properties of cardiac primitive cells: proliferation and migration were stimulated by biomatrix from normal heart, while both types of biomatrix protected cardiac primitive cells from apoptosis. Our model can be used for studies of cell-matrix interactions and help to determine the biochemical cues that regulate cardiac primitive cell biological properties and guide cardiac tissue regeneration.

  17. Central command dysfunction in rats with heart failure is mediated by brain oxidative stress and normalized by exercise training.

    Science.gov (United States)

    Koba, Satoshi; Hisatome, Ichiro; Watanabe, Tatsuo

    2014-09-01

    Sympathoexcitation elicited by central command, a parallel activation of the motor and autonomic neural circuits in the brain, has been shown to become exaggerated in chronic heart failure (CHF). The present study tested the hypotheses that oxidative stress in the medulla in CHF plays a role in exaggerating central command-elicited sympathoexcitation, and that exercise training in CHF suppresses central command-elicited sympathoexcitation through its antioxidant effects in the medulla. In decerebrate rats, central command was activated by electrically stimulating the mesencephalic locomotor region (MLR) after neuromuscular blockade. The MLR stimulation at a current intensity greater than locomotion threshold in rats with CHF after myocardial infarction (MI) evoked larger (P rats (Sham) and rats with CHF that had completed longterm (8–12 weeks) exercise training (MI + TR). In the Sham and MI + TR rats, bilateral microinjection of a superoxide dismutase (SOD) mimetic Tempol into the rostral ventrolateral medulla (RVLM) had no effects on MLR stimulation-elicited responses. By contrast, in MI rats, Tempol treatment significantly reduced MLR stimulation-elicited responses. In a subset of MI rats, treatment with Tiron, another SOD mimetic, within the RVLM also reduced responses. Superoxide generation in the RVLM, as evaluated by dihydroethidium staining, was enhanced in MI rats compared with that in Sham and MI + TR rats. Collectively, these results support the study hypotheses. We suggest that oxidative stress in the medulla in CHF mediates central command dysfunction, and that exercise training in CHF is capable of normalizing central command dysfunction through its antioxidant effects in the medulla.

  18. Design of a spatial data structure using the relational normal forms

    Science.gov (United States)

    van Roessel, Jan W.

    1987-01-01

    In previous work, a relational data structure aimed at the exchange of spatial data between systems was developed. As this data structure was relational it was of first normal form, but compliance with the higher normal forms was not investigated. Recently, a new procedural method for composing fully normalized data structures from the basic data fields has been developed by H. C. Smith, as an alternative to the process of non-loss decomposition which is difficult to understand. Smith's method has been applied to data fields required to store points, lines and polygons in a chain-node spatial data model. When geographic domain, coverage layer and map are also considered, the procedure naturally leads to a catalogue model, needed for the exchange of spatial data. Although the method produces a fully normalized data structure, it is not as easy to identify which normal forms are responsible for the ultimate arrangement of the data fields into relations, but the benefits of these criteria for data base development also apply to spatial data structures and related ancillary data.

  19. Structural and Functional Phenotyping of the Failing Heart: Is the Left Ventricular Ejection Fraction Obsolete?

    Science.gov (United States)

    Bristow, Michael R; Kao, David P; Breathett, Khadijah K; Altman, Natasha L; Gorcsan, John; Gill, Edward A; Lowes, Brian D; Gilbert, Edward M; Quaife, Robert A; Mann, Douglas L

    2017-11-01

    Diagnosis, prognosis, treatment, and development of new therapies for diseases or syndromes depend on a reliable means of identifying phenotypes associated with distinct predictive probabilities for these various objectives. Left ventricular ejection fraction (LVEF) provides the current basis for combined functional and structural phenotyping in heart failure by classifying patients as those with heart failure with reduced ejection fraction (HFrEF) and those with heart failure with preserved ejection fraction (HFpEF). Recently the utility of LVEF as the major phenotypic determinant of heart failure has been challenged based on its load dependency and measurement variability. We review the history of the development and adoption of LVEF as a critical measurement of LV function and structure and demonstrate that, in chronic heart failure, load dependency is not an important practical issue, and we provide hemodynamic and molecular biomarker evidence that LVEF is superior or equal to more unwieldy methods of identifying phenotypes of ventricular remodeling. We conclude that, because it reliably measures both left ventricular function and structure, LVEF remains the best current method of assessing pathologic remodeling in heart failure in both individual clinical and multicenter group settings. Because of the present and future importance of left ventricular phenotyping in heart failure, LVEF should be measured by using the most accurate technology and methodologic refinements available, and improved characterization methods should continue to be sought. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  20. Mapping of normal corneal K-structures by in vivo laser confocal microscopy.

    Science.gov (United States)

    Yokogawa, Hideaki; Kobayashi, Akira; Sugiyama, Kazuhisa

    2008-09-01

    To produce 2-dimensional reconstruction maps of normal human corneal fibrous structures beneath the Bowman layer (K-structures) by in vivo laser confocal microscopy and to show association of structures with the anterior corneal mosaic (ACM). Central corneal regions of 3 healthy volunteers were scanned. Acquired images of K-structures for each eye were arranged and mapped into a subconfluent montage. For each subject, electrical tracings of K-structures were superimposed on a slit-lamp photograph of the ACM produced by rubbing the eyelid. A mean of 677 +/- 211 images of K-structures were obtained for each eye. Mean dimensions of the mapped areas were 5.88 +/- 0.50 (horizontal) and 3.51 +/- 1.37 mm (vertical). In all subjects, K-structures formed a netlike pattern (mean area, 0.082 +/- 0.051 mm), and electrical tracings had good concordance with the ACM. This is the first study, to our knowledge, to elucidate the overall distribution of K-structures in normal human corneas. The netlike pattern of K-structures corresponded well with ACM pattern. These results support the hypothesis that the K-structures are the anterior collagen fiber bundles running at the posterior surface of the Bowman layer and thus are the structural basis for ACM formation.

  1. The effects of normalization on the correlation structure of microarray data

    Directory of Open Access Journals (Sweden)

    Klebanov Lev

    2005-05-01

    Full Text Available Abstract Background Stochastic dependence between gene expression levels in microarray data is of critical importance for the methods of statistical inference that resort to pooling test-statistics across genes. It is frequently assumed that dependence between genes (or tests is suffciently weak to justify the proposed methods of testing for differentially expressed genes. A potential impact of between-gene correlations on the performance of such methods has yet to be explored. Results The paper presents a systematic study of correlation between the t-statistics associated with different genes. We report the effects of four different normalization methods using a large set of microarray data on childhood leukemia in addition to several sets of simulated data. Our findings help decipher the correlation structure of microarray data before and after the application of normalization procedures. Conclusion A long-range correlation in microarray data manifests itself in thousands of genes that are heavily correlated with a given gene in terms of the associated t-statistics. By using normalization methods it is possible to significantly reduce correlation between the t-statistics computed for different genes. Normalization procedures affect both the true correlation, stemming from gene interactions, and the spurious correlation induced by random noise. When analyzing real world biological data sets, normalization procedures are unable to completely remove correlation between the test statistics. The long-range correlation structure also persists in normalized data.

  2. Detection of functional structures in isolated perfused pig heart: methods and technical principles

    Science.gov (United States)

    Hiller, Michael; Rauh, Robert; Trinks, Tobias; Kessler, Manfred D.

    2002-06-01

    Light scattering in living heart tissue is mainly caused by mitochondria, but also by actin and myosin filaments, glycogen particles and others. In living tissue these subcellular structures are not stable but rather in a permanent change. Thus, one should be able to perceive the status of scattering structures by measurement of backscattered light in microvolumes. Our recent efforts aimed at detecting these structures by use of micro lightguides and scanning tissue spectroscopy technique (EMPHO II SSK) at isolated perfused pig hearts. The paper describes the technical principles of the scanning technique and gives an overview of our latest results.

  3. Normal left ventricular torsion mechanics in healthy children: age related changes of torsion parameters are closely related to changes in heart rate.

    Science.gov (United States)

    Kim, Hye Jin; Yoon, Ji-Hong; Lee, Eun-Jung; Oh, Jin Hee; Lee, Jae Young; Lee, Soon Ju; Han, Ji Whan

    2015-03-01

    This study was aimed at assessing left ventricular torsion (LVtor) mechanics using speckle tracking echocardiography (STE), establishing normal reference values of principal LVtor parameters, and analyzing the age-related changes in normal children. Eighty children (aged 3 months to 15 years) with normal cardiac function and rhythm were recruited. LVtor parameters including rotations, twist and untwist, torsion, and their rate indices were measured using STE. Age and heart rate related changes of the parameters were analyzed. Speckle tracking echocardiography analyses for LVtor parameters had excellent reliability in 64 of 80 subjects (80%) (intraclass correlation coefficients; 0.93-0.97). Early systolic twist (EST) motions (-8.4--0.1°) were observed in all subjects during an early 20±7% of systolic time intervals. The peak systolic twist and torsion were 17.0±6.5° and 2.9±1.3°/cm, respectively. The peak twist velocity was recorded at 51±13% of systolic time and the peak untwist velocity at 13.8±11.5% of diastolic time intervals. Multivariate analysis showed that heart rate change was an independent predictor of changes in torsion parameters; significantly decreasing LV length-normalized apical and basal rotation, torsion, and twist and untwist rate with increasing age. Isovolumetric recoil rate was independent of change in age and heart rate. Left ventricle showed unique torsion mechanics in children with EST, torsion, and untwists. Heart rate was an independent predictor of the change in torsion parameters with aging.

  4. The Reproducibility of Short verses Long-Duration Heart Rate Variability Methods and Relations to Aerobic Fitness in Normal Adults

    OpenAIRE

    Arner, Alison Elizabeth

    2002-01-01

    ABSTRACT Heart rate variability (HRV) has been used to evaluate cardiac autonomic function by measuring variations in electrocardiographic R-R intervals between cardiac cycles. HRV was first used to associate decreases in autonomic nervous system (ANS) control with an increased risk of mortality in coronary heart disease and in the diagnosis of diabetes (1). Current clinical research interest has extended to investigate uses of HRV to evaluate changes in the cardiovascular system due to ...

  5. Tag-based Heart Rate Measurements of Harbor Porpoises During Normal and Noise-exposed Dives to Study Stress Responses

    Science.gov (United States)

    2015-09-30

    nitrogen management and can provide information on the level of stress the animals routinely experience. Here we examine the dive heart rate...ventilation rate and activity in both captive and wild porpoise to better understand the dive response and how it may be overruled by noise exposure. We...acoustic data in captive and wild harbor porpoises. The specific objectives are 1) Quantify the physiological (heart and ventilation rates) and behavioral

  6. Comparison of Immune Profiles in Fetal Hearts with Idiopathic Dilated Cardiomyopathy, Maternal Autoimmune-Associated Dilated Cardiomyopathy and the Normal Fetus.

    Science.gov (United States)

    Nield, Lynne E; von Both, Ingo; Popel, Najla; Strachan, Kate; Manlhiot, Cedric; Shannon, Patrick; McCrindle, Brian W; Atkinson, Adelle; Miner, Steven E S; Jaeggi, Edgar T; Taylor, Glenn P

    2016-02-01

    The etiology of idiopathic dilated cardiomyopathy (iDCM) remains unknown. Immune therapies have improved outcome in fetuses with DCM born to mothers with autoimmune disease (aDCM). The purpose of this retrospective study was to compare the myocardial B and T cell profiles in fetuses and neonates with idiopathic DCM (iDCM) versus autoimmune-mediated DCM (aDCM) and to describe the normal cell maturation within the human fetal myocardium. Of 60 fetal autopsy cases identified from institutional databases, 10 had aDCM (18-38 weeks), 12 iDCM (19-37 weeks) and 38 had normal hearts (11-40 weeks). Paraffin-embedded myocardium sections were stained for all lymphocyte (CD45), B cells (CD20, CD79a), T cells (CD3, CD4, CD7, CD8) and monocyte (CD68) surface markers. Two independent, blinded cell counts were performed. Normal hearts expressed all B and T cell markers in a bimodal fashion, with peaks at 22 and 37 weeks of gestation. The aDCM cohort was most distinct from normal hearts, with less overall T cell markers [EST -9.1 (2.6) cells/mm(2), p = 0.001], CD4 [EST -2.0 (0.6), p = 0.001], CD3 [EST -3.9 (1.0), p cell markers [EST -4.9 (1.8), p = 0.01] and CD79a counts [EST -2.3 (0.9), p = 0.01]. The iDCM group had less overall B cell markers [EST -4.0 (1.8), p = 0.03] and CD79a [EST -1.7 (0.9), p = 0.05], but no difference in T cell markers. Autoimmune-mediated DCM fetuses have less B and T cell markers, whereas iDCM fetuses have less B cell markers compared with normal fetal hearts. The fetal immune system may play a role in the normal development of the heart and evolution of dilated cardiomyopathy.

  7. Improvement of resolution in detection of 3D-functional structures in isolated perfused pig heart

    Science.gov (United States)

    Rauh, Robert; Hiller, Michael; Trinks, Tobias; Kessler, Manfred D.

    2001-10-01

    Subcellular structures play a decisive role in light scattering properties of tissue. Our recent efforts aimed at monitoring these structures by use of micro lightguides and scanning tissue spectroscopy technique (EMPHO II SSK) at isolated perfused organs. With application of 70micrometers lightguides at an isolated perfused pig heart model we were able to improve the resolution to a step size of 20micrometers .

  8. Estimating structural equation models with non-normal variables by using transformations

    NARCIS (Netherlands)

    van Montfort, C.A.G.M.; Mooijaart, A.; Meijer, F.

    2009-01-01

    We discuss structural equation models for non-normal variables. In this situation the maximum likelihood and the generalized least-squares estimates of the model parameters can give incorrect estimates of the standard errors and the associated goodness-of-fit chi-squared statistics. If the sample

  9. [The "athlete's heart": structure, function and differential diagnosis].

    Science.gov (United States)

    Carro, Amelia; Carro, Fernando; del Valle, Miguel Enrique

    2011-10-22

    Long-term, intense sport activity induces morphologic and functional adaptations on cardiovascular system. The magnitude of these changes is determined by various factors, creating a specific condition: the "Athlete's Heart" (AH). It is important to distinguish this entity from other cardiomyopathies, taking into account that the differential diagnosis can be challenging. There has been an increase in the number of people practicing sports, which goes in parallel with the increase in the prevalence of AH. However, the proportion of asymptomatic subjects affected by cardiovascular diseases taking part on competitive sports, is also growing. We revise the main characteristics of AH, as well as the key points to distinguish AH from pathologic conditions. A delicate characterization as AH or cardiomyopathy would help to settle appropriate measures to lower the risk of sports-related sudden cardiac death. Copyright © 2010 Elsevier España, S.L. All rights reserved.

  10. Segmentation of anatomical structures of the heart based on echocardiography

    Science.gov (United States)

    Danilov, V. V.; Skirnevskiy, I. P.; Gerget, O. M.

    2017-01-01

    Nowadays, many practical applications in the field of medical image processing require valid and reliable segmentation of images in the capacity of input data. Some of the commonly used imaging techniques are ultrasound, CT, and MRI. However, the main difference between the other medical imaging equipment and EchoCG is that it is safer, low cost, non-invasive and non-traumatic. Three-dimensional EchoCG is a non-invasive imaging modality that is complementary and supplementary to two-dimensional imaging and can be used to examine the cardiovascular function and anatomy in different medical settings. The challenging problems, presented by EchoCG image processing, such as speckle phenomena, noise, temporary non-stationarity of processes, unsharp boundaries, attenuation, etc. forced us to consider and compare existing methods and then to develop an innovative approach that can tackle the problems connected with clinical applications. Actual studies are related to the analysis and development of a cardiac parameters automatic detection system by EchoCG that will provide new data on the dynamics of changes in cardiac parameters and improve the accuracy and reliability of the diagnosis. Research study in image segmentation has highlighted the capabilities of image-based methods for medical applications. The focus of the research is both theoretical and practical aspects of the application of the methods. Some of the segmentation approaches can be interesting for the imaging and medical community. Performance evaluation is carried out by comparing the borders, obtained from the considered methods to those manually prescribed by a medical specialist. Promising results demonstrate the possibilities and the limitations of each technique for image segmentation problems. The developed approach allows: to eliminate errors in calculating the geometric parameters of the heart; perform the necessary conditions, such as speed, accuracy, reliability; build a master model that will be

  11. Resonant diffusion of normal alkanes in zeolites: Effect of the zeolite structure and alkane molecule vibrations

    CERN Document Server

    Tsekov, R

    2015-01-01

    Diffusion of normal alkanes in one-dimensional zeolites is theoretically studied on the basis of the stochastic equation formalism. The calculated diffusion coefficient accounts for the vibrations of the diffusing molecule and zeolite framework, molecule-zeolite interaction, and specific structure of the zeolite. It is shown that when the interaction potential is predominantly determined by the zeolite pore structure, the diffusion coefficient varies periodically with the number of carbon atoms of the alkane molecule, a phenomenon called resonant diffusion. A criterion for observable resonance is obtained from the balance between the interaction potentials of the molecule due to the atomic and pore structures of the zeolite. It shows that the diffusion is not resonant in zeolites without pore structure, such as ZSM-12. Moreover, even in zeolites with developed pore structure no resonant dependence of the diffusion constant can be detected if the pore structure energy barriers are not at least three times high...

  12. [Structural and functional stage of the myocardium in different forms of ischemic heart disease].

    Science.gov (United States)

    Maslovs'kyĭ, V Iu; Kolesnyk, O M

    2006-12-01

    152 patients with ischemic heart disease aged from 46 to 60 years have been observed. Among these patients, 69 were with stable stenocardia, 32--with unstable stenocardia and 53--in stage related to acute heart attack. Normal geometry of the heart was found in 33% of patients with stable stenocardia, excentric hypertrophy was found in 30% of patients with stable stenocardia. Excentric hypertrophy prevailed in patients with unstable stenocardia and myocardial infarction. Systolic disfunction of the myocardium was found in 72% of patients with stable stenocardia, in 41% of patients with unstable stenocardia and in 43% of patients with myocardial infarction. Diastolic dysfunction of the myocardium in terms of rigide and restrictive types was found oftener in patients with myocardial infarction.

  13. Identification of support structure damping of a full scale offshore wind turbine in normal operation

    DEFF Research Database (Denmark)

    Koukoura, Christina; Natarajan, Anand; Vesth, Allan

    2015-01-01

    maxima of an impulse response caused by a boat impact. The result is used in the verification of the non aerodynamic damping in normal operation for low wind speeds. The auto-correlation function technique for damping estimation of a structure under ambient excitation was validated against the identified...... damping from the decaying time series. The Enhanced Frequency Domain Decomposition (EFDD) method was applied to the wind turbine response under ambient excitation, for estimation of the damping in normal operation. The aero-servo-hydro-elastic tool HAWC2 is validated with offshore foundation load...

  14. Structural and functional effects of developmental exposure to ethanol on the zebrafish heart.

    Science.gov (United States)

    Dlugos, Cynthia A; Rabin, Richard A

    2010-06-01

    Fetal alcohol exposure during development results in a host of cardiac abnormalities including atrial and ventricular septal defects, teratology of Fallot, d-transposition of the great arteries, truncus arteriosus communis, and aortico-pulmonary window. The mechanisms behind these ethanol-induced deficits are unknown. The purpose of this study was to determine whether the zebrafish, a simple model in which heart development and the sequence of gene expression is well elucidated and comparable to that in higher vertebrates, is sensitive to developmental exposure of pharmacologically relevant concentrations of ethanol. Zebrafish eggs of the AB strain were raised in egg water or in 0.5% (v/v) ethanol solution for either 54 hpf (hours postfertilization) or 72 hpf. Heart pathology and volumes were evaluated on the latter group at 5 dpf (days postfertilization) on tissue sections from fixed larvae embedded in glycolmethacrylate. Heart rates were determined in embryos of 54 hpf and larvae of 5 dpf. The functional maturity of the heart's conducting system was measured by determining the response of ethanol-treated and control embryos and larvae to the adrenergic agonist, isoproterenol, and the cholinergic agonist, carbachol. Ethanol-induced alterations occurred in heart morphology and heart volume. A developmental lag in the isoproterenol response and the absence of carbachol-mediated bradycardia were also observed following ethanol treatment. These results show that exposure of the zebrafish to ethanol during development results in structural and functional changes in the heart that mimic malformations that occur in patients with fetal alcohol syndrome (FAS). These findings promote the zebrafish heart as a future model for investigating the mechanisms responsible for ethanol's adverse effects on vertebrate heart development.

  15. Long-term low dose dietary resveratrol supplement reduces cardiovascular structural and functional deterioration in chronic heart failure in rats.

    Science.gov (United States)

    Ahmet, Ismayil; Tae, Hyun-Jin; Lakatta, Edward G; Talan, Mark

    2017-03-01

    A short-term exposure to resveratrol at high dosages exerts a remarkable cardioprotective effect. Whether a long-term exposure to resveratrol at low dosages that can be obtained through consumption of a resveratrol-rich diet is beneficial to heart diseases is unknown. We tested the effects of a resveratrol-enriched diet on cardiovascular remodeling of chronic heart failure (CHF) in rats resulting from permanent ligation of left coronary artery. Two weeks after surgery, rats were started on either a resveratrol-enriched (R; 5 mg/kg per day; n = 23) or normal (Control; n = 23) diet for next 10 months. Serial echocardiography in Control showed a significant decline in LV ejection fraction, increases in LV end-systolic and end-diastolic volumes, and expansion in myocardial infarct from pre-treatment values. In R, compared with Control, there were substantial improvements in those parameters. End-point LV pressure-volume loop analysis showed a significantly improved LV systolic function and AV-coupling, an index of energy transfer efficacy between the heart and aortic tree, in R compared with Control (p resveratrol supplement reduces cardiovascular structural and functional deterioration in CHF.

  16. Predictive Value of the Model for End-Stage Liver Disease Score Excluding International Normalized Ratio One Year After Orthotopic Heart Transplantation.

    Science.gov (United States)

    Szyguła-Jurkiewicz, B; Zakliczyński, M; Szczurek, W; Nadziakiewicz, P; Gąsior, M; Zembala, M

    2016-06-01

    The Model for End-Stage Liver Disease (MELD) scoring system incorporating a combination of hepatic and renal laboratory parameters does not adequately reflect the degree of multi-organ dysfunction in patients with heart failure, who need oral anticoagulation. In order to exclude the impact of oral anticoagulation on the international normalized ratio (INR), we used the MELD excluding INR (MELD-XI) score. The aims of the study were to calculate the individual preoperative MELD-XI score and its ability to predict 1-year mortality after heart transplantation and to identify other preoperative laboratory prognostic parameters. We retrospectively analysed data of 87 consecutive adults undergoing heart transplantation between 2011 and 2014. Clinical data and laboratory parameters for the calculation of the MELD-XI score were obtained at the time of admission for the heart transplantation. The average age of the patients was 48.8 ± 13.3 years and 68.9% of them were male. During the observation period, the mortality rate was 18.4%. Multivariate analysis of Cox proportional hazard confirmed that the pretransplantation MELD-XI score (hazard ratio [HR] = 1.625 [1.286-2.053]; P < .001), sodium serum concentration (HR = 0.824 [0.677-1.001]; P < .05) and highly sensitive C-reactive protein (hs-CRP) serum concentration (HR = 1.045 [1.008-1.083]; P < .02) were independent predictors of death during the first year after heart transplantation. Area under the receiver operating characteristic (ROC) curve (AUC) indicated a good discriminatory power of MELD-XI (AUC 0.997; P < .04) and plasma sodium concentration (AUC 0.901; P < .01) in death prediction. Our study confirms that the pretransplantation MELD-XI score, as well as serum sodium and hsCRP concentrations, may be used to estimate postoperative risk in heart transplant recipients during a 1-year follow-up. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Three-dimensional Integrated Functional, Structural, and Computational Mapping to Define the Structural "Fingerprints" of Heart-Specific Atrial Fibrillation Drivers in Human Heart Ex Vivo.

    Science.gov (United States)

    Zhao, Jichao; Hansen, Brian J; Wang, Yufeng; Csepe, Thomas A; Sul, Lidiya V; Tang, Alan; Yuan, Yiming; Li, Ning; Bratasz, Anna; Powell, Kimerly A; Kilic, Ahmet; Mohler, Peter J; Janssen, Paul M L; Weiss, Raul; Simonetti, Orlando P; Hummel, John D; Fedorov, Vadim V

    2017-08-22

    Structural remodeling of human atria plays a key role in sustaining atrial fibrillation (AF), but insufficient quantitative analysis of human atrial structure impedes the treatment of AF. We aimed to develop a novel 3-dimensional (3D) structural and computational simulation analysis tool that could reveal the structural contributors to human reentrant AF drivers. High-resolution panoramic epicardial optical mapping of the coronary-perfused explanted intact human atria (63-year-old woman, chronic hypertension, heart weight 608 g) was conducted during sinus rhythm and sustained AF maintained by spatially stable reentrant AF drivers in the left and right atrium. The whole atria (107×61×85 mm 3 ) were then imaged with contrast-enhancement MRI (9.4 T, 180×180×360-μm 3 resolution). The entire 3D human atria were analyzed for wall thickness (0.4-11.7 mm), myofiber orientations, and transmural fibrosis (36.9% subendocardium; 14.2% midwall; 3.4% subepicardium). The 3D computational analysis revealed that a specific combination of wall thickness and fibrosis ranges were primarily present in the optically defined AF driver regions versus nondriver tissue. Finally, a 3D human heart-specific atrial computer model was developed by integrating 3D structural and functional mapping data to test AF induction, maintenance, and ablation strategies. This 3D model reproduced the optically defined reentrant AF drivers, which were uninducible when fibrosis and myofiber anisotropy were removed from the model. Our novel 3D computational high-resolution framework may be used to quantitatively analyze structural substrates, such as wall thickness, myofiber orientation, and fibrosis, underlying localized AF drivers, and aid the development of new patient-specific treatments. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  18. Structural Integrity of Normal Appearing White Matter and Sex-Specific Outcomes After Acute Ischemic Stroke.

    Science.gov (United States)

    Etherton, Mark R; Wu, Ona; Cougo, Pedro; Giese, Anne-Katrin; Cloonan, Lisa; Fitzpatrick, Kaitlin M; Kanakis, Allison S; Boulouis, Gregoire; Karadeli, Hasan H; Lauer, Arne; Rosand, Jonathan; Furie, Karen L; Rost, Natalia S

    2017-12-01

    Women have worse poststroke outcomes than men. We evaluated sex-specific clinical and neuroimaging characteristics of white matter in association with functional recovery after acute ischemic stroke. We performed a retrospective analysis of acute ischemic stroke patients with admission brain MRI and 3- to 6-month modified Rankin Scale score. White matter hyperintensity and acute infarct volume were quantified on fluid-attenuated inversion recovery and diffusion tensor imaging MRI, respectively. Diffusivity anisotropy metrics were calculated in normal appearing white matter contralateral to the acute ischemia. Among 319 patients with acute ischemic stroke, women were older (68.0 versus 62.7 years; P =0.004), had increased incidence of atrial fibrillation (21.4% versus 12.2%; P =0.04), and lower rate of tobacco use (21.1% versus 35.9%; P =0.03). There was no sex-specific difference in white matter hyperintensity volume, acute infarct volume, National Institutes of Health Stroke Scale, prestroke modified Rankin Scale score, or normal appearing white matter diffusivity anisotropy metrics. However, women were less likely to have an excellent outcome (modified Rankin Scale score stroke. The correlation between markers of white matter integrity and functional outcomes in women, but not men, suggests a potential sex-specific mechanism. © 2017 American Heart Association, Inc.

  19. Relationship of Structural Characteristics to Biomechanical Profile in Normal, Keratoconic, and Crosslinked Eyes.

    Science.gov (United States)

    Viswanathan, Deepa; Kumar, Nikhil L; Males, John J; Graham, Stuart L

    2015-07-01

    To evaluate the correlation of corneal biomechanical parameters with structural characteristics in normal, keratoconic, and collagen crosslinked eyes. A prospective observational study that included 50 normal, 100 keratoconic, and 25 crosslinked eyes. All eyes were imaged using a Scheimpflug camera and an ocular response analyzer. The main outcome measures analyzed were central corneal thickness (CCT), corneal volume (CV), maximal keratometry (Kmax), corneal hysteresis (CH), and corneal resistance factor (CRF). Significant differences were noted among all 3 groups of eyes for CCT, CV, Kmax, CH, and CRF values (P corneas with greater thickness and volume. Corneal biomechanical parameters progressively decrease as the severity of keratoconus increases. After collagen crosslinking, the relationship of the corneal curvature to the biomechanical profile is similar to normal eyes.

  20. Orthogonal projections to latent structures as a strategy for microarray data normalization

    Directory of Open Access Journals (Sweden)

    Moritz Thomas

    2007-06-01

    Full Text Available Abstract Background During generation of microarray data, various forms of systematic biases are frequently introduced which limits accuracy and precision of the results. In order to properly estimate biological effects, these biases must be identified and discarded. Results We introduce a normalization strategy for multi-channel microarray data based on orthogonal projections to latent structures (OPLS; a multivariate regression method. The effect of applying the normalization methodology on single-channel Affymetrix data as well as dual-channel cDNA data is illustrated. We provide a parallel comparison to a wide range of commonly employed normalization methods with diverse properties and strengths based on sensitivity and specificity from external (spike-in controls. On the illustrated data sets, the OPLS normalization strategy exhibits leading average true negative and true positive rates in comparison to other evaluated methods. Conclusion The OPLS methodology identifies joint variation within biological samples to enable the removal of sources of variation that are non-correlated (orthogonal to the within-sample variation. This ensures that structured variation related to the underlying biological samples is separated from the remaining, bias-related sources of systematic variation. As a consequence, the methodology does not require any explicit knowledge regarding the presence or characteristics of certain biases. Furthermore, there is no underlying assumption that the majority of elements should be non-differentially expressed, making it applicable to specialized boutique arrays.

  1. Structural properties of syntactically reduced speech: a comparison of normal speakers and Broca's aphasics.

    Science.gov (United States)

    de Roo, Esterella; Kolk, Herman; Hofstede, Ben

    2003-07-01

    We carried out a study in which we elicited spatial expressions from agrammatic and normal speakers by means of a picture description test. The purpose of our study was to investigate structural properties of Dutch agrammatic speech. We focussed on syntactic simplification phenomena that show up in addition to finiteness omission. We therefore invited the normal speakers to use sentences no longer than three or two words each and compared the picture descriptions of aphasic and normal speakers. In the picture descriptions two types of structures emerged that are relatively infrequent in free conversation: verbless predicative constructions with an adjectival head and intransitive prepositions as predicates. We have been able to show that the use of these construction types is directly related to syntactic reduction in both agrammatic and normal speech: it is present primarily in the speech of Broca's aphasics who produce one- and two-word utterances and of control speakers with a word limitation by instruction in the same range. The choice of reduced construction types is determined by the syntactic complexity of the phrases involved. A compensation strategy was observed both in control and aphasic speech: if utterances are shorter, the number of utterances increases.

  2. Analysis of structural changes in normal and aneurismal human aortic tissues using FTIR microscopy.

    Science.gov (United States)

    Rubin, S; Bonnier, F; Sandt, C; Ventéo, L; Pluot, M; Baehrel, B; Manfait, M; Sockalingum, G D

    2008-02-01

    Aortic aneurisms are frequently asymptomatic but can induce dramatic complications. The diagnosis is only based on the aortic diameter and not on a structural and compositional basis. In this preliminary study, we propose infrared microspectroscopy to nondestructively probe normal and aneurismal human aortas. Spectra from 19 human ascending aortic biopsies (10 normal and 9 aneurismal) were acquired using infrared microspectroscopy. A 1500 x 150 microm(2) area of each 7-microm thick cryosection was investigated using a 30-microm spatial resolution with a total of about 200 spectra per sample. Spectral differences between normal and aneurismal tissues were mainly located in spectral regions related to proteins, such as elastin and collagen, and proteoglycans (1750-1000 cm(-1)). Tissue heterogeneity and sample classification have been evaluated using hierarchical cluster analysis of individual or mean spectra and their second derivative. Using spectral range related to proteins, 100% of good classification was obtained whereas the proteoglycan spectral range was less discriminant. This in vitro study demonstrates the potential of such technique to differentiate between normal and aneurismal aortas using selected spectral ranges. Future investigations will be focused on these specific spectral regions to determine the role of elastin and collagen in the discrimination of normal and pathological aortas. (c) 2007 Wiley Periodicals, Inc.

  3. Normalization of Reverse Transcription Quantitative PCR Data During Ageing in Distinct Cerebral Structures.

    Science.gov (United States)

    Bruckert, G; Vivien, D; Docagne, F; Roussel, B D

    2016-04-01

    Reverse transcription quantitative-polymerase chain reaction (RT-qPCR) has become a routine method in many laboratories. Normalization of data from experimental conditions is critical for data processing and is usually achieved by the use of a single reference gene. Nevertheless, as pointed by the Minimum Information for Publication of Quantitative Real-Time PCR Experiments (MIQE) guidelines, several reference genes should be used for reliable normalization. Ageing is a physiological process that results in a decline of many expressed genes. Reliable normalization of RT-qPCR data becomes crucial when studying ageing. Here, we propose a RT-qPCR study from four mouse brain regions (cortex, hippocampus, striatum and cerebellum) at different ages (from 8 weeks to 22 months) in which we studied the expression of nine commonly used reference genes. With the use of two different algorithms, we found that all brain structures need at least two genes for a good normalization step. We propose specific pairs of gene for efficient data normalization in the four brain regions studied. These results underline the importance of reliable reference genes for specific brain regions in ageing.

  4. [Ischemic heart disease: structural changes of the atria in preinfarction and postinfarction stages].

    Science.gov (United States)

    Pangonyte, Dalia; Morkūnaite, Kristina; Stalioraityte, Elena; Zaikauskiene, Jolanta

    2007-01-01

    The aim of this study was to determine atrial structural remodeling during the development of ischemic heart disease. Quantitative histomorphometric parameters of interstitial collagen network (the percentage volume, perimeter, number of fibers per field and collagen-cardiomyocyte volume ratio) of the atria of 132 autopsied men (mean age 49.7+/-8.9 years) who had died suddenly (within 6 hours since the onset of terminal heart attack symptoms) due to the first (no postinfarction scars) and repeated (postinfarction scars present) acute "pure" ischemic heart disease were investigated. The main remodeling feature of the wall of the both atria among ischemic heart disease subjects is hypertrophy of cardiomyocytes and hyperplasia of interstitial fibrillar collagen network with the maintenance of the same proportion of contractile myocardium and fibrillar collagen network volume. This proportion in the case of the left atrium persists in both pre- and postinfarction ischemic heart disease groups, while myocardium of the right atrium in preinfarction group subjects is characterized by an excess increase of collagen network as compared to cardiomyocyte hypertrophy, which levels again with that of the control in postinfarction group. At preinfarction stage of ischemic heart disease, remodeling of both atria develops and progresses in the left atrium at postinfarction stage in the relationship with increase of left ventricular dysfunction.

  5. Fundamental Study on the Development of Structural Lightweight Concrete by Using Normal Coarse Aggregate and Foaming Agent

    National Research Council Canada - National Science Library

    Lee, Han-Seung; Ismail, Mohamed; Woo, Young-Je; Min, Tae-Beom; Choi, Hyun-Kook

    2014-01-01

    .... The physical and mechanical properties of specimens that were cast using normal coarse aggregates and different mixing ratios of foaming agent to evaluate the possibility of creating structural...

  6. Robert Feulgen Prize Lecture. Distribution and role of gap junctions in normal myocardium and human ischaemic heart disease.

    Science.gov (United States)

    Green, C R; Severs, N J

    1993-02-01

    In the heart, individual cardiac muscle cells are linked by gap junctions. These junctions form low resistance pathways along which the electrical impulse flows rapidly and repeatedly between all the cells of the myocardium, ensuring their synchronous contraction. To obtain probes for mapping the distribution of gap junctions in cardiac tissue, polyclonal antisera were raised to three synthetic peptides, each matching different cytoplasmically exposed portions of the sequence of connexin43, the major gap-junctional protein reported in the heart. The specificity of each antiserum for the peptide to which it was raised was established by dot blotting. New methods were developed for isolating enriched fractions of gap junctions from whole heart and from dissociated adult myocytes, in which detergent-treatment and raising the temperature (potentially damaging steps in previously described techniques) are avoided. Analysis of these fractions by SDS-polyacrylamide gel electrophoresis revealed major bands at 43 kDa (matching the molecular mass of connexin43) and at 70 kDa. Western blot experiments using our antisera indicated that both the 43-kDa and the 70-kDa bands represent cardiac gap-junctional proteins. Pre-embedding immunogold labelling of isolated gap junctions and post-embedding immunogold labelling of Lowicryl-embedded whole tissue demonstrated the specific binding of the antibodies to ultrastructurally defined gap junctions. One antiserum (raised to residues 131-142) was found to be particularly effective for cytochemical labelling. Using this antiserum for immunofluorescence labelling in combination with confocal scanning laser microscopy enabled highly sensitive detection and three-dimensional mapping of gap junctions through thick slices of cardiac tissue. By means of the serial optical sectioning ability of the confocal microscope, images of the entire gap junction population of complete en face-viewed disks were reconstructed. These reconstructions reveal

  7. Restrictive lung function in pediatric patients with structural congenital heart disease.

    Science.gov (United States)

    Hawkins, Stephen M M; Taylor, Amy L; Sillau, Stefan H; Mitchell, Max B; Rausch, Christopher M

    2014-07-01

    We sought to describe the prevalence of restrictive lung function in structural congenital heart disease and to determine the effect of cardiothoracic surgical intervention. The data from a retrospective review of the spirometry findings from pediatric patients with structural congenital heart disease were compared with the data from 220 matched controls. Restrictive lung function was defined as a forced vital capacity of 80%. Of the children with congenital heart disease, 20% met the criteria for restrictive lung function compared with 13.2% of the controls (P = .03). The prevalence in those with congenital heart disease without a surgical history was similar to that of the controls (odds ratio, 0.62; 95% confidence interval, 0.34-1.13). Restrictive lung function was more likely if surgical intervention had occurred within the first year of life (odds ratio, 1.96; 95% confidence interval, 1.08-3.55; P congenital heart disease after cardiothoracic surgical intervention than in the controls or patients without surgical intervention. The prevalence was also greater with surgical intervention at an earlier age. The risk was equivalent when sternotomy alone was compared with thoracotomy alone but was significantly greater when both sternotomy and thoracotomy were performed. The risk increased with each additional surgery performed. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  8. A review of fluid-structure interaction simulations of prosthetic heart valves.

    Science.gov (United States)

    Borazjani, Iman

    2015-01-01

    Dysfunctional natural heart valves are replaced with prosthetic heart valves through surgery. However, prosthetic valves are far from ideal. Bioprosthetic heart valves (BHVs) suffer from early calcification and structural damages. Mechanical heart valves (MHVs) are durable but highly thrombogenic and require lifelong anticoagulant treatment. These complications are believed to be related to nonphysiologic flow patterns created by these valves. Fluid-structure interaction (FSI) simulations are essential in revealing the hemodynamics of these valves. By combining the three-dimensional (3D) flow field obtained from realistic FSI simulations with platelet activation models, nonphysiologic flow patterns can be identified. In this review paper, state-of-the-art methods for simulating FSI in heart valves are reviewed, and the flow physics uncovered by FSI simulations are discussed. Finally, the limitations of current methods are discussed, and future research directions are proposed as follows: (1) incorporation of realistic, image-based ventricle and atrium geometries; (2) comparing MHV and BHV under similar conditions to identify nonphysiologic flow patterns; (3) developing better models to estimate platelet activation potential to be incorporated into the simulations; and (4) identifying the optimum placement of the valves in both mitral and aortic positions.

  9. Effect of care management program structure on implementation: a normalization process theory analysis.

    Science.gov (United States)

    Holtrop, Jodi Summers; Potworowski, Georges; Fitzpatrick, Laurie; Kowalk, Amy; Green, Lee A

    2016-08-15

    Care management in primary care can be effective in helping patients with chronic disease improve their health status, however, primary care practices are often challenged with implementation. Further, there are different ways to structure care management that may make implementation more or less successful. Normalization process theory (NPT) provides a means of understanding how a new complex intervention can become routine (normalized) in practice. In this study, we used NPT to understand how care management structure affected how well care management became routine in practice. Data collection involved semi-structured interviews and observations conducted at 25 practices in five physician organizations in Michigan, USA. Practices were selected to reflect variation in physician organizations, type of care management program, and degree of normalization. Data were transcribed, qualitatively coded and analyzed, initially using an editing approach and then a template approach with NPT as a guiding framework. Seventy interviews and 25 observations were completed. Two key structures for care management organization emerged: practice-based care management where the care managers were embedded in the practice as part of the practice team; and centralized care management where the care managers worked independently of the practice work flow and was located outside the practice. There were differences in normalization of care management across practices. Practice-based care management was generally better normalized as compared to centralized care management. Differences in normalization were well explained by the NPT, and in particular the collective action construct. When care managers had multiple and flexible opportunities for communication (interactional workability), had the requisite knowledge, skills, and personal characteristics (skill set workability), and the organizational support and resources (contextual integration), a trusting professional relationship

  10. Microgravity changes in heart structure and cyclic-AMP metabolism

    Science.gov (United States)

    Philpott, D. E.; Fine, A.; Kato, K.; Egnor, R.; Cheng, L.

    1985-01-01

    The effects of microgravity on cardiac ultrastructure and cyclic AMP metabolism in tissues of rats flown on Spacelab 3 are reported. Light and electron microscope studies of cell structure, measurements of low and high Km phosphodiesterase activity, cyclic AMP-dependent protein kinase activity, and regulatory subunit compartmentation show significant deviations in flight animals when compared to ground controls. The results indicate that some changes have occurred in cellular responses associated with catecholamine receptor interactions and intracellular signal processing.

  11. Gia/Mthl5 is an aorta specific GPCR required for Drosophila heart tube morphology and normal pericardial cell positioning.

    Science.gov (United States)

    Patel, Meghna V; Zhu, Jun-Yi; Jiang, Zhiping; Richman, Adam; VanBerkum, Mark F A; Han, Zhe

    2016-06-01

    G-protein signaling is known to be required for cell-cell contacts during the development of the Drosophila dorsal vessel. However, the identity of the G protein-coupled receptor (GPCR) that regulates this signaling pathway activity is unknown. Here we describe the identification of a novel cardiac specific GPCR, called Gia, for "GPCR in aorta". Gia is the only heart-specific GPCR identified in Drosophila to date and it is specifically expressed in cardioblasts that fuse at the dorsal midline to become the aorta. Gia is the only Drosophila gene so far identified for which expression is entirely restricted to cells of the aorta. Deletion of Gia led to a broken-hearted phenotype, characterized by pericardial cells dissociated from cardioblasts and abnormal distribution of cell junction proteins. Both phenotypes were similar to those observed in mutants of the heterotrimeric cardiac G proteins. Lack of Gia also led to defects in the alignment and fusion of cardioblasts in the aorta. Gia forms a protein complex with G-αo47A, the alpha subunit of the heterotrimeric cardiac G proteins and interacts genetically with G-αo47A during cardiac morphogenesis. Our study identified Gia as an essential aorta-specific GPCR that functions upstream of cardiac heterotrimeric G proteins and is required for morphological integrity of the aorta during heart tube formation. These studies lead to a redefinition of the bro phenotype, to encompass morphological integrity of the heart tube as well as cardioblast-pericardial cell spatial interactions. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Non-invasive estimation of myocardial efficiency using positron emission tomography and carbon-11 acetate - comparison between the normal and failing human heart

    Energy Technology Data Exchange (ETDEWEB)

    Bengel, F.M.; Nekolla, S.; Schwaiger, M. [Technische Univ. Muenchen (Germany). Nuklearmedizinische Klinik und Poliklinik; Permanetter, B. [Abteilung Innere Medizin, Kreiskrankenhaus Wasserburg/Inn (Germany); Ungerer, M. [Technische Univ. Muenchen (Germany). 1. Medizinische Klinik und Poliklinik

    2000-03-01

    We studied ten patients with idiopathic dilated cardiomyopathy (DCM) and 11 healthy normals by dynamic PET with {sup 11}C-acetate and either tomographic radionuclide ventriculography or cine magnetic resonance imaging. A ''stroke work index'' (SWI) was calculated by: SWI = systolic blood pressure x stroke volume/body surface area. To estimate myocardial efficiency, a ''work-metabolic index'' (WMI) was then obtained as follows: WMI = SWI x heart rate/k(mono), where k(mono) is the washout constant for {sup 11}C-acetate derived from mono-exponential fitting. In DCM patients, left ventricular ejection fraction was 19%{+-}10% and end-diastolic volume was 92{+-}28 ml/m{sup 2} (vs 64%{+-}7% and 55{+-}8 ml/m{sup 2} in normals, P<0.001). Myocardial oxidative metabolism, reflected by k(mono), was significantly lower compared with that in normals (0.040{+-}0.011/min vs 0.060{+-} 0.015/min; P<0.003). The SWI (1674{+-}761 vs 4736{+-} 895 mmHg x ml/m{sup 2}; P<0.001) and the WMI as an estimate of efficiency (2.98{+-}1.30 vs 6.20{+-}2.25 x 10{sup 6} mmHg x ml/m{sup 2}; P<0.001) were lower in DCM patients, too. Overall, the WMI correlated positively with ejection parameters (r=0.73, P<0.001 for ejection fraction; r=0.93, P<0.001 for stroke volume), and inversely with systemic vascular resistance (r=-0.77; P<0.001). There was a weak positive correlation between WMI and end-diastolic volume in normals (r=0.45; P=0.17), while in DCM patients, a non-significant negative correlation coefficient (r=-0.21; P=0.57) was obtained. In conclusion non-invasive estimates of oxygen consumption and efficiency in the failing heart were reduced compared with those in normals. Estimates of efficiency increased with increasing contractile performance, and decreased with increasing ventricular afterload. In contrast to normals, the failing heart was not able to respond with an increase in efficiency to increasing ventricular volume.(orig./MG) (orig.)

  13. Selection of reference genes for normalization of real-time PCR data in minipig heart failure model and evaluation of TNF-α mRNA expression.

    Science.gov (United States)

    Martino, Alessandro; Cabiati, Manuela; Campan, Manuela; Prescimone, Tommaso; Minocci, Daiana; Caselli, Chiara; Rossi, Anna Maria; Giannessi, Daniela; Del Ry, Silvia

    2011-05-20

    Real-time PCR is the benchmark method for measuring mRNA expression levels, but the accuracy and reproducibility of its data greatly depend on appropriate normalization strategies. Though the minipig model is largely used to study cardiovascular disease, no specific reference genes have been identified in porcine myocardium. The aim of the study was to identify and validate reference gene to be used in RT-PCR studies of failing (HF) and non-failing pig hearts. Eight candidate reference genes (GAPDH, ACTB, B2M, TBP, HPRT-1, PPIA, TOP2B, YWHAZ) were selected to compare cardiac tissue of normal (n=4) and HF (n=5) minipigs. The most stable genes resulted: HPRT-1, TBP, PPIA (right and left atrium); PPIA, GAPDH, ACTB (right ventricle); HPRT-1, TBP, GAPDH (left ventricle). The normalization strategy was tested analyzing mRNA expression of TNF-α, which is known to be up-regulated in HF and whose variations resulted more significant when normalized with the appropriately selected reference genes. The findings obtained in this study underline the importance to provide a set of reference genes to normalize mRNA expression in HF and control minipigs. The use of unvalidated reference genes can generate biased results because also their expression could be altered by the experimental conditions. Copyright © 2011 Elsevier B.V. All rights reserved.

  14. Effects of Hyponatremia Normalization on the Short-Term Mortality and Rehospitalizations in Patients with Recent Acute Decompensated Heart Failure: A Retrospective Study

    Directory of Open Access Journals (Sweden)

    Renato De Vecchis

    2016-10-01

    Full Text Available Background: Several studies have shown that hyponatremia is associated with increased risk of rehospitalization and death in patients with heart failure. In these studies, chronic heart failure (CHF patients with persistent hyponatremia were compared only with CHF patients with a normal sodium level at hospital admission. Aims: In the present retrospective study, conducted in a cohort of patients with recent acute decompensated heart failure (ADHF, all with hyponatremia ascertained at the time of hospital admission, we aimed to evaluate the effect of the normalization of serum sodium on the composite endpoint of short-term rehospitalization and mortality. Methods: A retrospective study centered on medical records of patients hospitalized for ADHF in the period April 2013 to April 2016 was performed. Data regarding serum sodium measurements had to be collected from medical records of cardiology wards of two hospitals, and were then processed for statistical analysis. As an inclusion criterion for enrollment, patients had to be suffering from heart failure that had required at least one hospitalization. Moreover, they had to be suffering from a state of hyponatremia (serum sodium < 135 mEq/L at admission on the occasion of the index hospitalization. Patients with hyponatremia at admission were divided into two groups, one comprising patients with hyponatremia that persisted at the time of discharge (persistent hyponatremia and a second including patients who had achieved normalization of their serum sodium levels (serum Na+ ≥ 135 mEq/L during hospitalization until discharge. For both groups, the risk of mortality and rehospitalization during a 30-day follow-up was assessed. Results: One hundred and sixty CHF patients with various degrees of functional impairment were enrolled in the study. Among them, 56 (35% had persistent hyponatremia over the course of hospitalization. At multivariable Cox proportional-hazards regression analysis, the risk of

  15. Finite element normal mode analysis of resistance welding jointed of dissimilar plate hat structure

    Science.gov (United States)

    Nazri, N. A.; Sani, M. S. M.

    2017-10-01

    Structural joints offer connection between structural element (beam, plate, solid etc.) in order to build a whole assembled structure. The complex behaviour of connecting elements plays a valuable role in characteristics of dynamic such as natural frequencies and mode shapes. In automotive structures, the trustworthiness arrangement of the structure extremely depends on joints. In this paper, top hat structure is modelled and designed with spot welding joint using dissimilar materials which is mild steel 1010 and stainless steel 304, using finite element software. Different types of connector elements such as rigid body element (RBE2), welding joint element (CWELD), and bar element (CBAR) are applied to represent real connection between two dissimilar plates. Normal mode analysis is simulated with different types of joining element in order to determine modal properties. Natural frequencies using RBE2, CBAR and CWELD are compared to equivalent rigid body method. Connection that gives the lowest percentage error among these three will be selected as the most reliable joining for resistance spot weld. From the analysis, it is shown that CWELD is better compared to others in term of weld joining among dissimilar plate materials. It is expected that joint modelling of finite element plays significant role in structural dynamics.

  16. Early-life perturbations in glucocorticoid activity impacts on the structure, function and molecular composition of the adult zebrafish (Danio rerio) heart

    Science.gov (United States)

    Wilson, K.S.; Baily, J.; Tucker, C.S.; Matrone, G.; Vass, S.; Moran, C.; Chapman, K.E.; Mullins, J.J.; Kenyon, C.; Hadoke, P.W.F.; Denvir, M.A.

    2015-01-01

    Background Transient early-life perturbations in glucocorticoids (GC) are linked with cardiovascular disease risk in later life. Here the impact of early life manipulations of GC on adult heart structure, function and gene expression were assessed. Methods and results Zebrafish embryos were incubated in dexamethasone (Dex) or injected with targeted glucocorticoid receptor (GR) morpholino knockdown (GR Mo) over the first 120 h post fertilisation (hpf); surviving embryos (>90%) were maintained until adulthood under normal conditions. Cardiac function, heart histology and cardiac genes were assessed in embryonic (120 hpf) and adult (120 days post fertilisation (dpf)) hearts. GR Mo embryos (120 hpf) had smaller hearts with fewer cardiomyocytes, less mature striation pattern, reduced cardiac function and reduced levels of vmhc and igf mRNA compared with controls. GR Mo adult hearts were smaller with diminished trabecular network pattern, reduced expression of vmhc and altered echocardiographic Doppler flow compared to controls. Dex embryos had larger hearts at 120 hpf (Dex 107.2 ± 3.1 vs. controls 90.2 ± 1.1 μm, p hearts were larger (1.02 ± 0.07 μg/mg vs controls 0.63 ± 0.06 μg/mg, p = 0.0007), had increased vmhc and gr mRNA levels. Conclusion Perturbations in GR activity during embryonic development results in short and long-term alterations in the heart. PMID:26219824

  17. Normal Mode Flexible Fitting of High-Resolution Structures of Biological Molecules Toward SAXS Data

    Directory of Open Access Journals (Sweden)

    Christian Gorba

    2010-06-01

    Full Text Available We present a method to reconstruct a three-dimensional protein structure from an atomic pair distribution function derived from the scattering intensity profile from SAXS data by flexibly fitting known x-ray structures. This method uses a linear combination of low-frequency normal modes from an elastic network description of the molecule in an iterative manner to deform the structure to conform optimally to the target pair distribution function derived from SAXS data. For computational efficiency, the protein and water molecules included in the protein first hydration shell are coarse-grained. In this paper, we demonstrate the validity of our coarse- graining approach to study SAXS data. Illustrative results of our flexible fitting studies on simulated SAXS data from five different proteins are presented.

  18. Prognostic Value of Normal Perfusion but Impaired Left Ventricular Function in the Diabetic Heart on Quantitative Gated Myocardial Perfusion SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Hwanjeong; Choi, Sehun; Han, Yeonhee [Research Institute of Chonbuk National Univ. Medical School and Hospitial, Jeonju (Korea, Republic of); Lee, Dong Soo; Lee, Hoyoung; Chung, Junekey [Seoul National Univ., Seoul (Korea, Republic of)

    2013-09-15

    This study aimed at identifying the predictive parameters on quantitative gated myocardial perfusion single-photon emission computed tomography (QG-SPECT) in diabetic patients with normal perfusion but impaired function. Methods Among the 533 consecutive diabetic patients, 379 patients with normal perfusion on rest Tl-201/dipyridamole-stress Tc-{sup 99m} sestamibi Gated SPECT were enrolled. Patients were grouped into those with normal post-stress left ventricular function (Group I) and those with impaired function (EF <50 or impaired regional wall motion, Group II). We investigated cardiac events and cause of death by chart review and telephone interview. Survival analysis and Cox proportional hazard model analysis were performed. Between the Group I and II, cardiac events as well as chest pain symptoms, smoking, diabetic complications were significantly different (P<0.05). On survival analysis, event free survival rate in Group II was significantly lower than in Group I (P=0.016). In univariate Cox proportional hazard analysis on overall cardiac event, Group (II over I), diabetic nephropathy, summed motion score (SMS), summed systolic thickening score (STS), numbers of abnormal segmental wall motion and systolic thickening predicted more cardiac events (P<0.05). Multivariate analysis showed that STS was the only independent predictor cardiac event. The functional parameter, especially summed systolic thickening score on QG-SPECT had prognostic values, despite normal perfusion, in predicting cardiac events in diabetic patients, and QG-SPECT provides clinically useful risk stratification in diabetic patients with normal perfusion.

  19. Evaluation of Prolonged QT Interval: Structural Heart Disease Mimicking Long QT Syndrome.

    Science.gov (United States)

    Weissler-Snir, Adaya; Gollob, Michael H; Chauhan, Vijay; Care, Melanie; Spears, Danna A

    2017-04-01

    In about 20-25% of patients with congenital long QT syndrome (LQTS) a causative pathogenic mutation is not found. The aim of this study was to explore the prevalence of alternative cardiac diagnoses among patients exhibiting prolongation of QT interval with negative genetic testing for LQTS genes. We conducted a retrospective analysis of 239 consecutive patients who were evaluated in the inherited arrhythmia clinic at the Toronto General Hospital between July 2013 and December 2015 for possible LQTS. A detailed review of the patients' charts, electrocardiograms, and imaging was carried out. The analysis included 56 gene-negative patients and 61 gene-positive patients. Of the gene-negative group, 25% had structural heart disease compared to only 1.6% of gene-positive patients (P < 0.001). Structural heart disease was more likely if only one abnormal QTc parameter was found in the course of the evaluation (35.2% vs 9.1%, P = 0.01). The most common structural cardiac pathology was bileaflet mitral valve prolapse (8.9%). No gene-positive patient had episodes of nonsustained ventricular tachycardia, compared to seven of the gene-negative patients (0% vs 12.5%, P = 0.005). Structural pathology was detected in a quarter of gene-negative patients evaluated for possible LQTS. Hence, cardiac imaging and Holter monitoring should be strongly encouraged to rule out structural heart disease in this population. © 2017 Wiley Periodicals, Inc.

  20. Application of the normalized curvature ratio to an in-service structure

    Science.gov (United States)

    Kliewer, Kaitlyn; Glisic, Branko

    2017-04-01

    Fiber optic sensors (FOS) offer numerous advantages for structural health monitoring. In addition to being durable, lightweight, and capable of multiplexing, they offer the ability to simultaneously monitor both static and dynamic strain. FOS also allow for the instrumentation of large areas of a structure with long-gages sensors which helps enable global monitoring of the structure. Drawing upon these benefits, the Normalized Curvature Ratio (NCR), a curvature based damage detection method, has been developed. This method utilizes a series of long-gage fiber Bragg grating (FBG) strain sensors for damage detection of a structure through dynamic strain measurements and curvature analysis. While dynamic SHM methods typically rely up frequency and acceleration based analysis, it has been found that strain and curvature based analysis may be a more reliable means for structural monitoring. Previous research was performed through small scale experimental testing and analytical models were developed and provided promising results for the NCR as a potential damage sensitive feature. Based on this success, this research focuses on the application of the NCR to an existing in-service structure, the US202/NJ23 highway overpass located in Wayne, NJ. The overpass is currently instrumented with a series of long-gage FBG strains sensors and periodic strain measurements for dynamic events induced by heavy weight vehicles have been recorded for more than 5 years. This research shows encouraging results and the potential for the NCR to be used as a simplistic metric for damage detection using FBG strain sensors.

  1. Comparing wake structures behind a finite aspect ratio and an infinite span normal thin flat plate

    Science.gov (United States)

    Hemmati, Arman; Wood, David H.; Martinuzzi, Robert J.

    2014-11-01

    The wake of an infinite span (2D) thin flat plate and that of a finite aspect ratio, AR = 3.2, plate, both normal to a uniform stream, are compared using DNS at Re = 1200. For the 2D plate, three wake flow regimes are observed. Intervals of typical anti-symmetric Karman shedding (Regime M) are interrupted by intervals where the shear layer folding process first delayed (Regime L) and then accelerated, Regime H. The distinct flow patterns in these regimes have significant impact on lift and drag values, wake structure and instantaneous pressure loads. In contrast, only Regime M is observed for the AR = 3.2 plate. The presence of two lateral shear layers appears to maintain the Karman shedding. Compared to the infinite plate: the mean recirculation region shrinks by 45 % to 1.57H; the magnitude of the Reynolds Stresses drops significantly; Turbulent kinetic energy levels along the wake centerline and peak production and dissipation rates are significantly lower. Further, the three normal Reynolds stresses are comparable in magnitude. To better understand the impact of additional shear layers on the wake stability and resultant wake structures, the 3D structures will be reconstructed using DNS results. Pressure and stress distribution along the plate surfaces will also be examined. This work is supported by AITF and NSERC fellowship grants.

  2. Adiabatic pumping current in a graphene based normal-insulator-superconductor junction with Corbino disk structure

    Directory of Open Access Journals (Sweden)

    Elham Moomivand

    2017-05-01

    Full Text Available We investigate adiabatic pumping current in a graphene based normal-insulator-superconductor (NIS junction with Corbino disk structure. The adiabatic pumping current is generated by two electrostatic potentials, oscillating periodically and out of phase, applied to the insulating and superconducting regions. Using the extended Brouwer’s formula for the adiabatic pumping current, which is based on the scattering theory, the pumping current is obtained. The results of this calculation show the pumped current oscillates as a function of the barrier strength and it has maximums at resonances with a π/2 phase shift in comparison to the planar NIS junction.

  3. Correlation of hetorogeneous blood flow and uptake of a di-methyl-branched IODO fatty acid in the normal and ischemic dog heart

    Energy Technology Data Exchange (ETDEWEB)

    Sloof, G.W.; Visser, F.C.; Comans, E.F.I. [Free Univ. Hospital, Amsterdam (Netherlands)]|[Oak Ridge National Lab., TN (United States)] [and others

    1995-05-01

    Myocardial blood flow (MBF) is heterogeneously distributed in normal and ischemic myocardium (myoc). Methylated iodinated fatty acids, like 15-(p-I-125-iodophenyl)-3,3-dimethylpentadecanoic acid (DMIPPA) can be used to study fatty acid metabolism with SPECT. We studied the relationship between DMIPPA uptake and MBF. In 10 open-chest dogs, ischemica was induced in the LAD coronary artery by an extra-corporal bypass system. MBF was measured with Sc-46 labeled microspheres. Fourty min. after DMIPPA iv. (34{plus_minus}4 MBq), hearts were excised and left ventricles were cut into 120 pieces, weighed and radioactivities counted. MBF and DMIPPA uptake were determined by counting in normal and ischemic myoc. Heterogeneity is expressed as the coefficient of variation (CV) and agreement as the CV of the DMIPPA uptake to MBF ratio. A control study, normal flow in LAD, in 4 dogs revealed no differences in MBF or DMIPPA uptake between the cannulated versus native perfused myoc. We conclude the DMIPPA detects ischemia, in which it shows a different relation with MBF compared to normal myoc. DMIPPA is less heterogeneously distributed than MBF and agreement between MFB and DMIPPA uptake decreases during ischemia.

  4. Simulation of a pulsatile total artificial heart: Development of a partitioned Fluid Structure Interaction model

    Science.gov (United States)

    Sonntag, Simon J.; Kaufmann, Tim A. S.; Büsen, Martin R.; Laumen, Marco; Linde, Torsten; Schmitz-Rode, Thomas; Steinseifer, Ulrich

    2013-04-01

    Heart disease is one of the leading causes of death in the world. Due to a shortage in donor organs artificial hearts can be a bridge to transplantation or even serve as a destination therapy for patients with terminal heart insufficiency. A pusher plate driven pulsatile membrane pump, the Total Artificial Heart (TAH) ReinHeart, is currently under development at the Institute of Applied Medical Engineering of RWTH Aachen University.This paper presents the methodology of a fully coupled three-dimensional time-dependent Fluid Structure Interaction (FSI) simulation of the TAH using a commercial partitioned block-Gauss-Seidel coupling package. Partitioned coupling of the incompressible fluid with the slender flexible membrane as well as a high fluid/structure density ratio of about unity led inherently to a deterioration of the stability (‘artificial added mass instability’). The objective was to conduct a stable simulation with high accuracy of the pumping process. In order to achieve stability, a combined resistance and pressure outlet boundary condition as well as the interface artificial compressibility method was applied. An analysis of the contact algorithm and turbulence condition is presented. Independence tests are performed for the structural and the fluid mesh, the time step size and the number of pulse cycles. Because of the large deformation of the fluid domain, a variable mesh stiffness depending on certain mesh properties was specified for the fluid elements. Adaptive remeshing was avoided. Different approaches for the mesh stiffness function are compared with respect to convergence, preservation of mesh topology and mesh quality. The resulting mesh aspect ratios, mesh expansion factors and mesh orthogonalities are evaluated in detail. The membrane motion and flow distribution of the coupled simulations are compared with a top-view recording and stereo Particle Image Velocimetry (PIV) measurements, respectively, of the actual pump.

  5. Temporal cohesion of the structural, functional and molecular characteristics of the developing zebrafish heart.

    Science.gov (United States)

    Matrone, Gianfranco; Wilson, Kathryn S; Mullins, John J; Tucker, Carl S; Denvir, Martin A

    2015-06-01

    Heart formation is a complex, dynamic and highly coordinated process of molecular, morphogenetic and functional factors with each interacting and contributing to formation of the mature organ. Cardiac abnormalities in early life can be lethal in mammals but not in the zebrafish embryo which has been widely used to study the developing heart. While early cardiac development in the zebrafish has been well characterized, functional changes during development and how these relate to architectural, cellular and molecular aspects of development have not been well described previously. To address this we have carefully characterised cardiac structure, function, cardiomyocyte proliferation and cardiac-specific gene expression between 48 and 120 hpf in the zebrafish. We show that the zebrafish heart increases in volume and changes shape significantly between 48 and 72 hpf accompanied by a 40% increase in cardiomyocyte number. Between 96 and 120 hpf, while external heart expansion slows, there is rapid formation of a mature and extensive trabecular network within the ventricle chamber. While ejection fraction does not change during the course of development other determinants of contractile function increase significantly particularly between 72 and 96 hpf leading to an increase in cardinal vein blood flow. This study has revealed a number of novel aspects of cardiac developmental dynamics with striking temporal orchestration of structure and function within the first few days of development. These changes are associated with changes in expression of developmental and maturational genes. This study provides important insights into the complex temporal relationship between structure and function of the developing zebrafish heart. Copyright © 2015 International Society of Differentiation. Published by Elsevier B.V. All rights reserved.

  6. Swimming exercise reverses aging-related contractile abnormalities of female heart by improving structural alterations.

    Science.gov (United States)

    Ozturk, Nihal; Olgar, Yusuf; Er, Hakan; Kucuk, Murathan; Ozdemir, Semir

    2017-01-01

    The objective of this study was to examine the effect of swimming exercise on aging-related Ca2+ handling alterations and structural abnormalities of female rat heart. For this purpose, 4-month and 24-month old female rats were used and divided into three following groups: sedentary young (SY), sedentary old (SO), and exercised old (Ex-O). Swimming exercise was performed for 8 weeks (60 min/day, 5 days/week). Myocyte shortening, L-type Ca2+ currents and associated Ca2+ transients were measured from ventricular myocytes at 36 ± 1°C. NOX-4 levels, aconitase activity, glutathione measurements and ultrastructural examination by electron microscopy were conducted in heart tissue. Swimming exercise reversed the reduced shortening and slowed kinetics of aged cardiomyocytes. Although the current density was similar for all groups, Ca2+ transients were higher in SO and Ex-O myocytes with respect to the SY group. Caffeine-induced Ca2+ transients and the integrated NCX current were lower in cardiomyocytes of SY rats compared with other groups, suggesting an increased sarcoplasmic reticulum Ca2+ content in an aged heart. Aging led to upregulated cardiac NOX-4 along with declined aconitase activity. Although it did not reverse these oxidative parameters, swimming exercise achieved a significant increase in glutathione levels and improved structural alterations of old rats' hearts. We conclude that swimming exercise upregulates antioxidant defense capacity and improves structural abnormalities of senescent female rat heart, although it does not change Ca2+ handling alterations further. Thereby, it improves contractile function of aged myocardium by mitigating detrimental effects of oxidative stress.

  7. Research on micro-structure and hemo-compatibility of the artificial heart valve surface

    Energy Technology Data Exchange (ETDEWEB)

    Ye Xia [Center of Photonics Fabrication, Jiangsu University, Zhenjiang 212013 (China); School of Mechanical Engineering, Jiangsu Teachers University of Technology, Changzhou 213015 (China); Shao Yunliang [Center of Photonics Fabrication, Jiangsu University, Zhenjiang 212013 (China); Zhou Ming, E-mail: zm_laser@126.com [Center of Photonics Fabrication, Jiangsu University, Zhenjiang 212013 (China); Li Jian; Cai Lan [Center of Photonics Fabrication, Jiangsu University, Zhenjiang 212013 (China)

    2009-04-15

    In order to seek the method to improve the hemo-compatibility of artificial mechanical heart valve, the surface of rabbit's heart valve was observed using the scanning electron microscopy (SEM). The results showed that the dual-scale structure which consists of cobblestones-like structure of 8 {mu}m in underside diameter and 3 {mu}m in height, and the fine cilia of about 150 nm in diameter, was helpful to the hemo-compatibility of the heart valve. Therefore, the polydimethylsiloxane (PDMS) surface with hierarchical micro-structure was fabricated using femtosecond laser fabrication technique and soft lithography. At the same time, the tests of apparent contact angle and platelet adhesion on both smooth and textured PDMS surfaces were carried out to study their wettability and hemo-compatibility. The results demonstrated that the surface with textured structure displayed more excellent wettabililty and anti-coagulation property than that of smooth surface. The apparent contact angle of textured surface enhanced from 113.1 deg. to 163.6 deg. and the amount of adsorbed platelet on such surface was fewer, no distortion and no activation were found.

  8. Integrating normal and abnormal personality structure: a proposal for DSM-V.

    Science.gov (United States)

    Widiger, Thomas A

    2011-06-01

    The personality disorders section of the American Psychiatric Association's fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) is currently being developed. The purpose of the current paper is to encourage the authors of DSM-V to integrate normal and abnormal personality structure within a common, integrative model, and to suggest that the optimal choice for such an integration would be the five-factor model (FFM) of general personality structure. A proposal for the classification of personality disorder from the perspective of the FFM is provided. Discussed as well are implications and issues associated with an FFM of personality disorder, including validity, coverage, feasibility, clinical utility, and treatment implications.

  9. Normal linear models with genetically structured residual variance heterogeneity: a case study

    DEFF Research Database (Denmark)

    Sorensen, Daniel; Waagepetersen, Rasmus Plenge

    2003-01-01

    Normal mixed models with different levels of heterogeneity in the residual variance are fitted to pig litter size data. Exploratory analysis and model assessment is based on examination of various posterior predictive distributions. Comparisons based on Bayes factors and related criteria favour...... models with a genetically structured residual variance heterogeneity. There is, moreover, strong evidence of a negative correlation between the additive genetic values affecting litter size and those affecting residual variance. The models are also compared according to the purposes for which they might...... be used, such as prediction of 'future' data, inference about response to selection and ranking candidates for selection. A brief discussion is given of some implications for selection of the genetically structured residual variance model....

  10. Structured telephone support or non-invasive telemonitoring for patients with heart failure.

    Science.gov (United States)

    Inglis, Sally C; Clark, Robyn A; Dierckx, Riet; Prieto-Merino, David; Cleland, John G F

    2015-10-31

    Specialised disease management programmes for heart failure aim to improve care, clinical outcomes and/or reduce healthcare utilisation. Since the last version of this review in 2010, several new trials of structured telephone support and non-invasive home telemonitoring have been published which have raised questions about their effectiveness. To review randomised controlled trials (RCTs) of structured telephone support or non-invasive home telemonitoring compared to standard practice for people with heart failure, in order to quantify the effects of these interventions over and above usual care. We updated the searches of the Cochrane Central Register of Controlled Trials (CENTRAL), Database of Abstracts of Reviews of Effects (DARE), Health Technology AsseFssment Database (HTA) on the Cochrane Library; MEDLINE (OVID), EMBASE (OVID), CINAHL (EBSCO), Science Citation Index Expanded (SCI-EXPANDED), Conference Proceedings Citation Index- Science (CPCI-S) on Web of Science (Thomson Reuters), AMED, Proquest Theses and Dissertations, IEEE Xplore and TROVE in January 2015. We handsearched bibliographies of relevant studies and systematic reviews and abstract conference proceedings. We applied no language limits. We included only peer-reviewed, published RCTs comparing structured telephone support or non-invasive home telemonitoring to usual care of people with chronic heart failure. The intervention or usual care could not include protocol-driven home visits or more intensive than usual (typically four to six weeks) clinic follow-up. We present data as risk ratios (RRs) with 95% confidence intervals (CIs). Primary outcomes included all-cause mortality, all-cause and heart failure-related hospitalisations, which we analysed using a fixed-effect model. Other outcomes included length of stay, health-related quality of life, heart failure knowledge and self care, acceptability and cost; we described and tabulated these. We performed meta-regression to assess homogeneity (the

  11. [Structural analysis of normal corneas and diseased corneas by applying second harmonic generation].

    Science.gov (United States)

    Morishige, Naoyuki

    2011-11-01

    We have established a second harmonic generation (SHG) microscopy system for imaging of the human cornea with a mode-locked femtosecond laser and a laser confocal microscope. This SHG microscopy system has allowed us to scan corneal tissue noninvasively ex vivo and to obtain three-dimensional images of corneal collagen lamellae. Such three-dimensional imaging of the normal anterior cornea revealed that collagen lamellae at the anterior stroma are inter-woven and adhere to Bowman membrane with these adherent lamellae being designated "sutural lamellae." Sutural lamellae adhere to Bowman membrane at an angle of approximately 19 degrees, whereas the angle of lamellae in the mid-stroma relative to Bowman membrane is smaller. We hypothesize that the structural unit consisting of both Bowman membrane and the sutural lamellae contributes to the rigidity and anterior curvature of the cornea. SHG imaging of keratoconic corneas revealed an either abnormal or a total lack of structure of the sutural lamellae, suggesting that this abnormality might be related to that of the corneal anterior curvature in such corneas. Furthermore, SHG imaging of corneas affected by stromal edema showed that the structure of the sutural lamellae was maintained, although abnormal collagen signals both above and below Bowman membrane were detected in corneas affected by clinical stromal edema for more than 12 months. SHG imaging of the structure of collagen lamellae in normal and diseased corneas thus has the potential to provide insight both into the mechanism for maintenance of corneal curvature as well as into the pathophysiology of corneal diseases.

  12. Structural and functional changes in the heart and clinical features of heart failure with preserved left ventricular ejection fraction in patients after myocardial infarction, comorbided with arterial hypertension

    Directory of Open Access Journals (Sweden)

    V. D. Syvolap

    2013-12-01

    Full Text Available Recently, much attention was paid to left ventricular diastolic dysfunction and its role in the occurrence of chronic heart failure. In patients after myocardial infarction, diastolic dysfunction often precedes systolic dysfunction and predicts prognosis. In patients after myocardial infarction, diastolic dysfunction is caused by a violation of early diastolic relaxation in the area of increasing stiffness. Diastolic dysfunction is formed by hypertrophy, fibrosis, myocardial ischemia and arterial hypertension. Given the important role of diastolic dysfunction in the formation of heart failure in postinfarction patients with concomitant arterial hypertension, the mechanisms of its impact on clinical features and structural-functional changes of the heart is an actual problem. Objective: To determine the structural and functional changes in the heart and clinical features of heart failure with preserved left ventricular ejection fraction in patients after myocardial infarction with concomitant arterial hypertension. Materials and methods: In 91 patients with post-infarction cardiosclerosis and preserved left ventricular ejection fraction (EF > 45 % with arterial hypertension were investigated structural and functional changes in the heart and clinical features of heart failure by assessing clinical status and ultrasound of the heart. Prescription myocardial infarction ranged from 2 months to 3 years. Patients were divided into 3 groups. The first group included 50 patients with diastolic dysfunction and symptoms of heart failure (mean age 64,1 ± 1,2 years. In the second group were 31 patients with diastolic dysfunction without heart failure symptoms (mean age 59,5 ± 1,6 years. The third group consisted of 10 patients without diastolic dysfunction and manifestations of heart failure (mean age 57 ± 2,8 years. Results and discussion: 10% patients with postinfarction cardiosclerosis and concomitant hypertension with diastolic heart failure had NYHA

  13. Association of structural global brain network properties with intelligence in normal aging.

    Science.gov (United States)

    Fischer, Florian U; Wolf, Dominik; Scheurich, Armin; Fellgiebel, Andreas

    2014-01-01

    Higher general intelligence attenuates age-associated cognitive decline and the risk of dementia. Thus, intelligence has been associated with cognitive reserve or resilience in normal aging. Neurophysiologically, intelligence is considered as a complex capacity that is dependent on a global cognitive network rather than isolated brain areas. An association of structural as well as functional brain network characteristics with intelligence has already been reported in young adults. We investigated the relationship between global structural brain network properties, general intelligence and age in a group of 43 cognitively healthy elderly, age 60-85 years. Individuals were assessed cross-sectionally using Wechsler Adult Intelligence Scale-Revised (WAIS-R) and diffusion-tensor imaging. Structural brain networks were reconstructed individually using deterministic tractography, global network properties (global efficiency, mean shortest path length, and clustering coefficient) were determined by graph theory and correlated to intelligence scores within both age groups. Network properties were significantly correlated to age, whereas no significant correlation to WAIS-R was observed. However, in a subgroup of 15 individuals aged 75 and above, the network properties were significantly correlated to WAIS-R. Our findings suggest that general intelligence and global properties of structural brain networks may not be generally associated in cognitively healthy elderly. However, we provide first evidence of an association between global structural brain network properties and general intelligence in advanced elderly. Intelligence might be affected by age-associated network deterioration only if a certain threshold of structural degeneration is exceeded. Thus, age-associated brain structural changes seem to be partially compensated by the network and the range of this compensation might be a surrogate of cognitive reserve or brain resilience.

  14. Association of structural global brain network properties with intelligence in normal aging.

    Directory of Open Access Journals (Sweden)

    Florian U Fischer

    Full Text Available Higher general intelligence attenuates age-associated cognitive decline and the risk of dementia. Thus, intelligence has been associated with cognitive reserve or resilience in normal aging. Neurophysiologically, intelligence is considered as a complex capacity that is dependent on a global cognitive network rather than isolated brain areas. An association of structural as well as functional brain network characteristics with intelligence has already been reported in young adults. We investigated the relationship between global structural brain network properties, general intelligence and age in a group of 43 cognitively healthy elderly, age 60-85 years. Individuals were assessed cross-sectionally using Wechsler Adult Intelligence Scale-Revised (WAIS-R and diffusion-tensor imaging. Structural brain networks were reconstructed individually using deterministic tractography, global network properties (global efficiency, mean shortest path length, and clustering coefficient were determined by graph theory and correlated to intelligence scores within both age groups. Network properties were significantly correlated to age, whereas no significant correlation to WAIS-R was observed. However, in a subgroup of 15 individuals aged 75 and above, the network properties were significantly correlated to WAIS-R. Our findings suggest that general intelligence and global properties of structural brain networks may not be generally associated in cognitively healthy elderly. However, we provide first evidence of an association between global structural brain network properties and general intelligence in advanced elderly. Intelligence might be affected by age-associated network deterioration only if a certain threshold of structural degeneration is exceeded. Thus, age-associated brain structural changes seem to be partially compensated by the network and the range of this compensation might be a surrogate of cognitive reserve or brain resilience.

  15. Kiss1 mutant placentas show normal structure and function in the mouse

    Science.gov (United States)

    Herreboudt, A.M.; Kyle, V.R.L.; Lawrence, J.; Doran, J.; Colledge, W.H.

    2015-01-01

    Introduction Kisspeptins, encoded by the Kiss1 gene, are a set of related neuropeptides that are required for activation of the mammalian reproductive axis at puberty and to maintain fertility. In addition, kisspeptin signaling via the G-protein coupled receptor GPR54 (KISS1R) has been suggested to regulate human placental formation and correlations have been found between altered kisspeptin levels in the maternal blood and the development of pre-eclampsia. Methods We have used Kiss1 and Gpr54 mutant mice to investigate the role of kisspeptin signaling in the structure and function of the mouse placenta. Results Expression of Kiss1 and Gpr54 was confirmed in the mouse placenta but no differences in birth weight were found in mice that had been supported by a mutant placenta during fetal development. Stereological measurements found no differences between Kiss1 mutant and wild-type placentas. Measurement of amino-acid and glucose transport across the Kiss1 mutant placentas at E15.5 days did not reveal any functional defects. Discussion These data indicate that mouse placentas can develop a normal structure and function without kisspeptin signaling and can support normal fetal development and growth. PMID:25468546

  16. Damage identification in beam structure based on thresholded variance of normalized wavelet scalogram

    Science.gov (United States)

    Janeliukstis, R.; Rucevskis, S.; Wesolowski, M.; Chate, A.

    2017-10-01

    In this paper, a damage identification algorithm based on continuous wavelet transform of one-dimensional structures exploiting mode shapes is presented. Numerical models of aluminium and carbon composite beams, containing a mill-cut and impact damage, respectively are considered for this study. Wavelet scalogram is used to obtain the transform coefficients at different wavelet scales and is subsequently normalized in order to emphasize locations with largest coefficients. Variance of normalized wavelet scalogram is computed along the axis of the beam yielding sharp peaks in the zones corresponding to damage in beams. This operation excludes wavelet scale factors as variables for damage localization problems. The universal threshold is applied to filter out lower amplitude peaks that do not indicate damage. These results are summed up for all nodes of beams and all wavelet functions that are analysed in this paper in order to also exclude the number of different wavelet functions as another variable for damage localization. The universal threshold is applied the second time to yield the final result on the locations of damage. Results suggest that the proposed damage localization method is a fast and reliable tool for damage detection in one-dimensional metal and composite beam structures.

  17. Cardiovascular Magnetic Resonance Imaging for Structural and Valvular Heart Disease Interventions.

    Science.gov (United States)

    Cavalcante, João L; Lalude, Omosalewa O; Schoenhagen, Paul; Lerakis, Stamatios

    2016-03-14

    The field of percutaneous interventions for the treatment of structural and valvular heart diseases has been expanding rapidly in the last 5 years. Noninvasive cardiac imaging has been a critical part of the planning, procedural guidance, and follow-up of these procedures. Although echocardiography and cardiovascular computed tomography are the most commonly used and studied imaging techniques in this field today, advances in cardiovascular magnetic resonance imaging continue to provide important contributions in the comprehensive assessment and management of these patients. In this comprehensive paper, we will review and demonstrate how cardiovascular magnetic resonance imaging can be used to assist in diagnosis, treatment planning, and follow-up of patients who are being considered for and/or who have undergone interventions for structural and valvular heart diseases. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  18. Modifying the Target Normal Sheath Accelerated Ion Spectrum Using Structured Targets

    Science.gov (United States)

    George, Kevin Mitchell

    In the interaction of high intensity (> 1018 W/cm2), ultrashort (physical mechanism known as target normal sheath acceleration (TNSA). Since its discovery in 2000, TNSA has been widely studied throughout the High Energy Density Physics community in order to understand and enhance this process for its potential applications ranging from cancer therapy to radiography. However, much of this work has been conducted on thin (1s to 10s of microns thick) metal foils exploring optimization only through critical laser parameters such as intensity, energy, and prepulse. This thesis addresses the development of novel micro-structured targets for the enhancement of TNSA ions. These targets were developed through the use of optical lithography techniques to pattern micron-scale structures onto thin substrates at the OSU Nanosystem Laboratory (NSL) user facility. These targets permit on-demand patterning of designs with 1 mum lateral resolution, heights varying between 0.5-2 mum, on substrates ranging from 0.5-2 mum thick with high throughput. An experiment was conducted at the Scarlet laser facility to characterize the effect of structuring the laser-target interface on the energy spectrum of TNSA protons. A comparison of the proton dose from structured versus at photoresist on silicon nitride substrates was performed. Results obtained using radiochromic film demonstrate an increase in proton dose by a factor of 2.3 through the use of structured photoresist as compared to unstructured photoresist of the same thickness. Two dimensional absorption simulations were conducted to verify enhanced absorption from the structured targets which, in turn, generates a stronger TNSA field. A nearly 200% increase in absorption was found to occur with the use of the structured interface and vacuum heating was identified as the dominant absorption mechanism. An intuitive structured target vacuum heating model was developed to account for the structured surface orientations which are

  19. Characterizing structure connectivity correlation with the default mode network in Alzheimer's patients and normal controls

    Science.gov (United States)

    Guo, Jia; Xu, Peng; Song, Chao; Yao, Li; Zhao, Xiaojie

    2012-03-01

    Magnetic resonance diffusion tensor imaging (DTI) is a kind of effective measure to do non-invasive investigation on brain fiber structure at present. Studies of fiber tracking based on DTI showed that there was structural connection of white matter fiber among the nodes of resting-state functional network, denoting that the connection of white matter was the basis of gray matter regions in functional network. Nevertheless, relationship between these structure connectivity regions and functional network has not been clearly indicated. Moreover, research of fMRI found that activation of default mode network (DMN) in Alzheimer's disease (AD) was significantly descended, especially in hippocampus and posterior cingulated cortex (PCC). The relationship between this change of DMN activity and structural connection among functional networks needs further research. In this study, fast marching tractography (FMT) algorithm was adopted to quantitative calculate fiber connectivity value between regions, and hippocampus and PCC which were two important regions in DMN related with AD were selected to compute white matter connection region between them in elderly normal control (NC) and AD patient. The fiber connectivity value was extracted to do the correlation analysis with activity intensity of DMN. Results showed that, between PCC and hippocampus of NC, there exited region with significant high connectivity value of white matter fiber whose performance has relatively strong correlation with the activity of DMN, while there was no significant white matter connection region between them for AD patient which might be related with reduced network activation in these two regions of AD.

  20. Organizational structure and processes in pediatric heart transplantation: a survey of practices.

    Science.gov (United States)

    Stendahl, Gail; Bobay, Kathleen; Berger, Stuart; Zangwill, Steven

    2012-05-01

    Despite emerging literature on pediatric heart transplantation, there continues to be variation in current practices. The degree of variability among heart transplant programs has not been previously characterized. The purpose of this study was to evaluate organizational structure and practices of pediatric heart transplant programs. The UNOS database was queried to identify institutions according to volume. Coordinators from 50 institutions were invited to participate with a 70% response rate. Centers were grouped by volume into four categories. Some institutional practices were dominated by clear volume trends. Ninety-five percent of larger centers routinely transplant patients with known antibody sensitization and report a broader range and acuity of recipients. Ninety-four percent report problems with non-adherence. Sixty-nine percent of centers routinely require prospective crossmatches. There was dramatic variation in the use of steroids across all centers. Sixty-five percent of centers transition adolescents to an adult program. Prophylaxis protocols were also highly inconsistent. This survey provided a comprehensive insight into current practices at pediatric heart transplant programs. The results delineated remarkably variable strategies for routine aspects of care. Analysis of divergence along with uniformity across protocols is a valuable exercise and may serve as a stepping-stone toward ongoing cooperation and clarity for evidence-based practice protocols. © 2012 John Wiley & Sons A/S.

  1. 4D flow MRI assessment of right atrial flow patterns in the normal heart - influence of caval vein arrangement and implications for the patent foramen ovale.

    Directory of Open Access Journals (Sweden)

    Jehill D Parikh

    Full Text Available To investigate atrial flow patterns in the normal adult heart, to explore whether caval vein arrangement and patency of the foramen ovale (PFO may be associated with flow pattern.Time-resolved, three-dimensional velocity encoded magnetic resonance imaging (4D flow was employed to assess atrial flow patterns in thirteen healthy subjects (6 male, 40 years, range 25-50 and thirteen subjects (6 male, 40 years, range 21-50 with cryptogenic stroke and patent foramen ovale (CS-PFO. Right atrial flow was defined as vortical, helico-vortical, helical and multiple vortices. Time-averaged and peak systolic and diastolic flows in the caval and pulmonary veins and their anatomical arrangement were compared.A spectrum of right atrial flow was observed across the four defined categories. The right atrial flow patterns were strongly associated with the relative position of the caval veins. Right atrial flow patterns other than vortical were more common (p = 0.015 and the separation between the superior and inferior vena cava greater (10±5mm versus 3±3mm, p = 0.002 in the CS-PFO group. In the left atrium all subjects except one had counter-clockwise vortical flow. Vortex size varied and was associated with left lower pulmonary vein flow (systolic r = 0.61, p = 0.001, diastolic r = 0.63 p = 0.002. A diastolic vortex was less common and time-averaged left atrial velocity was greater in the CS-PFO group (17±2cm/sec versus 15±1, p = 0.048. One CS-PFO subject demonstrated vortical retrograde flow in the descending aortic arch; all other subjects had laminar descending aortic flow.Right atrial flow patterns in the normal heart are heterogeneous and are associated with the relative position of the caval veins. Patterns, other than 'typical' vortical flow, are more prevalent in the right atrium of those with cryptogenic stroke in the context of PFO. Left atrial flow patterns are more homogenous in normal hearts and show a relationship with flow arising from the left

  2. Heart Rate Dynamics and their Relation with the Cyclic Alternating Pattern of Sleep in Normal Subjects and NFLE Patients

    Science.gov (United States)

    González, Jose S.; Dorantes, Guadalupe; Alba, Alfonso; Méndez, Martin O.; Camacho, Sergio; Luna-Rivera, Martin; Parrino, Liborio; Riccardi, Silvia; Terzano, Mario G.; Milioli, Giulia

    The aim of this work is to study the behavior of the autonomic system through variations in the heart rate (HR) during the Cyclic Alternating Pattern (CAP) which is formed by A-phases. The analysis was carried out in 10 healthy subjects and 10 patients with Nocturnal Front Lobe Epilepsy (NFLE) that underwent one whole night of polysomnographic recordings. In order to assess the relation of A-phases with the cardiovascular system, two time domain features were computed: the amplitude reduction and time delay of the minimum of the R-R intervals with respect to A-phases onset. In addition, the same process was performed over randomly chosen R-R interval segments during the NREM sleep for baseline comparisons. A non-parametric bootstrap procedure was used to test differences of the kurtosis values of two populations. The results suggest that the onset of the A-phases is correlated with a significant increase of the HR that peaks at around 4s after the A-phase onset, independently of the A-phase subtype and sleep time for both healthy subjects and NFLE patients. Furthermore, the behavior of the reduction in the R-R intervals during the A-phases was significantly different for NFLE patients with respect to control subjects.

  3. Hemocompatibility research on the micro-structure surface of a bionic heart valve.

    Science.gov (United States)

    Ye, Xia; Wang, Ze; Zhang, Xianghua; Zhou, Ming; Cai, Lan

    2014-01-01

    In order to study how the geometric parameters and shape of the micro-structure surface of a bionic heart valve affects hemocompatibility, mastoid micro-structures with different periodic space were fabricated using a femtosecond laser on a polyurethane (PU) surface. The apparent contact angles of droplets on the micro-structure surfaces were measured to characterize their wettability. Then a series of blood compatibility experiments, including platelet adhesion, dynamic coagulation and hemolysis were completed. The experimental results showed that the micro-structure on the biomaterial surface helped improve its hydrophobicity and hemocompatibility. Also, the periodic space affected not only the hydrophobicity but also the hemocompatibility of the biomaterial. With the increasing of the periodic space, the apparent contact angle increased, the number of platelet adhesion decreased, the dynamic clotting time became longer and the hemolysis ratio reduced. In addition, the shape of the micro-structure also affected the hemocompatibility of the biomaterial.

  4. Overnight weight loss: relationship with sleep structure and heart rate variability

    OpenAIRE

    Walter Moraes; Dalva Poyares; Christian Guilleminault; Agostinho Rosa; Marco Tulio de Mello; Adriana Rueda; Sergio Tufik

    2008-01-01

    Background: Weight loss can be caused by a loss of body mass due to metabolism and by water loss as unsensible water loss, sweating, or excretion in feces and urine. Although weight loss during sleep is a well-known phenomenon, it has not yet been studied in relation to sleep structure or autonomic tonus during sleep. Our study is proposed to be a first step in assessing the relationship between overnight weight loss, sleep structure, and HRV (heart rate variability) parameters.Methods: Twent...

  5. A longitudinal study of structural brain network changes with normal aging

    Directory of Open Access Journals (Sweden)

    Kai eWu

    2013-04-01

    Full Text Available The aim of this study was to investigate age-related changes in the topological organization of structural brain networks by applying a longitudinal design over 6 years. Structural brain networks were derived from measurements of regional gray matter volume and were constructed in age-specific groups from baseline and follow-up scans. The structural brain networks showed economical small-world properties, providing high global and local efficiency for parallel information processing at low connection costs. In the analysis of the global network properties, the local and global efficiency of the baseline scan were significantly lower compared to the follow-up scan. Moreover, the annual rate of changes in local and global efficiency showed a positive and negative quadratic correlation with the baseline age, respectively; both curvilinear correlations peaked at approximately the age of 50. In the analysis of the regional nodal properties, significant negative correlations between the annual rate of changes in nodal strength and the baseline age were found in the brain regions primarily involved in the visual and motor/ control systems, whereas significant positive quadratic correlations were found in the brain regions predominately associated with the default-mode, attention, and memory systems. The results of the longitudinal study are consistent with the findings of our previous cross-sectional study: the structural brain networks develop into a fast distribution from young to middle age (approximately 50 years old and eventually became a fast localization in the old age. Our findings elucidate the network topology of structural brain networks and its longitudinal changes, thus enhancing the understanding of the underlying physiology of normal aging in the human brain.

  6. The Chemiluminescence and Structure Properties of Normal/Inverse Diffusion Flames

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    Ting Zhang

    2013-01-01

    Full Text Available The flame emission spectrometry was applied to detect the distribution of excited radicals in two types CH4/O2 coflow jet diffusion flames (normal and inverse diffusion flames. Combining the image analysis along with the spectrometry, the chemiluminescence and structure characteristics of these diffusion flames were investigated. The results show that the inverse diffusion flame (IDF with relatively high inlet oxygen velocity is composed of two regions: a bright base and a tower on top of the base, which is quite different from the normal diffusion flame (NDF. The flame is divided into two regions along the flame axis based on maximum OH* position (Region I: initial reaction zone; Region II: further oxidation zone. The degree of the further oxidization taking place in Region II is obvious in accordance with OH* distribution, which is the main difference in reaction zone between fuel-rich condition and fuel-lean condition for NDFs. For IDFs, the change of OH* distribution with increasing equivalence O/C ratio ([O/C]e in Region II is not conspicuous. More OH* and CH* are generated in IDFs, due to the inner high-speed O2 flow promoting the mixing of fuel and oxygen to a certain extent.

  7. Time to achieving therapeutic international normalized ratio increases hospital length of stay after heart valve replacement surgery.

    Science.gov (United States)

    Arendt, Christopher J; Hong, Joon Hwa; Daly, Richard C; Scott, Christopher; Mehta, Ramila A; Bailey, Kent; Pathak, Jyotishman; Pereira, Naveen L

    2017-05-01

    Achieving a therapeutic international normalized ratio (INR) before hospital discharge is an important inpatient goal for patients undergoing mechanical cardiac valve replacement (MCVR). The use of clinical algorithms has reduced the time to achieve therapeutic INR (TTI) with warfarin therapy. Whether TTI prolongs length of stay (LOS) is unknown. Patients who underwent MCVR over a consecutive 42-month period were included. Clinical data were obtained from the Society of Thoracic Surgeons Adult Cardiac Surgery database and electronic medical records. Therapeutic INR was defined as per standard guidelines. Warfarin dose was prescribed using an inpatient pharmacy-managed algorithm and computer-based dosing tool. International normalized ratio trajectory, procedural needs, and drug interactions were included in warfarin dose determination. There were 708 patients who underwent MCVR, of which 159 were excluded for reasons that would preclude or interrupt warfarin use. Among the remainder of 549 patients, the average LOS was 6.4days and mean TTI was 3.5days. Landmark analysis showed that subjects in hospital on day 4 (n=542) who achieved therapeutic INR were more likely to be discharged by day 6 compared with those who did not achieve therapeutic INR (75% vs 59%, P<.001). Multivariable proportional hazards regression with TTI as a time-dependent effect showed a strong association with discharge (P=.0096, hazard ratio1.3) after adjustment for other significant clinical covariates. Time to achieve therapeutic INR is an independent predictor of LOS in patients requiring anticoagulation with warfarin after MCVR surgery. Alternative dosing and anticoagulation strategies will need to be adopted to reduce LOS in these patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Global geometric structures associated with dynamical systems admitting normal shift of hypersurfaces in Riemannian manifolds

    Directory of Open Access Journals (Sweden)

    Ruslan A. Sharipov

    2002-01-01

    keeps orthogonality to the trajectories of all its points. Geodesic lines correspond to the motion of free particles if the points of hypersurface are treated as physical entities obeying Newton's second law. An attempt to introduce some external force F acting on the points of moving hypersurface in Bonnet construction leads to the theory of dynamical systems admitting a normal shift. As appears in this theory, the force field F of dynamical system should satisfy some system of partial differential equations. Recently, this system of equations was integrated, and explicit formula for F was obtained. But this formula is local. The main goal of this paper is to reveal global geometric structures associated with local expressions for F given by explicit formula.

  9. Chain length effects on the vibrational structure and molecular interactions in the liquid normal alkyl alcohols

    Science.gov (United States)

    Kiefer, Johannes; Wagenfeld, Sabine; Kerlé, Daniela

    2018-01-01

    Alkyl alcohols are widely used in academia, industry, and our everyday lives, e.g. as cleaning agents and solvents. Vibrational spectroscopy is commonly used to identify and quantify these compounds, but also to study their structure and behavior. However, a comprehensive investigation and comparison of all normal alkanols that are liquid at room temperature has not been performed, surprisingly. This study aims at bridging this gap with a combined experimental and computational effort. For this purpose, the alkyl alcohols from methanol to undecan-1-ol have been analyzed using infrared and Raman spectroscopy. A detailed assignment of the individual peaks is presented and the influence of the alkyl chain length on the hydrogen bonding network is discussed. A 2D vibrational mapping allows a straightforward visualization of the effects. The conclusions drawn from the experimental data are backed up with results from Monte Carlo simulations using the simulation package Cassandra.

  10. [Sodium hydrosulfide improves cardiac functions and structures in rats with chronic heart failure].

    Science.gov (United States)

    Li, Xiao-hui; Zhang, Chao-ying; Zhang, Ting

    2011-11-22

    To explore the effects of sodium hydrosulfide (NaHS), a hydrogen sulphide (H(2)S) donor, on cardiac functions and structures in rats with chronic heart failure induced by volume overload and examine its influence on cardiac remodelling. A total of 47 SD rats (120 - 140 g) were randomly divided into 5 groups:shunt group (n = 11), sham group (n = 8), shunt + NaHS group (n = 10), sham + NaHS group (n = 8) and shunt + phentolamine group (n = 10). The rat model of chronic heart failure was induced by abdominal aorta-inferior vena cava puncture. At Week 8 post-operation, hemodynamic parameters, microstructures and ultrastructures of myocardial tissues were analyzed. Extracellular collagen content in myocardial tissues was analyzed after Sirius red staining. Right ventricular hydroxyproline concentration was determined and compared. At Week 8 post-operation, compared with the sham operation and shunt + NaHS groups, the shunt group showed significantly increased right ventricular systolic pressure (RVSP) and right ventricular end diastolic pressure (RVEDP) (mm Hg: 35.2 ± 3.9 vs 21.4 ± 3.7 and 28.1 ± 2.7, 32 ± 5 vs 21 ± 4 and 26 ± 4, all P cardiac functions and ameliorate cardiac structures in rats with chronic heart failure probably through dilating the blood vessels and affecting the extracellular collagen metabolism.

  11. Left atrial mechanics strongly predict functional capacity assessed by cardiopulmonary exercise testing in subjects without structural heart disease.

    Science.gov (United States)

    Leite, Luís; Mendes, Sofia Lázaro; Baptista, Rui; Teixeira, Rogério; Oliveira-Santos, Manuel; Ribeiro, Nelson; Coutinho, Rosa; Monteiro, Victor; Martins, Rui; Castro, Graça; Ferreira, Maria João; Pego, Mariano

    2017-05-01

    Left atrium function is essential for cardiovascular performance and is evaluable by two-dimensional speckle-tracking echocardiography (2D-STE). Our aim was to determine how echocardiographic parameters interrelate with exercise capacity and ventilatory efficiency in subjects with no structural heart disease. Asymptomatic volunteers, in sinus rhythm and with normal biventricular size and function, were recruited from a community-based population. Individuals with moderate-to-severe valvular disease, pulmonary hypertension, and history of cardiac disease were excluded. We performed a transthoracic echocardiogram and assessed left atrial (LA) and left ventricular (LV) mechanics via 2D-STE. Cardiopulmonary exercise testing by treadmill took place immediately thereafter. Peak oxygen uptake (VO2) served as measure of functional capacity and ventilation/carbon dioxide output (VE/VCO2) slope as surrogate of ventilation/perfusion mismatch. 20 subjects were included (age 51 ± 14 years, male gender 65%). Peak VO2 strongly correlated with age (r = -0.83; P mechanics, particularly with LA conduit strain rate (SR) (r = -0.82; P mechanics. A similar pattern of associations was identified for VE/VCO2 slope. In multivariate analysis, LA conduit SR (β = -0.69; P = 0.02) emerged as sole independent correlate of peak VO2, adjusted for age and for E/e' ratio (adjusted r 2  = 0.76; P mechanics displayed strong associations with peak VO2 and VE/VCO2 slope. LA conduit-phase SR seems best suited as echocardiographic marker of functional capacity in subjects with no structural heart disease.

  12. Capturing structure and function in an embryonic heart with Biophotonic tools

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    Ganga eKarunamuni

    2014-09-01

    Full Text Available Disturbed cardiac function (flow, excitation, contraction, calcium transients at an early stage of development has been shown to correlate with and may lead to cellular/molecular, functional and structural cardiac anomalies at later stages culminating in the congenital heart defects (CHDs that present at birth. It is not surprising that cardiac function, which drives embryonic and extraembryonic circulation, is also connected to neural and placental development. While our knowledge of molecular and cellular steps in cardiac development is growing rapidly, our understanding of the role of cardiovascular function in the embryo is still rudimentary. One reason for the scanty information in this area is that the tools to study early cardiac function are limited. Recently developed and adapted Biophotonic tools may overcome the challenges of studying the tiny fragile beating heart. In this chapter, the strengths and limitations of Biophotonic tools will be described with emphasis on Optical Coherence Tomography (OCT. OCT can be used for detailed structural and functional studies of the tubular and looping avian embryo heart under physiological conditions. The same hearts can be subsequently rapidly and quantitatively phenotyped at a later stage using OCT. When combined with other tools such as Optimal Mapping (OM and Optical Pacing (OP, OCT has the potential to reveal in spatial and temporal detail the biophysical changes that can potentially impact mechanotransduction pathways. This information may provide better explanations for the etiology of the CHDs when interwoven with our understanding of the multiple molecular pathways that have been described to be involved. Examples of application of these tools to study the etiology of CHDs are presented. Directions for future directions and advances in the use of Biophotonic tools are discussed.

  13. Effect of high-voltage impulse current on the structure and function of rabbit heart

    Directory of Open Access Journals (Sweden)

    Xin-ping XU

    2011-06-01

    Full Text Available Objective To explore the effect of high-voltage impulse current(HVIC on the structure and function of rabbit heart.Methods Sixty healthy male rabbits were involved in present study and divided into 6 groups randomly(n=10.The rabbits were then shocked using a high-voltage pulse generator with current intensity of 0,50,100,150,250 and 500mA(pulse width 100μs,duration 5s respectively.The heart rate and electrocardiogram(ECG of rabbits were detected before and 0,1,3,7,14 and 28 days after the electric shock.Moreover,the myocardial tissue of rabbits was obtained immediately and 28 days after shock to observe the pathological changes.Results Immediately after electric shock of 50 to 500mA,the heart rate of rabbit increased by different degree,and the ECG showed arrhythmia,myocardial ischemia,atrial fibrillation and atrioventricular block,and the changes recovered gradually one day later.The pathological observation showed cell swelling,separation of myofibril and sarcoplasmic condensation of Purkinje fibers immediately after electric shock of 50 to 500mA,and the changes recovered 28 days after shock.The cardiac injuries aggravated with the increasing of current intensity,especially when it exceeded 150mA,and the recovery time prolonged.Conclusion High-voltage impulse current may induce recoverable injuries on heart structure and function,and the damage effect shows a correlation with the current intensity.

  14. Prevalence of symptomatic heart failure with reduced and with normal ejection fraction in an elderly general population-the CARLA study.

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    Daniel Tiller

    Full Text Available BACKGROUND/OBJECTIVES: Chronic heart failure (CHF is one of the most important public health concerns in the industrialized world having increasing incidence and prevalence. Although there are several studies describing the prevalence of heart failure with reduced ejection fraction (HFREF and heart failure with normal ejection fraction (HFNEF in selected populations, there are few data regarding the prevalence and the determinants of symptomatic heart failure in the general population. METHODS: Cross-sectional data of a population-based German sample (1,779 subjects aged 45-83 years were analyzed to determine the prevalence and determinants of chronic SHF and HFNEF defined according to the European Society of Cardiology using symptoms, echocardiography and serum NT-proBNP. Prevalence was age-standardized to the German population as of December 31st, 2005. RESULTS: The overall age-standardized prevalence of symptomatic CHF was 7.7% (95%CI 6.0-9.8 for men and 9.0% (95%CI 7.0-11.5 for women. The prevalence of CHF strongly increased with age from 3.0% among 45-54- year-old subjects to 22.0% among 75-83- year-old subjects. Symptomatic HFREF could be shown in 48% (n = 78, symptomatic HFNEF in 52% (n = 85 of subjects with CHF. The age-standardized prevalence of HFREF was 3.8 % (95%CI 2.4-5.8 for women and 4.6 % (95%CI 3.6-6.3 for men. The age-standardized prevalence of HFNEF for women and men was 5.1 % (95%CI 3.8-7.0 and 3.0 % (95%CI 2.1-4.5, respectively. Persons with CHF were more likely to have hypertension (PR = 3.4; 95%CI 1.6-7.3 or to have had a previous myocardial infarction (PR = 2.5, 95%CI 1.8-3.5. CONCLUSION: The prevalence of symptomatic CHF appears high in this population compared with other studies. While more women were affected by HFNEF than men, more male subjects suffered from HFREF. The high prevalence of symptomatic CHF seems likely to be mainly due to the high prevalence of cardiovascular risk factors in this population.

  15. Is age a factor in the success or failure of remote monitoring in heart failure? Telemonitoring and structured telephone support in elderly heart failure patients.

    Science.gov (United States)

    Inglis, Sally C; Conway, Aaron; Cleland, John Gf; Clark, Robyn A

    2015-06-01

    There are few data regarding the effectiveness of remote monitoring for older people with heart failure. We conducted a post-hoc sub-analysis of a previously published large Cochrane systematic review and meta-analysis of relevant randomized controlled trials to determine whether structured telephone support and telemonitoring were effective in this population. A post hoc sub-analysis of a systematic review and meta-analysis that applied the Cochrane methodology was conducted. Meta-analyses of all-cause mortality, all-cause hospitalizations and heart failure-related hospitalizations were performed for studies where the mean or median age of participants was 70 or more years. The mean or median age of participants was 70 or more years in eight of the 16 (n=2659/5613; 47%) structured telephone support studies and four of the 11 (n=894/2710; 33%) telemonitoring studies. Structured telephone support (RR 0.80; 95% CI=0.63-1.00) and telemonitoring (RR 0.56; 95% CI=0.41-0.76) interventions reduced mortality. Structured telephone support interventions reduced heart failure-related hospitalizations (RR 0.81; 95% CI=0.67-0.99). Despite a systematic bias towards recruitment of individuals younger than the epidemiological average into the randomized controlled trials, older people with heart failure did benefit from structured telephone support and telemonitoring. These post-hoc sub-analysis results were similar to overall effects observed in the main meta-analysis. While further research is required to confirm these observational findings, the evidence at hand indicates that discrimination by age alone may be not be appropriate when inviting participation in a remote monitoring service for heart failure. © The European Society of Cardiology 2014.

  16. Form Follows Function: Advances in Trilayered Structure Replication for Aortic Heart Valve Tissue Engineering

    Directory of Open Access Journals (Sweden)

    Dan T. Simionescu

    2012-01-01

    Full Text Available Tissue engineering the aortic heart valve is a challenging endeavor because of the particular hemodynamic and biologic conditions present in the native aortic heart valve. The backbone of an ideal valve substitute should be a scaffold that is strong enough to withstand billions of repetitive bending, flexing and stretching cycles, while also being slowly degradable to allow for remodeling. In this review, we highlight three overlooked aspects that might influence the long term durability of tissue engineered valves: (i replication of the native valve trilayered histoarchitecture, (ii duplication of the three-dimensional shape of the valve, (iii and cell integration efforts focused on getting the right number and type of cells to the right place within the valve structure and driving them towards homeostatic maintenance of the valve matrix. We propose that the trilayered structure in the native aortic valve that includes a middle spongiosa layer cushioning the motions of the two external fibrous layers should be our template for creation of novel scaffolds with improved mechanical durability. Furthermore, since cells adapt to micro-loads within the valve structure, we believe that interstitial cell remodeling of the valvular matrix will depend on the accurate replication of the structures and loads, resulting in successful regeneration of the valve tissue and extended durability.

  17. Automatic segmentation of histological structures in normal and neoplastic mammary gland tissue sections

    Energy Technology Data Exchange (ETDEWEB)

    Fernandez-Gonzalez, Rodrigo; Deschamps, Thomas; Idica, Adam K.; Malladi, Ravi; Ortiz de Solorzano, Carlos

    2003-01-18

    In this paper we present a scheme for real time segmentation of histological structures in microscopic images of normal and neoplastic mammary gland sections. Paraffin embedded or frozen tissue blocks are sliced, and sections are stained with hematoxylin and eosin (H&E). The sections are then imaged using conventional bright field microscopy. The background of the images is corrected by arithmetic manipulation using a ''phantom.'' Then we use the fast marching method with a speed function that depends on the brightness gradient of the image to obtain a preliminary approximation to the boundaries of the structures of interest within a region of interest (ROI) of the entire section manually selected by the user. We use the result of the fast marching method as the initial condition for the level set motion equation. We run this last method for a few steps and obtain the final result of the segmentation. These results can be connected from section to section to build a three-dimensional reconstruction of the entire tissue block that we are studying.

  18. suPAR level is associated with myocardial impairment assessed with advanced echocardiography in patients with type 1 diabetes with normal ejection fraction and without known heart disease or end-stage renal disease

    DEFF Research Database (Denmark)

    Theilade, Simone; Rossing, Peter; Eugen-Olsen, Jesper

    2016-01-01

    AIM: Heart disease is a common fatal diabetes-related complication. Early detection of patients at particular risk of heart disease is of prime importance. Soluble urokinase plasminogen activator receptor (suPAR) is a novel biomarker for development of cardiovascular disease. We investigate if su......PAR is associated with early myocardial impairment assessed with advanced echocardiographic methods. METHODS: In an observational study on 318 patients with type 1 diabetes without known heart disease and with normal left ventricular ejection fraction (LVEF) (biplane LVEF >45%), we performed conventional, tissue...... heart disease, suPAR is associated with early systolic and diastolic myocardial impairment. Our study implies that both suPAR and advanced echocardiography are useful diagnostic tools for identifying patients with diabetes at risk of future clinical heart disease, suited for intensified medical therapy....

  19. Revisiting the slow force response: the role of the PKG signaling pathway in the normal and the ischemic heart.

    Science.gov (United States)

    Castro-Ferreira, Ricardo; Neves, João Sérgio; Ladeiras-Lopes, Ricardo; Leite-Moreira, André M; Neiva-Sousa, Manuel; Almeida-Coelho, João; Ferreira-Martins, João; F Leite-Moreira, Adelino

    2014-09-01

    The myocardial response to acute stretch consists of a two-phase increase in contractility: an acute increase by the Frank-Starling mechanism and a gradual and time-dependent increase in force generated known as the slow force response (SFR). The SFR is actively modulated by different signaling pathways, but the role of protein kinase G (PKG) signaling is unknown. In this study we aim to characterize the role of the PKG signaling pathway in the SFR under normal and ischemic conditions. Rabbit papillary muscles were stretched from 92 to 100% of maximum length (Lmax) under basal conditions, in the absence (1) or presence of: a PKG agonist (2) and a PKG inhibitor (3); under ischemic conditions in the absence (4) or presence of: a PKG agonist (5); a nitric oxide (NO) donor (6) and a phosphodiesterase 5 (PDE5) inhibitor (7). Under normoxia, the SFR was significantly attenuated by inhibition of PKG and remained unaltered with PKG activation. Ischemia induced a progressive decrease in myocardial contractility after stretch. Neither the PKG agonist nor the NO donor altered the myocardial response to stretch under ischemic conditions. However, the use of a PDE5 inhibitor in ischemia partially reversed the progressive deterioration in contractility. PKG activity is essential for the SFR. During ischemia, a progressive decline in the force is observed in response to acute myocardial stretch. This dysfunctional response can be partially reversed by the use of PDE5 inhibitors. Copyright © 2013 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  20. Brain structural correlates of reward sensitivity and impulsivity in adolescents with normal and excess weight.

    Directory of Open Access Journals (Sweden)

    Laura Moreno-López

    Full Text Available INTRODUCTION: Neuroscience evidence suggests that adolescent obesity is linked to brain dysfunctions associated with enhanced reward and somatosensory processing and reduced impulse control during food processing. Comparatively less is known about the role of more stable brain structural measures and their link to personality traits and neuropsychological factors on the presentation of adolescent obesity. Here we aimed to investigate regional brain anatomy in adolescents with excess weight vs. lean controls. We also aimed to contrast the associations between brain structure and personality and cognitive measures in both groups. METHODS: Fifty-two adolescents (16 with normal weight and 36 with excess weight were scanned using magnetic resonance imaging and completed the Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ, the UPPS-P scale, and the Stroop task. Voxel-based morphometry (VBM was used to assess possible between-group differences in regional gray matter (GM and to measure the putative differences in the way reward and punishment sensitivity, impulsivity and inhibitory control relate to regional GM volumes, which were analyzed using both region of interest (ROI and whole brain analyses. The ROIs included areas involved in reward/somatosensory processing (striatum, somatosensory cortices and motivation/impulse control (hippocampus, prefrontal cortex. RESULTS: Excess weight adolescents showed increased GM volume in the right hippocampus. Voxel-wise volumes of the second somatosensory cortex (SII were correlated with reward sensitivity and positive urgency in lean controls, but this association was missed in excess weight adolescents. Moreover, Stroop performance correlated with dorsolateral prefrontal cortex volumes in controls but not in excess weight adolescents. CONCLUSION: Adolescents with excess weight have structural abnormalities in brain regions associated with somatosensory processing and motivation.

  1. Telemedicine-guided, very low-dose international normalized ratio self-control in patients with mechanical heart valve implants.

    Science.gov (United States)

    Koertke, Heinrich; Zittermann, Armin; Wagner, Otto; Secer, Songuel; Sciangula, Alfonso; Saggau, Werner; Sack, Falk-Udo; Ennker, Jürgen; Cremer, Jochen; Musumeci, Francesco; Gummert, Jan F

    2015-06-01

    To study in patients performing international normalized ratio (INR) self-control the efficacy and safety of an INR target range of 1.6-2.1 for aortic valve replacement (AVR) and 2.0-2.5 for mitral valve replacement (MVR) or double valve replacement (DVR). In total, 1304 patients undergoing AVR, 189 undergoing MVR and 78 undergoing DVR were randomly assigned to low-dose INR self-control (LOW group) (INR target range, AVR: 1.8-2.8; MVR/DVR: 2.5-3.5) or very low-dose INR self-control once a week (VLO group) and twice a week (VLT group) (INR target range, AVR: 1.6-2.1; MVR/DVR: 2.0-2.5), with electronically guided transfer of INR values. We compared grade III complications (major bleeding and thrombotic events; primary end-points) and overall mortality (secondary end-point) across the three treatment groups. Two-year freedom from bleedings in the LOW, VLO, and VLT groups was 96.3, 98.6, and 99.1%, respectively (P = 0.008). The corresponding values for thrombotic events were 99.0, 99.8, and 98.9%, respectively (P = 0.258). The risk-adjusted composite of grade III complications was in the per-protocol population (reference: LOW-dose group) as follows: hazard ratio = 0.307 (95% CI: 0.102-0.926; P = 0.036) for the VLO group and = 0.241 (95% CI: 0.070-0.836; P = 0.025) for the VLT group. The corresponding values of 2-year mortality were = 1.685 (95% CI: 0.473-5.996; P = 0.421) for the VLO group and = 4.70 (95% CI: 1.62-13.60; P = 0.004) for the VLT group. Telemedicine-guided very low-dose INR self-control is comparable with low-dose INR in thrombotic risk, and is superior in bleeding risk. Weekly testing is sufficient. Given the small number of MVR and DVR patients, results are only valid for AVR patients. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

  2. Cost-effectiveness of transcatheter versus surgical management of structural heart disease

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    Fanari, Zaher, E-mail: zfanari@gmail.com [Division of Cardiology, University of Kansas School of Medicine, Kansas City, KS (United States); Weintraub, William S. [Section of Cardiology, Christiana Care Health System, Newark, DE (United States); Value institute, Christiana Care Health System, Newark, DE (United States)

    2016-01-15

    Transcatheter management of valvular and structural heart disease is the most growing aspect of interventional cardiology. While the early experience was limited to patients who were not candidate for surgery, the continuous improvement in the efficacy and safety expanded its use to different degree depending on the procedure and the disease involved. The cost of these procedures is a major concern for health care in developed world. Cost-effectiveness of these transcatheter structural procedures varies depending on the procedure itself, the burden of the underlying disease, the feasibility and cost of both the Transcatheter and surgical procedures. In this review, we turn now to a specific discussion of the medical economics of percutaneous valvular and structural interventions.

  3. Structural equation modeling of gene-environment interactions in coronary heart disease.

    Science.gov (United States)

    Mi, Xiaojuan; Eskridge, Kent M; George, Varghese; Wang, Dong

    2011-03-01

    Coronary heart disease (CHD) is a complex disease, which is influenced not only by genetic and environmental factors but also by gene-environment (GE) interactions in interconnected biological pathways or networks. The classical methods are inadequate for identifying GE interactions due to the complex relationships among risk factors, mediating risk factors (e.g., hypertension, blood lipids, and glucose), and CHD. Our aim was to develop a two-level structural equation model (SEM) to identify genes and GE interactions in the progress of CHD to take into account the causal structure among mediating risk factors and CHD (Level 1), and hierarchical family structure (Level 2). The method was applied to the Framingham Heart Study (FHS) Offspring Cohort data. Our approach has several advantages over classical methods: (1) it provides important insight into how genes and contributing factors affect CHD by investigating the direct, indirect, and total effects; and (2) it aids the development of biological models that more realistically reflect the complex biological pathways or networks. Using our method, we are able to detect GE interaction of SERPINE1 and body mass index (BMI) on CHD, which has not been reported. We conclude that SEM modeling of GE interaction can be applied in the analysis of complex epidemiological data sets. © 2011 The Authors Annals of Human Genetics © 2011 Blackwell Publishing Ltd/University College London.

  4. Patient participation in patients with heart failure receiving structured home care--a prospective longitudinal study.

    Science.gov (United States)

    Näsström, Lena; Jaarsma, Tiny; Idvall, Ewa; Årestedt, Kristofer; Strömberg, Anna

    2014-12-18

    Patient participation is important for improving outcomes, respect for self-determination and legal aspects in care. However, how patients with heart failure view participation and which factors may be associated with participation is not known. The aim of this study was therefore to describe the influence of structured home care on patient participation over time in patients diagnosed with heart failure, and to explore factors associated with participation in care. The study had a prospective pre-post longitudinal design evaluating the influence of structured home care on participation in patients at four different home care units. Patient participation was measured using 3 scales and 1 single item. Self-care behavior, knowledge, symptoms of depression, socio- demographic and clinical characteristics were measured to explore factors associated with patient participation. Repeated measure ANOVA was used to describe change over time, and stepwise regression analyses were used to explore factors associated with patient participation. One hundred patients receiving structured heart failure home care were included. Mean age was 82 years, 38 were women and 80 were in New York Heart Association functional class III. One aspect of participation, received information, showed a significant change over time and had increased at both six and twelve months. Better self-care behavior was associated with all four scales measuring different aspects of participation. Experiencing lower degree of symptoms of depression, having better knowledge, being of male sex, being of lower age, cohabiting and having home help services were associated with one or two of the four scales measuring different aspects of participation. Patients experienced a fairly high level of satisfaction with participation in care at baseline, and there was a significant improvement over time for participation with regard to received information after being admitted to structured home care. Higher level of

  5. Organizational structure for chronic heart failure and chronic obstructive pulmonary disease.

    Science.gov (United States)

    Rinne, Seppo T; Liu, Chuan-Fen; Wong, Edwin S; Hebert, Paul L; Heidenreich, Paul; Bastian, Lori A; Au, David H

    2016-03-01

    In contrast to chronic heart failure (CHF), measures of quality of care for chronic obstructive pulmonary disease (COPD) are poor. Our objective was to examine differences in organizational structure available to support quality of care for patients with CHF and COPD. We performed 2 nationwide surveys exploring organizational structure for the management of CHF and COPD. We surveyed the chief of medicine and the chief of cardiology and pulmonary medicine at 120 Veterans Affairs facilities in the United States. Analogous questions about organizational structure that enhanced adherence to guideline-based care were compared between CHF and COPD surveys. We found large and notable differences in the organizational structure for disease management, with systematically less attention given to COPD than CHF. These differences were evident in multiple processes of care. Key differences included fewer facilities: having COPD clinics than CHF clinics (12.7% vs 50.8%; P organizational structure existed for COPD than CHF. Lack of organizational structure for COPD likely impedes an organization's abilities to encourage high-quality care and avoid recently implemented hospital readmission penalties. Our results suggest the need to develop a systematic approach for healthcare systems to provide essential organizational structure based on the burden of disease in the population.

  6. Fluid-structure Interaction Modeling of Aneurysmal Conditions with High and Normal Blood Pressures

    Science.gov (United States)

    Torii, Ryo; Oshima, Marie; Kobayashi, Toshio; Takagi, Kiyoshi; Tezduyar, Tayfun E.

    2006-09-01

    Hemodynamic factors like the wall shear stress play an important role in cardiovascular diseases. To investigate the influence of hemodynamic factors in blood vessels, the authors have developed a numerical fluid-structure interaction (FSI) analysis technique. The objective is to use numerical simulation as an effective tool to predict phenomena in a living human body. We applied the technique to a patient-specific arterial model, and with that we showed the effect of wall deformation on the WSS distribution. In this paper, we compute the interaction between the blood flow and the arterial wall for a patient-specific cerebral aneurysm with various hemodynamic conditions, such as hypertension. We particularly focus on the effects of hypertensive blood pressure on the interaction and the WSS, because hypertension is reported to be a risk factor in rupture of aneurysms. We also aim to show the possibility of FSI computations with hemodynamic conditions representing those risk factors in cardiovascular disease. The simulations show that the transient behavior of the interaction under hypertensive blood pressure is significantly different from the interaction under normal blood pressure. The transient behavior of the blood-flow velocity, and the resulting WSS and the mechanical stress in the aneurysmal wall, are significantly affected by hypertension. The results imply that hypertension affects the growth of an aneurysm and the damage in arterial tissues.

  7. Left Atrial Structure and Function in Heart Failure with Preserved Ejection Fraction: A RELAX Substudy.

    Directory of Open Access Journals (Sweden)

    Siddique A Abbasi

    Full Text Available Given the emerging recognition of left atrial structure and function as an important marker of disease in heart failure with preserved ejection fraction (HF-pEF, we investigated the association between left atrial volume and function with markers of disease severity and cardiac structure in HF-pEF. We studied 100 patients enrolled in the PhosphdiesteRasE-5 Inhibition to Improve CLinical Status and EXercise Capacity in Diastolic Heart Failure (RELAX trial who underwent cardiac magnetic resonance (CMR, cardiopulmonary exercise testing, and blood collection before randomization. Maximal left atrial volume index (LAVi; N = 100, left atrial emptying fraction (LAEF; N = 99; including passive and active components (LAEFP, LAEFA; N = 80, 79, respectively were quantified by CMR. After adjustment for multiple testing, maximal LAVi was only associated with age (ρ = 0.39, transmitral filling patterns (medial E/e' ρ = 0.43, and N-terminal pro-BNP (NT-proBNP; ρ = 0.65; all p<0.05. Lower LAEF was associated with older age, higher transmitral E/A ratio and higher NT-proBNP. Peak VO2 and VE/VCO2 slope were not associated with left atrial structure or function. After adjustment for age, sex, transmitral E/A ratio, CMR LV mass, LV ejection fraction, and creatinine clearance, NT-proBNP remained associated with maximal LAVi (β = 0.028, p = 0.0007 and total LAEF (β = -0.033, p = 0.001. Passive and active LAEF were most strongly associated with age and NT-proBNP, but not gas exchange or other markers of ventricular structure or filling properties. Left atrial volume and emptying function are associated most strongly with NT-proBNP and diastolic filling properties, but not significantly with gas exchange, in HFpEF. Further research to explore the relevance of left atrial structure and function in HF-pEF is warranted.

  8. Hierarchical Factor Structure of the Turkish Version of the Posttraumatic Growth Inventory in a Normal Population

    Directory of Open Access Journals (Sweden)

    Mucahit Kagan

    2012-10-01

    Full Text Available Background: Negative consequences of traumatic experiences, such as depression, anxiety, or dissociative symptoms, etc. have been reported by many researchers. However, it is proposed that stressful events not only lead to poor psychological outcomes but also may trigger positive changes. Several instruments gauging posttraumatic benefits have been developed to examine the effects of factors that may promote positive psychological outcomes in the aftermath of stressful events. The Posttraumatic Growth Inventory (PTGI is one of the prominent instruments that assess posttraumatic positive changes. In this study we aimed to assess psychometric properties of the Turkish version of the PTGI. Method: This study differed to an extent from previous studies concerning the features of the PTGI. We used a dispositional form of the instrument in a sample recruited from high school and university students. Our data were collected from 723 volunteers. 367 subjects were males (50.76% and 356 subjects were females (49.24%. Also we did not specify any selection criteria in recruiting subjects owing to their adverse life experiences with a presumption that stressful life events are not uncommon in normal population. We administered to participants a dispositional form of the Posttraumatic Growth Inventory and the Personal View Survey-III. Item statistics for the measure were computed. We performed an explanatory factor analysis by using principal components with promax rotation and a confirmatory factor analysis by using structural equation modeling. Since the factor inter-correlations were higher than .40 we computed Schmid-Leiman transformation to obtain second-order general factor loadings. Inner consistencies and 15-day test-retest intracorrelations were calculated. Results: Item discrimination indexes ranged from .28 to .72. Promax rotated principal components analysis pointed out a three-factor structure. It was found in model testing with structural

  9. Heart valve scaffold fabrication: Bioinspired control of macro-scale morphology, mechanics and micro-structure.

    Science.gov (United States)

    D'Amore, Antonio; Luketich, Samuel K; Raffa, Giuseppe M; Olia, Salim; Menallo, Giorgio; Mazzola, Antonino; D'Accardi, Flavio; Grunberg, Tamir; Gu, Xinzhu; Pilato, Michele; Kameneva, Marina V; Badhwar, Vinay; Wagner, William R

    2018-01-01

    Valvular heart disease is currently treated with mechanical valves, which benefit from longevity, but are burdened by chronic anticoagulation therapy, or with bioprosthetic valves, which have reduced thromboembolic risk, but limited durability. Tissue engineered heart valves have been proposed to resolve these issues by implanting a scaffold that is replaced by endogenous growth, leaving autologous, functional leaflets that would putatively eliminate the need for anticoagulation and avoid calcification. Despite the diversity in fabrication strategies and encouraging results in large animal models, control over engineered valve structure-function remains at best partial. This study aimed to overcome these limitations by introducing double component deposition (DCD), an electrodeposition technique that employs multi-phase electrodes to dictate valve macro and microstructure and resultant function. Results in this report demonstrate the capacity of the DCD method to simultaneously control scaffold macro-scale morphology, mechanics and microstructure while producing fully assembled stent-less multi-leaflet valves composed of microscopic fibers. DCD engineered valve characterization included: leaflet thickness, biaxial properties, bending properties, and quantitative structural analysis of multi-photon and scanning electron micrographs. Quasi-static ex-vivo valve coaptation testing and dynamic organ level functional assessment in a pressure pulse duplicating device demonstrated appropriate acute valve functionality. Copyright © 2017. Published by Elsevier Ltd.

  10. Structural brain correlates of heart rate variability in a healthy young adult population.

    Science.gov (United States)

    Winkelmann, Tobias; Thayer, Julian F; Pohlack, Sebastian; Nees, Frauke; Grimm, Oliver; Flor, Herta

    2017-03-01

    The high frequency component of heart rate variability (HRV) has reliably been shown to serve as an index of autonomic inhibitory control and is increasingly considered as a biomarker of adaptability and health. While several functional neuroimaging studies identified associations between regional cerebral blood flow and HRV, studies on structural brain correlates of HRV are scarce. We investigated whether interindividual differences in HRV are related to brain morphology in healthy humans. Thirty participants underwent HRV recording at rest subsequent to structural magnetic resonance imaging. Cortical reconstruction and subcortical volumetry were performed with the Freesurfer image analysis suite. The amount of resting HRV was positively correlated with the cortical thickness of an area within the right anterior midcingulate cortex (aMCC). Consistent with existing studies implicating forebrain regions in cardiac regulation, our findings show that the thickness of the right aMCC is associated with the degree of parasympathetic regulation of heart rate. Evidence for the neural correlates of interindividual differences in HRV may complement our understanding of the mechanisms underlying the association between HRV and self-regulatory capacity.

  11. Pig heart short chain L-3-hydroxyacyl-CoA dehydrogenase revisited: sequence analysis and crystal structure determination.

    OpenAIRE

    Barycki, J. J.; O'Brien, L. K.; Birktoft, J. J.; Strauss, A. W.; Banaszak, L. J.

    1999-01-01

    Short chain L-3-hydroxyacyl CoA dehydrogenase (SCHAD) is a soluble dimeric enzyme critical for oxidative metabolism of fatty acids. Its primary sequence has been reported to be conserved across numerous tissues and species with the notable exception of the pig heart homologue. Preliminary efforts to solve the crystal structure of the dimeric pig heart SCHAD suggested the unprecedented occurrence of three enzyme subunits within the asymmetric unit, a phenomenon that was thought to have hampere...

  12. Changes in fractal structure of heart rate variability during a nap in one case.

    Science.gov (United States)

    Shono, H; Shono, M; Takasaki, M; Iwasaka, T; Sugimori, H

    2001-06-01

    The objective of the present study was to analyze fractal structures of adult heart rate (HR) variability during a nap. Fractal analysis was carried out in one case over consecutive 10-min time series of HR, which were simultaneously recorded with electroencephalogram. Scaling relationships showed cross-over patterns characterized by alphas and alphal (i.e. slopes above and below a cross-over point). The alphas and alphal were black and white noise at Stage 4 of NREM sleep, and black and 1/f noise in REM sleep. Cross-over points changed from the first to second sleep cycle. We demonstrate the multifractal structures of HR variability during a nap in the present case.

  13. Normal behaviour of circulatory parameters during exercise. Reference values for heart rate and systemic blood pressure. The ECCIS Project data. Epidemiologia e Clinica della Cardiopatia Ischemica Silente.

    Science.gov (United States)

    Menghini, F; Dally, L; Fazzini, P F; Menotti, A; Prati, P L; Rovelli, F; Antoniucci, D; Seccareccia, F

    1995-08-01

    The study of simultaneous variations in heart rate (HR) and systemic blood pressure is of great interest in ergometric practice complementing the analysis of the ST segment by ECG. This paper examines data proceeding from 500 consecutive, normal, exercise stress tests with the aim of offering reference values on the step-by-step behaviour of HR, systolic and diastolic blood pressure (SBP, DBP) during exercise in a normal population. The sample comes from a large epidemiological study (ECCIS Project) conducted on 4842 healthy, working men, aged 40-59, which proposes to identify, by a 3 stage procedure, subjects with totally asymptomatic coronary artery disease (type I silent ischemia). A further aim of our paper is to examine the influence of some physiological variables (age, height, weight, body mass index, resting HR, SBP and DBP) on the response to effort of HR, SBP and DBP; reciprocal HR/SBP adjustment during exercise; maximal attained workload and recovery time. Due to a preliminary observation that the rate of step-by-step increase in HR and SBP is inversely related to total duration, the population was split into 4 groups according to exercise tolerance (defined by maximal attained workload) to elaborate reference values. Furthermore our data demonstrate that: 1) SBP increases more rapidly with respect to HR for older and heavier subjects; 2) Exercise tolerance is inversely related to age, baseline HR and SBP, and directly related to weight and height; 3) return to baseline conditions, during recovery, is quicker for subjects with better exercise tolerance and lower baseline HR, SBP and weight.

  14. Quantifying the effects of normal ageing on white matter structure using unsupervised tract shape modelling.

    Science.gov (United States)

    Bastin, Mark E; Muñoz Maniega, Susana; Ferguson, Karen J; Brown, Laura J; Wardlaw, Joanna M; MacLullich, Alasdair M J; Clayden, Jonathan D

    2010-05-15

    Quantitative tractography may provide insights into regional heterogeneity of changes in white matter structure in normal ageing. Here we examine how brain atrophy and white matter lesions affect correlations between tract shape, tract integrity and age in a range of frontal and non-frontal tracts in 90 non-demented subjects aged over 65 years using an enhanced version of probabilistic neighbourhood tractography. This novel method for automatic single seed point placement employs unsupervised learning and streamline selection to provide reliable and accurate tract segmentation, whilst also indicating how the shape of an individual tract compares to that of a predefined reference tract. There were significant negative correlations between tract shape similarity to reference tracts derived from a young brain white matter atlas and age in genu and splenium of corpus callosum. Controlling for intracranial and lateral ventricle volume, the latter of which increased significantly with age, attenuated these correlations by 40% and 84%, respectively, indicating that this age-related change in callosal tract topology is significantly mediated by global atrophy and ventricular enlargement. In accordance with the "frontal ageing" hypothesis, there was a significant positive correlation between mean diffusivity (D) and age, and a significant negative correlation between fractional anisotropy (FA) and age in corpus callosum genu; correlations not seen in splenium. Significant positive correlations were also observed between D and age in bilateral cingulum cingulate gyri, uncinate fasciculi and right corticospinal tract. This pattern of correlations was not, however, reproduced when those subjects with significant white matter lesion load were analyzed separately from those without. These data therefore suggest that brain atrophy and white matter lesions play a significant role in driving regional patterns of age-related changes in white matter tract shape and integrity

  15. Changes in the arterial blood pressure, heart rate and normal ECG parameters of rat after envenomation with Egyptian cobra (Naja haje) venom.

    Science.gov (United States)

    Omran, M A; Abdel-Nabi, I M

    1997-06-01

    1. The effect of Egyptian cobra (Naja haje) venom on the normal electrical activity of the cardiac muscles (ECG) and arterial blood pressure of envenomated rats were investigated in this study. 2. Rats were divided into three groups. The first group was injected im with saline and considered as control group. Rats of the second and third groups were injected IM with 0.02 micrograms and 0.04 micrograms cobra venom/gim b.wt, respectively. 3. Mean blood pressure (MBP), heart rate (HR) and four different ECG parameters (PR and QT intervals, R and T wave amplitudes) were measured over 1 h following envenomation. 4. The low dose (0.02 micrograms/g) of N. haje venom caused hypotension accompanied by an increase in the HR, whereas hypertension and bradycardia developed after injection of the high dose (0.04 micrograms/g) of venom. 5. There was a decrease in the P-R interval after administration of the low dose and prolongation of it after the high dose. The Q-T interval and R-wave amplitude were significantly increased after injection of both doses. T-wave amplitude was significantly elevated only after injection of the high dose. 6. The present results indicate that the Egyptian cobra (N. haje) venom significantly alters the arterial blood pressure and ECG parameters of envenomated rats. The suggests that impairment of the electrical activity of cardiac muscle may be one of the reasons why victims of cobra bite die.

  16. Diabetes, impaired glucose tolerance, and metabolic biomarkers in individuals with normal glucose tolerance are inversely associated with lung function: the Jackson Heart Study.

    Science.gov (United States)

    Hickson, DeMarc A; Burchfiel, Cecil M; Liu, Jiankang; Petrini, Marcy F; Harrison, Kimystian; White, Wendy B; Sarpong, Daniel F

    2011-08-01

    The objectives of this study were to test the hypothesis that diabetes and impaired glucose tolerance (IGT), diabetes control and diabetes duration, and metabolic biomarkers in adults with normal glucose tolerance (NGT) are inversely associated with spirometry-measured lung function. We conducted a cross-sectional observational cohort study that included nonsmoking African American adults (n = 2,945; mean age = 52.5 ± 12.6 years; 69.2% female), who were free of cardiovascular disease, from the Jackson Heart Study. The interventions were diabetes, metabolic biomarkers and lung function. We measured the associations of glycemia with forced expiratory volume (FEV) in 1 s, FEV in 6 s, and vital capacity. Multivariable adjusted mean lung function values were lower among adults with diabetes and IGT (in women only, but not after adjustment for waist circumference) than adults with NGT. Among adults with diabetes, no associations were observed between lung function and diabetes control or duration. In women with NGT, lower lung function was consistently associated with higher glucose levels and less consistently with higher insulin levels and insulin resistance. Lower lung function was consistently associated with higher insulin levels and insulin resistance and less consistently associated with insulin and hemoglobin A1c in men with NGT. Overall, our findings generally support the hypothesis that diabetes, IGT, and increased levels of metabolic biomarkers in individuals with NGT are inversely associated with lung function in African Americans, independent of adiposity.

  17. High-Resolution Mapping of Chromatin Conformation in Cardiac Myocytes Reveals Structural Remodeling of the Epigenome in Heart Failure.

    Science.gov (United States)

    Rosa-Garrido, Manuel; Chapski, Douglas J; Schmitt, Anthony D; Kimball, Todd H; Karbassi, Elaheh; Monte, Emma; Balderas, Enrique; Pellegrini, Matteo; Shih, Tsai-Ting; Soehalim, Elizabeth; Liem, David; Ping, Peipei; Galjart, Niels J; Ren, Shuxun; Wang, Yibin; Ren, Bing; Vondriska, Thomas M

    2017-10-24

    Cardiovascular disease is associated with epigenomic changes in the heart; however, the endogenous structure of cardiac myocyte chromatin has never been determined. To investigate the mechanisms of epigenomic function in the heart, genome-wide chromatin conformation capture (Hi-C) and DNA sequencing were performed in adult cardiac myocytes following development of pressure overload-induced hypertrophy. Mice with cardiac-specific deletion of CTCF (a ubiquitous chromatin structural protein) were generated to explore the role of this protein in chromatin structure and cardiac phenotype. Transcriptome analyses by RNA-seq were conducted as a functional readout of the epigenomic structural changes. Depletion of CTCF was sufficient to induce heart failure in mice, and human patients with heart failure receiving mechanical unloading via left ventricular assist devices show increased CTCF abundance. Chromatin structural analyses revealed interactions within the cardiac myocyte genome at 5-kb resolution, enabling examination of intra- and interchromosomal events, and providing a resource for future cardiac epigenomic investigations. Pressure overload or CTCF depletion selectively altered boundary strength between topologically associating domains and A/B compartmentalization, measurements of genome accessibility. Heart failure involved decreased stability of chromatin interactions around disease-causing genes. In addition, pressure overload or CTCF depletion remodeled long-range interactions of cardiac enhancers, resulting in a significant decrease in local chromatin interactions around these functional elements. These findings provide a high-resolution chromatin architecture resource for cardiac epigenomic investigations and demonstrate that global structural remodeling of chromatin underpins heart failure. The newly identified principles of endogenous chromatin structure have key implications for epigenetic therapy. © 2017 The Authors.

  18. Cats with diabetes mellitus have diastolic dysfunction in the absence of structural heart disease.

    Science.gov (United States)

    Pereira, N J; Novo Matos, J; Baron Toaldo, M; Bartoszuk, U; Summerfield, N; Riederer, A; Reusch, C; Glaus, T M

    2017-07-01

    Diabetes mellitus (DM) can result in cardiovascular dysfunction and heart failure characterized by diastolic dysfunction with or without the presence of systolic dysfunction in people and laboratory animals. The objective of this prospective study was to determine if cats with newly diagnosed DM had myocardial dysfunction and, if present, whether it would progress if appropriate antidiabetic therapy was commenced. Thirty-two diabetic cats were enrolled and received baseline echocardiographic examination; of these, 15 cats were re-examined after 6 months. Ten healthy age- and weight-matched cats served as controls. Diabetic cats at diagnosis showed decreased diastolic, but not systolic function, when compared to healthy controls, with lower mitral inflow E wave (E) and E/E' than controls. After 6 months, E and E/IVRT' decreased further in diabetic cats compared to the baseline evaluation. After excluding cats whose DM was in remission at 6 months, insulin-dependent diabetic cats had lower E, E/A and E' than controls. When classifying diastolic function according to E/A and E'/A', there was shift towards impaired relaxation patterns at 6 months. All insulin-dependent diabetic cats at 6 months had abnormal diastolic function. These results indicate that DM has similar effects on diastolic function in feline and human diabetics. The dysfunction seemed to progress rather than to normalize after 6 months, despite antidiabetic therapy. In cats with pre-existing heart disease, the development of DM could represent an important additional health risk. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Abdominal obesity and structure and function of the heart in healthy male Koreans: The ARIRANG study.

    Science.gov (United States)

    Son, Jung-Woo; Sung, Joong Kyung; Lee, Jun-Won; Youn, Young Jin; Ahn, Min-Soo; Ahn, Sung Gyun; Yoo, Byung-Su; Lee, Seung-Hwan; Yoon, Junghan; Koh, Sang Baek; Kim, Jang-Young

    2016-09-01

    Although central obesity is a more powerful predictor of cardiovascular disease (CVD) than general obesity, there is limited information on structural and functional changes of the heart in central obesity. Therefore, we evaluated the association between abdominal obesity and geometric and functional changes of the heart in healthy males. A total of 1460 healthy males aged 40 to 70 years without known CVD from the Korean Genome and Epidemiology Study on Atherosclerosis Risk of Rural Areas in the Korean General Population were included. All individuals underwent conventional 2-dimensional echocardiography and tissue Doppler imaging to measure left atrial (LA) and left ventricle (LV) geometry and function. Increasing tertiles of waist circumference (WC) were associated with stepwise increases in LA volume, LV end-diastolic dimension, LV mass to height, deceleration time of E wave, and lower E/A ratio (all P trends 89 cm) to the lowest tertile (obesity may be a stronger predictor than general obesity of geometric and functional changes in the LV and LA.

  20. A structure-preserving approach to normal form analysis of power systems; Una propuesta de preservacion de estructura al analisis de su forma normal en sistemas de potencia

    Energy Technology Data Exchange (ETDEWEB)

    Martinez Carrillo, Irma

    2008-01-15

    Power system dynamic behavior is inherently nonlinear and is driven by different processes at different time scales. The size and complexity of these mechanisms has stimulated the search for methods that reduce the original dimension but retain a certain degree of accuracy. In this dissertation, a novel nonlinear dynamical analysis method for the analysis of large amplitude oscillations that embraces ideas from normal form theory and singular perturbation techniques is proposed. This approach allows the full potential of the normal form method to be reached, and is suitably general for application to a wide variety of nonlinear systems. Drawing on the formal theory of dynamical systems, a structure-preserving model of the system is developed that preservers network and load characteristics. By exploiting the separation of fast and slow time scales of the model, an efficient approach based on singular perturbation techniques, is then derived for constructing a nonlinear power system representation that accurately preserves network structure. The method requires no reduction of the constraint equations and gives therefore, information about the effect of network and load characteristics on system behavior. Analytical expressions are then developed that provide approximate solutions to system performance near a singularity and techniques for interpreting these solutions in terms of modal functions are given. New insights into the nature of nonlinear oscillations are also offered and criteria for characterizing network effects on nonlinear system behavior are proposed. Theoretical insight into the behavior of dynamic coupling of differential-algebraic equations and the origin of nonlinearity is given, and implications for analyzing for design and placement of power system controllers in complex nonlinear systems are discussed. The extent of applicability of the proposed procedure is demonstrated by analyzing nonlinear behavior in two realistic test power systems

  1. Structure and function of adenylate kinase isozymes in normal humans and muscular dystrophy patients.

    Science.gov (United States)

    Hamada, M; Takenaka, H; Fukumoto, K; Fukamachi, S; Yamaguchi, T; Sumida, M; Shiosaka, T; Kurokawa, Y; Okuda, H; Kuby, S A

    1987-01-01

    Two isozymes of adenylate kinase from human Duchenne muscular dystrophy serum, one of which was an aberrant form specific to DMD patients, were separated by Blue Sepharose CL-6B affinity chromatography. The separated aberrant form possessed a molecular weight of 98,000 +/- 1,500, whereas the normal serum isozyme had a weight of 87,000 +/- 1,600, as determined by SDS-polyacrylamide gel electrophoresis, gel filtration, and sedimentation equilibrium. The sedimentation coefficients were 5.8 S and 5.6 S for the aberrant form and the normal form, respectively. Both serum isozymes are tetramers. The subunit size of the aberrant isozyme (Mr = 24,700) was very similar to that of the normal human liver isozyme, and the subunit size of the normal isozyme (Mr = 21,700) was very similar to that of the normal human muscle enzyme. The amino acid composition of the normal serum isozyme was similar to that of the muscle-type enzyme, and that of the aberrant isozyme was similar to that of the liver enzyme, with some exceptions in both cases.

  2. Application Experience of Composite Materials with Macro-Heterogeneous Structure for Normalization of Thermal-Mechanical State of Steam Turbines

    Directory of Open Access Journals (Sweden)

    Yu. Kobzar

    2013-01-01

    Full Text Available The paper presents an application experience of composite materials with macro-hetero-geneous structure for normalization of thermo-mechanical state of steam turbines. It has been shown that the developed repairing technology with application of composite materials with macro-heterogeneous structure makes it possible to ensure thermo-mechanical state of steam turbines after their reconstruction  at the level of newly assembled ones.

  3. Fluid structure interaction (FSI) simulation of a bileaflet mechanical heart valve (MHV)

    Science.gov (United States)

    Ge, Liang; Bor, Iman; Dasi, Lakshmi; Sotiropoulos, Fotis; Yoganathan, Ajit

    2006-11-01

    MHVs are widely used as prosthetics for dysfunctional heart valves. All current MHV designs, however, are prone to thrombus formation, which is believed to be strongly associated with the non-physiological hemodynamics patterns and elevated shear stress level induced by the valve; it is, therefore, of enormous practical importance to study the hemodynamics through MHVs. Here we present an FSI solver modeling the physiological MHV hemodynamics. The solver uses a strong coupling scheme for the FSI problem and a recently developed curvilinear grid/immersed boundary method for flow simulation. The FSI solver is applied to model an in-vitro MHV hemodynamics measurement. The experimental pulsatile flow waveform with peak Reynolds number of 4000 is specified at the inlet and the flow is modeled by DNS. The results, including the dynamics of wake vortical structure, shear distribution and leaflet kinematics, are validated against the experimental data.

  4. Diagnostic Utility of High Sensitivity Troponins for Echocardiographic Markers of Structural Heart Disease.

    Science.gov (United States)

    Wang, Tom Kai Ming; Dugo, Clementina; Gillian, Yvonne; Yvonne, Wynne; Heather, Semple; Kevin, Smith; Peter, Cleave; Jonathan, Christiansen; Andrew, To; Nezar, Amir; Scott, Tony; Ross, Boswell; Patrick, Gladding

    2018-02-15

    The conventional use of high-sensitivity troponins (hs-troponins) is for diagnosing myocardial infarction however they also have a role in chronic disease management. This pilot study assessed the relationship of hs-troponins with echocardiographic markers of left ventricular hypertrophy (LVH) and structural heart disease (SHD). Patients undergoing computer gomography (CT) coronary angiogram for low-intermediate risk chest pain and healthy volunteers were recruited. Hs-troponins Singulex I, Abbott I and Roche T and N-terminal pro-brain natriuretic peptide (NT-proBNP) were evaluated in relation to SHD parameters including left ventricular hypertrophy (LVH Echo ) and left atrial enlargement (LAE Echo ) on echocardiography. 78 subjects who underwent echocardiography were included in this study. C-statistics (95% confidence interval) of the four biomarkers for predicting LVH Echo were 0.84 (0.72-0.92), 0.84 (0.73-0.92), 0.75 (0.63-0.85) and 0.62 (0.49-0.74); for LAE Echo 0.74 (0.6-0.85), 0.78 (0.66-0.88), 0.55 (0.42-0.67) and 0.68 (0.62-0.85); and composite SHD 0.79 (0.66-0.88), 0.87 (0.75-0.94), 0.62 (0.49-0.73) and 0.74 (0.62-0.84) respectively. Optimal cut points for SHD were >1.2 ng/L, >1.6 ng/L, >8 ng/L and >18 pmol/L respectively. These results advocate the potential role of hs-troponins as screening tools for structural heart disease with theranostic implications.

  5. Structured telephone support or telemonitoring programmes for patients with chronic heart failure.

    Science.gov (United States)

    Inglis, Sally C; Clark, Robyn A; McAlister, Finlay A; Ball, Jocasta; Lewinter, Christian; Cullington, Damien; Stewart, Simon; Cleland, John Gf

    2010-08-04

    Specialised disease management programmes for chronic heart failure (CHF) improve survival, quality of life and reduce healthcare utilisation. The overall efficacy of structured telephone support or telemonitoring as an individual component of a CHF disease management strategy remains inconclusive. To review randomised controlled trials (RCTs) of structured telephone support or telemonitoring compared to standard practice for patients with CHF in order to quantify the effects of these interventions over and above usual care for these patients. Databases (the Cochrane Central Register of Controlled Trials (CENTRAL), Database of Abstracts of Reviews of Effects (DARE) and Health Technology Assessment Database (HTA) on The Cochrane Library, MEDLINE, EMBASE, CINAHL, AMED and Science Citation Index Expanded and Conference Citation Index on ISI Web of Knowledge) and various search engines were searched from 2006 to November 2008 to update a previously published non-Cochrane review. Bibliographies of relevant studies and systematic reviews and abstract conference proceedings were handsearched. No language limits were applied. Only peer reviewed, published RCTs comparing structured telephone support or telemonitoring to usual care of CHF patients were included. Unpublished abstract data was included in sensitivity analyses. The intervention or usual care could not include a home visit or more than the usual (four to six weeks) clinic follow-up. Data were presented as risk ratio (RR) with 95% confidence intervals (CI). Primary outcomes included all-cause mortality, all-cause and CHF-related hospitalisations which were meta-analysed using fixed effects models. Other outcomes included length of stay, quality of life, acceptability and cost and these were described and tabulated. Twenty-five studies and five published abstracts were included. Of the 25 full peer-reviewed studies meta-analysed, 16 evaluated structured telephone support (5613 participants), 11 evaluated

  6. Arrhythmia risk assessment using heart rate variability parameters in patients with frequent ventricular ectopic beats without structural heart disease.

    Science.gov (United States)

    Barutçu, Ahmet; Temiz, Ahmet; Bekler, Adem; Altun, Burak; Kirilmaz, Bahadir; Aksu, Feyza Ulusoy; Küçük, Uğur; Gazi, Emine

    2014-11-01

    Ventricular ectopic beats (VEBs) are usually considered a benign condition that can be managed with conservative measures. Heart rate variability (HRV), which is one of the most important methods for assessing autonomic activity, is a noninvasive, quantitative method of analyzing autonomic effects on the heart. We aimed to investigate the risk of arrhythmia in patients with VEBs and without cardiovascular disease by using HRV parameters. Patients with frequent VEBs (more than 30 times in 1 hour, according to the Lown classification) were identified. Identified patients were evaluated by 24-hour ECG recording. Our study included 43 patients with frequent VEBs and 43 controls. General characteristics of the study population were similar. The LF (low frequency)/HF (high frequency) ratio was significantly higher in the frequent VEBs group than in the control group (P < 0.001). The rate of paroxysmal atrial fibrillation (PAF) was higher in the frequent VEB group than in the control group (P = 0.003). The number of VEBs was correlated with LF/HF ratio and PAF (r = 0.339, P = 0.001 and r = 0.294, P = 0.006, respectively). Our study showed that the sympathetic nervous system is dominant in young patients with VEBs and without significant comorbidities. There is a higher risk of atrial fibrillation in patients with VEBs and they should be monitored closely for atrial fibrillation. ©2014 Wiley Periodicals, Inc.

  7. Regression equations for calculation of z scores for echocardiographic measurements of right heart structures in healthy Han Chinese children.

    Science.gov (United States)

    Wang, Shan-Shan; Zhang, Yu-Qi; Chen, Shu-Bao; Huang, Guo-Ying; Zhang, Hong-Yan; Zhang, Zhi-Fang; Wu, Lan-Ping; Hong, Wen-Jing; Shen, Rong; Liu, Yi-Qing; Zhu, Jun-Xue

    2017-06-01

    Clinical decision making in children with congenital and acquired heart disease relies on measurements of cardiac structures using two-dimensional echocardiography. We aimed to establish z-score regression equations for right heart structures in healthy Chinese Han children. Two-dimensional and M-mode echocardiography was performed in 515 patients. We measured the dimensions of the pulmonary valve annulus (PVA), main pulmonary artery (MPA), left pulmonary artery (LPA), right pulmonary artery (RPA), right ventricular outflow tract at end-diastole (RVOTd) and at end-systole (RVOTs), tricuspid valve annulus (TVA), right ventricular inflow tract at end-diastole (RVIDd) and at end-systole (RVIDs), and right atrium (RA). Regression analyses were conducted to relate the measurements of right heart structures to 4body surface area (BSA). Right ventricular outflow-tract fractional shortening (RVOTFS) was also calculated. Several models were used, and the best model was chosen to establish a z-score calculator. PVA, MPA, LPA, RPA, RVOTd, RVOTs, TVA, RVIDd, RVIDs, and RA (R 2  = 0.786, 0.705, 0.728, 0.701, 0.706, 0.824, 0.804, 0.663, 0.626, and 0.793, respectively) had a cubic polynomial relationship with BSA; specifically, measurement (M) = β0 + β1 × BSA + β2 × BSA 2  + β3 × BSA. 3 RVOTFS (0.28 ± 0.02) fell within a narrow range (0.12-0.51). Our results provide reference values for z scores and regression equations for right heart structures in Han Chinese children. These data may help interpreting the routine clinical measurement of right heart structures in children with congenital or acquired heart disease. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:293-303, 2017. © 2017 Wiley Periodicals, Inc.

  8. A high normal TSH level is associated with an atherogenic lipid profile in euthyroid non-smokers with newly diagnosed asymptomatic coronary heart disease.

    Science.gov (United States)

    Wanjia, Xing; Chenggang, Wang; Aihong, Wang; Xiaomei, Yang; Jiajun, Zhao; Chunxiao, Yu; Jin, Xu; Yinglong, Hou; Ling, Gao

    2012-03-27

    Serum lipid profiles may be influenced by thyroid function, but the detailed mechanism remains unclear. Increasing evidence suggests that thyrotropin (TSH) may exert extra-thyroidal effects. The goal of this study was to evaluate the relationship between serum TSH levels and the lipid profiles in euthyroid non-smokers with newly diagnosed asymptomatic coronary heart disease (CHD). This was a retrospective study of 406 euthyroid non-smokers (187 males and 219 females) with newly diagnosed asymptomatic CHD from 2004 to 2010 in Jinan, China. Lipid parameters and the levels of TSH, FT3, and FT4 were determined. Multiple linear regression analysis and Logistic regression analysis were used to assess the influence of TSH on the lipid profiles and the risks of dyslipidemia. The TSH level, even within the normal range, was positively and linearly correlated with total cholesterol (TC), non-high density lipoprotein cholesterol (non-HDL-C) and triglycerides (TG) (Beta = 0.173, 0.181 and 0.103, respectively, P levels of TC, TG and non-HDL-C will increase by 1.010, 1.064, and 1.062 mmol/L, respectively. The odds ratio of hypercholesterolemia and hypertriglyceridemia with respect to the serum TSH level was 1.640 (95% CI 1.199-2.243, P = 0.002) and 1.349 (95% CI 1.054-1.726, P = 0.017), respectively. TSH levels were correlated in a positive linear manner with the TC, non-HDL-C and TG levels in euthyroid non-smokers with newly diagnosed asymptomatic CHD. TSH in the upper limits of the reference range might exert adverse effects on lipid profiles and thus representing as a risk factor for hypercholesterolemia and hypertriglyceridemia in the context of CHD. © 2012 Wanjia et al; licensee BioMed Central Ltd.

  9. Correlation between regular mouthing movements and heart rate patterns during non-rapid eye movement periods in normal human fetuses between 32 and 40 weeks of gestation.

    Science.gov (United States)

    Otera, Yuka; Morokuma, Seiichi; Fukushima, Kotaro; Wake, Norio; Kato, Kiyoko

    2013-06-01

    Regular mouthing movements (RMMs) are observed during fetal non-rapid eye movement (NREM) periods. To determine the correlation between RMM and fetal heart rate (FHR) patterns during NREM periods. Fetal eye and mouth movements and FHR patterns were observed and recorded. 50 normal singleton pregnancies between 32 and 40 weeks of gestation. Changes in the power spectrum ratio of 3-minute blocks of RMM clusters, FHR with RMM clusters (HR+), and FHR without RMM clusters (HR-) were calculated at a frequency band of 0.02 Hz among 3 gestational age groups: group 1, 32-34 weeks gestation; group 2, 35-37 weeks gestation; group 3, 38-40 weeks gestation. We calculated the percentage of cases showing dominant peak ratios of RMM and HR+ in the same frequency band, the maximum correlation coefficient, and its lag time. In group 3, the dominant peaks of both RM and HR+ were present at the same frequency band, 0.06-0.08 Hz; this was not seen in the other groups' relative power spectral patterns. The percentage of cases showing dominant peaks of RMM and HR+ in the same frequency band increased with advancing gestational age. The maximum correlation coefficient in groups 1 (0.28 ± 0.11) and 3 (0.45 ± 0.14) differed significantly (p<0.05). The correlation between RMM and FHR patterns became stronger, and their rhythmicity was similar, from 38 to 40 gestational weeks, suggesting that a common center starts to govern both patterns at approximately 38 weeks gestation. Copyright © 2012 Elsevier Ltd. All rights reserved.

  10. Diastolic tissue Doppler indexes correlate with the degree of collagen expression and cross-linking in heart failure and normal ejection fraction.

    Science.gov (United States)

    Kasner, Mario; Westermann, Dirk; Lopez, Begoña; Gaub, Regina; Escher, Felicitas; Kühl, Uwe; Schultheiss, Heinz-Peter; Tschöpe, Carsten

    2011-02-22

    We attempted to correlate echocardiographic analysis of diastolic function with changes of myocardial collagen in middle-aged patients with heart failure (HF) despite normal ejection fraction (EF). Increased collagen deposition may contribute to the deterioration of the left ventricular compliance and diastolic dysfunction in HF. We investigated 41 patients (median age 50 years [interquartile range: 41 to 57 years]) with normal EF (median 62% [interquartile range: 56% to 70%]) whose endomyocardial biopsies were taken previously. Assessment of diastolic function was performed by mitral-flow and tissue Doppler measurements. Sirius red and immunohistologic staining was performed to determine collagen volume fraction (CVF) and cross-linking, collagen types I and III expression, and lysyl-oxidase (LOX) expression. Expression of collagen messenger ribonucleic acid was determined by real-time polymerase chain reaction. Twenty-six patients with HFNEF with diastolic dysfunction showed a significant increase in total collagen and collagen I expression compared with that of 15 controls. This was accompanied with enhanced collagen cross-linking and LOX overexpression in HFNEF. Among all flow Doppler, only deceleration time of E was associated with CVF (R = 0.43), whereas tissue Doppler parameters correlated with CVF, collagen I at the protein and mRNA levels (E' [R = -0.58, -0.60, -0.45]; E'/A' [R = -0.32, -0.36, -0.31]), and left ventricular filling index (E/E' [R = 0.72, 0.68, 0.63]), respectively. No correlation with collagen III was found. The degree of collagen cross-linking and LOX expression was related to E' (R = -0.55 and -0.60) and E/E' (R = 0.72 and 0.71), respectively, but not to flow Doppler. Collagen overexpression correlated with reduced exercise capacity. Patients with HFNEF showed increased content of myocardial collagen type I, enhanced collagen cross-linking, and LOX expression, which were associated with impaired diastolic tissue Doppler parameters

  11. Factor structure of the Hospital Anxiety and Depression Scale (HADS in German coronary heart disease patients

    Directory of Open Access Journals (Sweden)

    Martin Colin R

    2005-03-01

    Full Text Available Abstract Background Depression and anxiety in patients with coronary heart disease (CHD are associated with a poorer prognosis. Therefore the screening for psychological distress is strongly recommended in cardiac rehabilitation. The Hospital Anxiety and Depression Scale (HADS is a widely used screening tool that has demonstrated good sensitivity and specificity for mental disorders. Methods We assessed mental distress in in-patient cardiac rehabilitation in Germany. The factor structure of the German language version of the HADS was investigated in 1320 patients with CHD. Exploratory factor analysis and confirmatory factor analysis were used to determine the underlying factor structure of the instrument. Results Three-factor models were found to offer a superior fit to the data compared to two-factor (anxiety and depression models. The German language HADS performs similarly to the English language version of the instrument in CHD patients. The German language HADS fundamentally comprises a tri-dimensional underlying factor structure (labelled by Friedman et al. as psychomotor agitation, psychic anxiety and depression. Conclusion Despite of clinical usefulness in screening for mental disturbances the construct validity of the HADS is not clear. The resulting scores of the tri-dimensional model can be interpreted as psychomotor agitation, psychic anxiety, and depression in individual patient data or clinical investigations.

  12. Poorer physical fitness is associated with reduced structural brain integrity in heart failure.

    Science.gov (United States)

    Alosco, Michael L; Brickman, Adam M; Spitznagel, Mary Beth; Griffith, Erica Y; Narkhede, Atul; Raz, Naftali; Cohen, Ronald; Sweet, Lawrence H; Colbert, Lisa H; Josephson, Richard; Hughes, Joel; Rosneck, Jim; Gunstad, John

    2013-05-15

    Physical fitness is an important correlate of structural and functional integrity of the brain in healthy adults. In heart failure (HF) patients, poor physical fitness may contribute to cognitive dysfunction and we examined the unique contribution of physical fitness to brain structural integrity among patients with HF. Sixty-nine HF patients performed the Modified Mini Mental State examination (3MS) and underwent brain magnetic resonance imaging. All participants completed the 2-minute step test (2MST), a brief measure of physical fitness. We examined the associations between cognitive performance, physical fitness, and three indices of global brain integrity: total cortical gray matter volume, total white matter volume, and whole brain cortical thickness. Regression analyses adjusting for demographic characteristics, medical variables (e.g., left ventricular ejection fraction), and intracranial volume revealed reduced performance on the 2MST were associated with decreased gray matter volume and thinner cortex (passociated with poorer 3MS scores (pphysical fitness is common in HF and associated with reduced structural brain integrity. Prospective studies are needed to elucidate underlying mechanisms for the influence of physical fitness on brain health in HF. Copyright © 2013 Elsevier B.V. All rights reserved.

  13. Influence of beta-adrenoblockers on structural-functional heart indices in patients with acute q-wave myocardial infarction

    Directory of Open Access Journals (Sweden)

    Сергій Михайлович Кисельов

    2015-11-01

    Full Text Available The problem of myocardium infraction (MI remains actually. An early postinfraction period is characterized with intensive remodeling of the left ventricle (LV and high risk of dangerous complications that is ten times more than the monthly number of complications during the next year. The aim of research was the study of an influence of beta-1 adrenoreceptors on the heart rhythm variability, ectopic heart activity, daily profile of arterial pressure, postinfraction remodeling in patients with an acute Q-myocardium infraction. Methods. There were examined 235 patients with Q-myocardium infraction. There was evaluated the risk of forming LV aneurism, dynamic indices of combined daily monitoring of arterial pressure and electrocardiogram, echocardiography under influence of the complex treatment using beta-1 adrenoreceptors blockers.Results. Under an influence of treatment there was established the growth of temporal indices of the heart rhythm variability (HRV, spectral indices that present the parasympathetic influence on the background of decrease of the spectral components of sympathetic origin and mean HR, decrease of ectopic heart activity, normalization of daily profile of arterial pressure, improvement of systolic and diastolic function of LV.Conclusions. The use of beta-1 adrenoreceptors in the complex treatment of patients with acute Q-MI decreases the risk of forming LV aneurism, favors an improvement of HRV indices, ectopic heart activity, daily profile of arterial pressure, intracardiac hemodynamics

  14. Detailed Studies on the Structure and Dynamics of Reacting Dusty Flows at Normal and Microgravity

    Science.gov (United States)

    Andac, M. Gurhan; Cracchiola, Brad; Egolfopoulos, Fokion N.; Campbell, Charles S.

    1999-01-01

    Dusty reacting flows are of particular interest for a wide range of applications. Inert particles can alter the flammability and extinction limits of a combustible mixture. Reacting particles can release substantial amount of heat and can be used either for power generation or propulsion. Accumulation of combustible particles in air can result in explosions which, for example, can occur in grain elevators, during lumber milling and in mine galleries. Furthermore, inert particles are used as flow velocity markers in reacting flows, and their velocity is measured by non-intrusive laser diagnostic techniques. Despite their importance, dusty reacting flows have been less studied and understood compared to gas phase as well as sprays. The addition of solid particles in a flowing gas stream can lead to strong couplings between the two phases, which can be of dynamic, thermal, and chemical nature. The dynamic coupling between the two phases is caused by the inertia that causes the phases to move with different velocities. Furthermore, gravitational, thermophoretic, photophoretic, electrophoretic, diffusiophoretic, centrifugal, and magnetic forces can be exerted on the particles. In general, magnetic, electrophoretic, centrifugal, photophoretic, and diffusiophoretic can be neglected. On the other hand, thermophoretic forces, caused by steep temperature gradients, can be important. The gravitational forces are almost always present and can affect the dynamic response of large particles. Understanding and quantifying the chemical coupling between two phases is a challenging task. However, all reacting particles begin this process as inert particles, and they must be heated before they participate in the combustion process. Thus, one must first understand the interactions of inert particles in a combustion environment. The in-detail understanding of the dynamics and structure of dusty flows can be only advanced by considering simple flow geometries such as the opposed

  15. A heart-coronary arteries structure of carbon nanofibers/graphene/silicon composite anode for high performance lithium ion batteries.

    Science.gov (United States)

    Ma, Xiaoxin; Hou, Guangmei; Ai, Qing; Zhang, Lin; Si, Pengchao; Feng, Jinkui; Ci, Lijie

    2017-08-29

    In an animal body, coronary arteries cover around the whole heart and supply the necessary oxygen and nutrition so that the heart muscle can survive as well as can pump blood in and out very efficiently. Inspired by this, we have designed a novel heart-coronary arteries structured electrode by electrospinning carbon nanofibers to cover active anode graphene/silicon particles. Electrospun high conductive nanofibers serve as veins and arteries to enhance the electron transportation and improve the electrochemical properties of the active "heart" particles. This flexible binder free carbon nanofibers/graphene/silicon electrode consists of millions of heart-coronary arteries cells. Besides, in the graphene/silicon "hearts", graphene network improves the electrical conductivity of silicon nanopaticles, buffers the volume change of silicon, and prevents them from directly contacting with electrolyte. As expected, this novel composite electrode demonstrates excellent lithium storage performance with a 86.5% capacity retention after 200 cycles, along with a high rate performance with a 543 mAh g -1 capacity at the rate of 1000 mA g -1 .

  16. Structural cerebral abnormalities and neurodevelopmental status in single ventricle congenital heart disease before Fontan procedure.

    Science.gov (United States)

    Knirsch, Walter; Mayer, Kristina Nadine; Scheer, Ianina; Tuura, Ruth; Schranz, Dietmar; Hahn, Andreas; Wetterling, Kristina; Beck, Ingrid; Latal, Beatrice; Reich, Bettina

    2017-04-01

    Neonates with single ventricle congenital heart disease are at risk for structural cerebral abnormalities. Little is known about the further evolution of cerebral abnormalities until Fontan procedure. Between August 2012 and July 2015, we conducted a prospective cross-sectional two centre study using cerebral magnetic resonance imaging (MRI) and neuro-developmental outcome assessed by the Bayley-III. Forty-seven children (31 male) were evaluated at a mean age of 25.9 ± 3.4 months with hypoplastic left heart syndrome (25) or other single ventricle (22). Cerebral MRI was abnormal in 17 patients (36.2%) including liquor space enlargements (10), small grey (9) and minimal white (5) matter injuries. Eight of 17 individuals had combined lesions. Median (range) cognitive composite score (CCS) (100, 65-120) and motor composite score (MCS) (97, 55-124) were comparable to the reference data, while language composite score (LCS) (97, 68-124) was significantly lower ( P  = 0.040). Liquor space enlargement was associated with poorer performance on all Bayley-III subscores (CCS: P  = 0.02; LCS: P  = 0.002; MCS: P  = 0.013). The number of re-operations [odds ratio (OR) 2.2, 95% confidence interval (CI) 1.1-4.3] ( P  = 0.03) and re-interventions (OR 2.1, 95% CI 1.1-3.8) ( P  = 0.03) was associated with a higher rate of overall MRI abnormalities. Cerebral MRI abnormalities occur in more than one third of children with single ventricle, while the neuro-developmental status is less severely affected before Fontan procedure. Liquor space enlargement is the predominant MRI finding associated with poorer neuro-developmental status, warranting further studies to determine aetiology and further evolution until school-age.

  17. Improving medication titration in heart failure by embedding a structured medication titration plan.

    Science.gov (United States)

    Hickey, Annabel; Suna, Jessica; Marquart, Louise; Denaro, Charles; Javorsky, George; Munns, Andrew; Mudge, Alison; Atherton, John J

    2016-12-01

    To improve up-titration of medications to target dose in heart failure patients by improving communication from hospital to primary care. This quality improvement project was undertaken within three heart failure disease management (HFDM) services in Queensland, Australia. A structured medication plan was collaboratively designed and implemented in an iterative manner, using methods including awareness raising and education, audit and feedback, integration into existing work practice, and incentive payments. Evaluation was undertaken using sequential audits, and included process measures (use of the titration plan, assignment of responsibility) and outcome measures (proportion of patients achieving target dose) in HFDM service patients with reduced left ventricular ejection fraction. Comparison of the three patient cohorts (pre-intervention cohort A n=96, intervention cohort B n=95, intervention cohort C n=89) showed increase use of the titration plan, a shift to greater primary care responsibility for titration, and an increase in the proportion of patients achieving target doses of angiotensin converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB) (A 37% vs B 48% vs C 55%, p=0.051) and beta-blockers (A 38% vs B 33% vs C 51%, p=0.045). Combining all three cohorts, patients not on target doses when discharged from hospital were more likely to achieve target doses of ACEI/ARB (ptitration plan. A medication titration plan was successfully implemented in three HFDM services and improved transitional communication and achievement of target doses of evidence-based therapies within six months of hospital discharge. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. The anterior complex: A visual mnemonic to aid in identification of normal structures.

    Science.gov (United States)

    Ranzini, Angela C

    2017-10-01

    The anterior complex of the fetal brain is a group of structures that are important to evaluate during the routine anatomic survey to exclude several serious brain malformations. These structures include the cavum septum pellucidum, anterior horns, interhemispheric fissure, callosal sulcus, and corpus callosum. The relationship between these structures is easily remembered with the presented visual cartoon. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:477-479, 2017. © 2017 Wiley Periodicals, Inc.

  19. Structural correlation method for model reduction and practical estimation of patient specific parameters illustrated on heart rate regulation

    DEFF Research Database (Denmark)

    Ottesen, Johnny T.; Mehlsen, Jesper; Olufsen, Mette

    2014-01-01

    We consider the inverse and patient specific problem of short term (seconds to minutes) heart rate regulation specified by a system of nonlinear ODEs and corresponding data. We show how a recent method termed the structural correlation method (SCM) can be used for model reduction and for obtainin...

  20. Coronary heart disease prevalence and occupational structure in U.S. metropolitan areas: a multilevel analysis.

    Science.gov (United States)

    Michimi, Akihiko; Ellis-Griffith, Gregory; Nagy, Christine; Peterson, Tina

    2013-05-01

    This research explored the link between coronary heart disease (CHD) prevalence and metropolitan-area level occupational structure among 137 metropolitan/micropolitan statistical areas (MMSA) in the United States. Using data from the 2006-2008 Behavioral Risk Factor Surveillance System and 2007 County Business Patterns, logistic mixed models were developed to estimate CHD prevalence between MMSAs controlling for individual-level socioeconomic characteristics and various types of occupational structure. Results showed that CHD prevalence was lower in MMSAs where their economy was dominated by 'tourism and resort' and 'the quaternary sector' and higher in MMSAs dominated by 'manufacturing', 'transportation and warehousing', and 'mining'. MMSA-level effects on CHD were found in 'tourism and resort' and 'the quaternary sector' having lower risk and 'mining' having higher risk of CHD. Although these effects prevailed in many MMSAs, some MMSAs did not fit into these effects. Additional analysis indicated a possible link between metropolitan population loss and higher CHD prevalence especially in the coal mining region of the Appalachian Mountains. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Integrated x-ray and echocardiography imaging for structural heart interventions.

    Science.gov (United States)

    Corti, Roberto; Biaggi, Patric; Gaemperli, Oliver; Bühler, Ines; Felix, Christian; Bettex, Dominique; Kretschmar, Oliver; Falk, Volkmar; Grünenfelder, Jürg

    2013-11-01

    Treatment of structural heart disease (SHD) represents a growing need and, with increasing device availability, an increasing number of SHD can be and will be treated percutaneously. However, interventional treatment of SHD is challenging. Long procedure times and steep learning curves are recognised obstacles. The main difficulties arise, however, from the inability to visualise simultaneously the anatomy and the devices using a single imaging technology. In fact, the majority of percutaneous interventions in SHD are guided by fluoroscopy. On the other hand, a multitude of imaging technologies are presently available to guide the interventionalist. Of these technologies, transoesophageal echocardiography (TEE), and particularly 3-D TEE, is rapidly becoming the imaging modality of choice for many of these procedures because it provides critical insights into soft tissue anatomy. However, adequate visualisation and appreciation of the relationships between the cardiac structures and the devices using various imaging modalities remain a challenge. Hence, the interaction between the operator and imager is a crucial factor in attaining procedural success. Innovative technology that fuses live 3-D TEE with live x-ray in an intuitive way could have an important added value. This new imaging technology seeks to improve the communication between the echocardiographer and the interventionalist, to increase the confidence and anatomical awareness, to assist in guidance, and to increase procedural efficiency.

  2. Normal and Dirac fermions in graphene multilayers: Tight-binding description of the electronic structure

    Science.gov (United States)

    Partoens, B.; Peeters, F. M.

    2007-05-01

    Within a tight-binding approach we show that around the K point of the energy spectrum Dirac fermions are present in AB stacked graphene multilayers if they have mirror plane symmetry. In other words, Dirac fermions are present in graphene stacks with an odd number of layers. For an even number of stacked graphene layers, only normal fermions with a parabolic energy dispersion are found near the K point.

  3. Fundamental Study on the Development of Structural Lightweight Concrete by Using Normal Coarse Aggregate and Foaming Agent

    Directory of Open Access Journals (Sweden)

    Han-Seung Lee

    2014-06-01

    Full Text Available Structural lightweight concrete (SLWC has superior properties that allow the optimization of super tall structure systems for the process of design. Because of the limited supply of lightweight aggregates in Korea, the development of structural lightweight concrete without lightweight aggregates is needed. The physical and mechanical properties of specimens that were cast using normal coarse aggregates and different mixing ratios of foaming agent to evaluate the possibility of creating structural lightweight concrete were investigated. The results show that the density of SLWC decreases as the dosage of foaming agent increases up to a dosage of 0.6%, as observed by SEM. It was also observed that the foaming agent induced well separated pores, and that the size of the pores ranged from 50 to 100 μm. Based on the porosity of concrete specimens with foaming agent, compressive strength values of structural lightweight foam concrete (SLWFC were obtained. It was also found that the estimated values from proposed equations for compressive strength and modulus of elasticity of SLWFC, and values obtained by actual measurements were in good agreement. Thus, this study confirms that new structural lightweight concrete using normal coarse aggregates and foaming agent can be developed successfully.

  4. Impact of normal sexual dimorphisms on sex differences in structural brain abnormalities in schizophrenia assessed by magnetic resonance imaging.

    Science.gov (United States)

    Goldstein, Jill M; Seidman, Larry J; O'Brien, Liam M; Horton, Nicholas J; Kennedy, David N; Makris, Nikos; Caviness, Verne S; Faraone, Stephen V; Tsuang, Ming T

    2002-02-01

    Previous studies suggest that the impact of early insults predisposing to schizophrenia may have differential consequences by sex. We hypothesized that brain regions found to be structurally different in normal men and women (sexual dimorphisms) and abnormal in schizophrenia would show significant sex differences in brain abnormalities, particularly in the cortex, in schizophrenia. Forty outpatients diagnosed as having schizophrenia by DSM-III-R were systematically sampled to be comparable within sex with 48 normal comparison subjects on the basis of age, ethnicity, parental socioeconomic status, and handedness. A comprehensive assessment of the entire brain was based on T1-weighted 3-dimensional images acquired from a 1.5-T magnet. Multivariate general linear models for correlated data were used to test for sex-specific effects regarding 22 hypothesized cortical, subcortical, and cerebrospinal fluid brain volumes, adjusted for age and total cerebrum size. Sex x group interactions were also tested on asymmetries of the planum temporale, Heschl's gyrus, and superior temporal gyrus, additionally controlled for handedness. Normal patterns of sexual dimorphisms were disrupted in schizophrenia. Sex-specific effects were primarily evident in the cortex, particularly in the frontomedial cortex, basal forebrain, cingulate and paracingulate gyri, posterior supramarginal gyrus, and planum temporale. Normal asymmetry of the planum was also disrupted differentially in men and women with schizophrenia. There were no significant differential sex effects in subcortical gray matter regions or cerebrospinal fluid. Factors that produce normal sexual dimorphisms may be associated with modulating insults producing schizophrenia, particularly in the cortex.

  5. Comparative Structural and functional changes in the heart and aorta of retire active and non- active endurance and bodybuilder athletes

    Directory of Open Access Journals (Sweden)

    Eskandar Rahimi

    2016-06-01

    We concluded that the BA had a greater thickness of LV posterior wall than EI and also they had a significant difference in aortic wall elasticity than BI and EI. This may be due to the Valsalva maneuver or differences in breathing of bodybuilder. We also found that the structure changes of heart in spite of detraining remain for years. Keywords: former endurance athletes, former bodybuilder athletes, Aortic elasticity, cardiac structure and function

  6. Perinatal outcomes of normal cotwins in twin pregnancies with one structurally anomalous fetus: a population-based retrospective study.

    Science.gov (United States)

    Sun, Lu-Ming; Chen, Xi-Kuan; Wen, Shi Wu; Fung, Karen Fung Kee; Yang, Qiuying; Walker, Mark C

    2009-01-01

    We examined the impact of the presence of one anomalous fetus in a twin pregnancy on perinatal outcomes in the normal cotwin. Perinatal outcomes in cotwins with an anomalous twin and cotwins without an anomalous twin were compared using data from the 1995 to 1997 United States Matched Multiple Births dataset. The two groups were matched by maternal age, parity, birth order, gender, and sex concordance (1:4 matching). The risks of preterm birth, low birth weight, small-for-gestational-age birth, fetal distress, the use of assisted ventilation, low Apgar score, fetal death, neonatal death, and infant death in the 3307 normal cotwins with a twin affected by structural anomalies were significantly higher than those of the 12,813 matched cotwins without an anomalous twin. The presence of one structurally anomalous fetus in a twin pregnancy increases the risks of adverse perinatal outcomes in the cotwin without a fetal anomaly.

  7. Genetic basis in epilepsies caused by malformations of cortical development and in those with structurally normal brain.

    Science.gov (United States)

    Andrade, Danielle M

    2009-07-01

    Epilepsy is the most common neurological disorder affecting young people. The etiologies are multiple and most cases are sporadic. However, some rare families with Mendelian inheritance have provided evidence of genes' important role in epilepsy. Two important but apparently different groups of disorders have been extensively studied: epilepsies associated with malformations of cortical development (MCDs) and epilepsies associated with a structurally normal brain (or with minimal abnormalities only). This review is focused on clinical and molecular aspects of focal cortical dysplasia, polymicrogyria, periventricular nodular heterotopia, subcortical band heterotopia, lissencephaly and schizencephaly as examples of MCDs. Juvenile myoclonic epilepsy, childhood absence epilepsy, some familial forms of focal epilepsy and epilepsies associated with febrile seizures are discussed as examples of epileptic conditions in (apparently) structurally normal brains.

  8. Tau and β-Amyloid Are Associated with Medial Temporal Lobe Structure, Function, and Memory Encoding in Normal Aging

    Energy Technology Data Exchange (ETDEWEB)

    Marks, Shawn M. [Univ. of California, Berkeley, CA (United States). Helen Wills Neuroscience Inst.; Lockhart, Samuel N. [Univ. of California, Berkeley, CA (United States). Helen Wills Neuroscience Inst.; Baker, Suzanne L. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Molecular Biophysics and Integrated Bioimaging; Jagust, William J. [Univ. of California, Berkeley, CA (United States). Helen Wills Neuroscience Inst.; Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Molecular Biophysics and Integrated Bioimaging

    2017-03-22

    Normal aging is associated with a decline in episodic memory and also with aggregation of the β-amyloid (Aβ) and tau proteins and atrophy of medial temporal lobe (MTL) structures crucial to memory formation. Although some evidence suggests that Aβ is associated with aberrant neural activity, the relationships among these two aggregated proteins, neural function, and brain structure are poorly understood. Using in vivo human Aβ and tau imaging, we demonstrate that increased Aβ and tau are both associated with aberrant fMRI activity in the MTL during memory encoding in cognitively normal older adults. This pathological neural activity was in turn associated with worse memory performance and atrophy within the MTL. A mediation analysis revealed that the relationship with regional atrophy was explained by MTL tau. These findings broaden the concept of cognitive aging to include evidence of Alzheimer’s disease-related protein aggregation as an underlying mechanism of age-related memory impairment.

  9. Ectopic expression of retinoic acid receptors and change of myocardial structure in the offspring heart with vitamin A deficiency.

    Science.gov (United States)

    Feng, Yi; Yu, Ya-mei; Yin, Min-zhi; Hong, Li; Cai, Wei

    2012-01-01

    Vitamin A is a key micronutrient required during crucial stages of embryonic development and vitamin A deficiency (VAD) results in embryonic heart malformation. The pleiotropic functions of vitamin A are mediated by specific nuclear receptors: the retinoic acid receptors (RARα, -β, and -γ) and the retinoic X receptors (RXRα, -β, and -γ). The action of nuclear receptors has been implicated in controlling of cell proliferation, differentiation and apoptosis, and the expressions of these receptor genes are regulated by retinoic acid levels during the early stages of embryonic development. GATA-4 is one of the earliest transcription factors expressed in developing cardiac cells. However, the functional links of specific nuclear receptors to heart development in VAD embryos are not clearly understood. In our study, weaning female Sprague-Dawley rats were fed a modified diet containing different concentrations of vitamin A according to the American Institute of Nutrition 93 Growth Purified Diet. After 10-wk feeding, the female rats were mated with normal male rats, and a portion of them were transferred to a diet with enough added vitamin A for the pregnancy cycle. The embryo hearts were dissected out at embryonic day 13.5 (E13.5) to study the expression of RARs, RXRs and GATA-4. The embryo hearts from E18.5 were for observation of ultrastructural changes. In comparison to vitamin A supplemented groups, the embryo hearts from vitamin A insufficient groups exhibited ultrastructural changes and significantly lower expression of GATA-4, RARα, and -γ, and higher expression of RXRα and -β. Our findings suggest that the down-regulation of RARs and the up-regulation of RXRs resulted from VAD affected GATA-4 gene expression, which resulted in ultrastructural changes in embryo hearts due to maternal insufficiency of vitamin A during pregnancy.

  10. Status of High Power Tests of Normal Conducting Single-Cell Standing Wave Structures

    Energy Technology Data Exchange (ETDEWEB)

    Dolgashev, Valery; /SLAC; Tantawi, Sami; /SLAC; Yeremian, Anahid; /SLAC; Higashi, Yasuo; /KEK, Tsukuba; Spataro, Bruno; /INFN, Rome

    2012-06-25

    Our experiments are directed toward the understanding of the physics of rf breakdown in systems that can be used to accelerate electron beams at {approx}11.4 GHz. The structure geometries have apertures, stored energy per cell, and rf pulse duration close to that of the NLC or CLIC. The breakdown rate is the main parameter that we use to compare rf breakdown behavior for different structures at a given set of rf pulse parameters (pulse shape and peak power) at 60 Hz repetition rate. In our experiments, the typical range of the breakdown rate is from one per few hours to {approx}100 per hour. To date we have tested 29 structures. We consistently found that after the initial conditioning, the behavior of the breakdown rate is reproducible for structures of the same geometry and material, and the breakdown rate dependence on peak magnetic fields is stronger than on peak surface electric fields for structures of different geometries. Below we report the main results from tests of seven structures made from hard copper, soft copper alloys and hard-copper alloys. Additional details on these and other structures will be discussed in future publications.

  11. Effects of systemic administration of 0.5% tropicamide on intraocular pressure, pupillary diameter, blood pressure, and heart rate in normal cats.

    Science.gov (United States)

    Schmidt, Kristiane S; Hacker, Dennis V; Kass, Philip H; Barkhoodarian, Alex L

    2006-01-01

    The objective of the study was to determine the effects of systemic 0.5% tropicamide on intraocular pressure (IOP), pupillary diameter (PD), blood pressure, and heart rate (HR) in normal felines with normotensive eyes. Intraocular pressure, PD, systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP), and HR were measured in 18 clinically healthy cats. Each of the previously mentioned parameters was measured every 30 min during the trial period. At T(60), each cat was treated with one to two drops of 0.5% tropicamide ophthalmic solution placed on the dorsal aspect of the tongue. Changes in SBP, DBP, MBP, and HR were evaluated using one-way repeated measures analysis of variance, with time as the repeated factor. IOP and PD were evaluated using two-way repeated measures analysis of variance, with time and side (OD vs. OS) as the repeated factors. P values less than or equal to 0.05 were considered statistically significant. After lingual tropicamide administration, the mean PD at T(60) was 3.53 mm OD and 3.53 mm OS. The mean PD at T(90) was 6.36 mm OD and 6.31 mm OS. The mean PD at T(120) was 8.25 mm OD and 8.19 mm OS. This change in PD from T(60), T(90), and T(120) was statistically significant, demonstrating a linear increase in PD over time after tropicamide application on the tongue (Ptropicamide application on the tongue (P=0.034). There was no statistically significant difference in IOP when comparing the right eye to the left eye (P=0.28). There were no statistically significant differences in SBP, DBP, MBP, and HR values over time for the duration of the study. We conclude that although lingual application of tropicamide appears to result in systemic absorption, causing significant pupillary dilation and elevations in IOP, systemic effects on SBP, DBP, MBP, and HR were not observed.

  12. Finite Element Study of Container Structure under Normal and High Temperature

    National Research Council Canada - National Science Library

    Zha, Xiaoxiong; Zuo, Yang

    2016-01-01

    ...) are obtained and compared with the standard temperature curve of ISO-834. Secondly, using the software of Abaqus, a full scale finite element model of multilayer container structure is established...

  13. Non-stationary random vibration analysis of structures under multiple correlated normal random excitations

    Science.gov (United States)

    Li, Yanbin; Mulani, Sameer B.; Kapania, Rakesh K.; Fei, Qingguo; Wu, Shaoqing

    2017-07-01

    An algorithm that integrates Karhunen-Loeve expansion (KLE) and the finite element method (FEM) is proposed to perform non-stationary random vibration analysis of structures under excitations, represented by multiple random processes that are correlated in both time and spatial domains. In KLE, the auto-covariance functions of random excitations are discretized using orthogonal basis functions. The KLE for multiple correlated random excitations relies on expansions in terms of correlated sets of random variables reflecting the cross-covariance of the random processes. During the response calculations, the eigenfunctions of KLE used to represent excitations are applied as forcing functions to the structure. The proposed algorithm is applied to a 2DOF system, a 2D cantilever beam and a 3D aircraft wing under both stationary and non-stationary correlated random excitations. Two methods are adopted to obtain the structural responses: a) the modal method and b) the direct method. Both the methods provide the statistics of the dynamic response with sufficient accuracy. The structural responses under the same type of correlated random excitations are bounded by the response obtained by perfectly correlated and uncorrelated random excitations. The structural response increases with a decrease in the correlation length and with an increase in the correlation magnitude. The proposed methodology can be applied for the analysis of any complex structure under any type of random excitation.

  14. UNDERSTANDING THE STRUCTURE OF THE HOT INTERSTELLAR MEDIUM IN NORMAL EARLY-TYPE GALAXIES.

    Science.gov (United States)

    Traynor, Liam; Kim, Dong-Woo; Chandra Galaxy Atlas

    2018-01-01

    The hot interstellar medium (ISM) of early-type galaxies (ETG's) provides crucial insight into the understanding of their formation and evolution. Mechanisms such as type Ia supernovae heating, AGN feedback, deepening potential depth through dark matter assembly and ramp-pressure stripping are known to affect the structure of the ISM. By using temperature maps and radial temperature profiles of the hot ISM from ~70 ETG's with archival Chandra data, it is possible to classify the galaxy's ISM into common structural types. This is extended by using 3D fitting of the radial temperature profile in order to provide models that further constrain the structural types. Five structural types are present, negative (temperature decreases with radii), positive (temperature increases with radii), hybrid-dip (temperature decreases at small radii and increases at large radii), hybrid-bump (inverse of hybrid-dip) and quasi-isothermal (temperature is constant at all radii). This work will be continued by 1) determining which mechanisms are present in which galaxies and 2) analysing the model parameters between galaxies within each structural type to determine whether each type can be described by a single set of model parameters, indicating that the same physical processes are responsible for creating that structural type.

  15. Fine structures of the normal mucosa in developing rat middle ear.

    Science.gov (United States)

    Maeda, S; Mogi, G; Oh, M

    1976-01-01

    Forty-two fetal and 90 developing young rats were studied electron microscopically to obtain a normal cellular distribution pattern of middle ear mucosa. The results showed that while ciliated columnar or cuboidal cells interspersed with secretory cells were predominantly distributed around the tympanic orifice and transitional zone, cuboidal or squamous nonciliated cells without secretory granules were numerous in the remaining part of the bulla. Development of ciliated cells started at the 17th or 18 th fetal day,paralleling that of secretory cells. The number of ciliated and secretory cells increased rapidly after birth. Glands were not found in the osseous tube, tympanic orifice, or other portions of the middle ear cavity in fetal, newborn, or suckling rats, while they are abundant in the cartilaginous portion of the tube. The findings of this study indicate that both secretory and ciliated cells are normal components of middle ear mucosa although these cells are restricted to the tympanic orifice and transitional zone, and that the mucociliary defense system starts to develop during the fetal stage.

  16. Myocardial structural, contractile and electrophysiological changes in the guinea-pig heart failure model induced by chronic sympathetic activation

    DEFF Research Database (Denmark)

    Soltysinska, Ewa; Osadchiy, Oleg; Olesen, Søren-Peter

    2011-01-01

    whether sustained adrenergic activation may produce a clinically relevant heart failure phenotype in the guinea-pig, an animal species whose ventricular action potential shape and restitution properties resemble those determined in humans. Isoprenaline (ISO), a ß-adrenoceptor agonist, was infused......-treated hearts, thereby contributing to impaired activation-to-repolarization coupling and reversed right ventricular-to-LV difference in repolarization time. In summary, we establish the guinea-pig model of ISO-induced cardiomyopathy, which enables the correlation of detrimental structural and contractile......Widely used murine models of adrenergic-induced cardiomyopathy offer little insight into electrical derangements seen in human heart failure owing to profound differences in the characteristics of ventricular repolarization in mice and rats compared with humans. We therefore sought to determine...

  17. Physical activity recommendations for patients with electrophysiologic and structural congenital heart disease: a survey of Canadian health care providers.

    Science.gov (United States)

    Roston, Thomas M; De Souza, Astrid M; Sandor, George G S; Sanatani, Shubhayan; Potts, James E

    2013-08-01

    Determining safe levels of physical activity for children and adolescents with electrophysiologic and structural congenital heart disease is a challenging clinical problem. The body of evidence for making these recommendations is limited and likely based on expert opinion, medicolegal concerns, and perceived risks of sudden cardiac death (SCD) with activity. The Bethesda Conference has established consensus guidelines for determining the eligibility of athletes with cardiovascular abnormalities for competitive sports and their disqualification from them. However, literature on guidelines for noncompetitive physical activity is not available. A survey was designed to determine practice patterns for patients with electrophysiologic and structural congenital heart disease. Between July 2011 and December 2011, approximately 350 health care providers working with this group of patients were recruited by email or while attending professional meetings. The survey received 81 responses, primarily from pediatric cardiologists (70 %). The findings indicate that the majority of Canadian cardiac care providers surveyed are only partially implementing current recommendations. Areas of variance included physical activity recommendations for hypertrophic cardiomyopathy, long QT syndrome, catecholaminergic polymorphic ventricular tachycardia, and heart transplantation, among others. The development of comprehensive consensus guidelines for activity recommendations was supported by 96 % of the respondents. The heterogeneity of responses may be attributable to conflicting and poorly evidenced information in the literature, a lack of emphasis on recreational activity, an entrenched tendency toward bed rest in the cardiology community, and a lack of awareness by cardiac care providers regarding the actual risk associated with physical activity in electrophysiologic and structural congenital heart disease. A balanced discussion is required in considering both the significant benefit of

  18. Still Heart Encodes a Structural HMT, SMYD1b, with Chaperone-Like Function during Fast Muscle Sarcomere Assembly.

    Directory of Open Access Journals (Sweden)

    Kendal Prill

    Full Text Available The vertebrate sarcomere is a complex and highly organized contractile structure whose assembly and function requires the coordination of hundreds of proteins. Proteins require proper folding and incorporation into the sarcomere by assembly factors, and they must also be maintained and replaced due to the constant physical stress of muscle contraction. Zebrafish mutants affecting muscle assembly and maintenance have proven to be an ideal tool for identification and analysis of factors necessary for these processes. The still heart mutant was identified due to motility defects and a nonfunctional heart. The cognate gene for the mutant was shown to be smyd1b and the still heart mutation results in an early nonsense codon. SMYD1 mutants show a lack of heart looping and chamber definition due to a lack of expression of heart morphogenesis factors gata4, gata5 and hand2. On a cellular level, fast muscle fibers in homozygous mutants do not form mature sarcomeres due to the lack of fast muscle myosin incorporation by SMYD1b when sarcomeres are first being assembled (19hpf, supporting SMYD1b as an assembly protein during sarcomere formation.

  19. Fluid-structure interaction in the left ventricle of the human heart coupled with mitral valve

    Science.gov (United States)

    Meschini, Valentina; de Tullio, Marco Donato; Querzoli, Giorgio; Verzicco, Roberto

    2016-11-01

    In this paper Direct Numerical Simulations (DNS), implemented using a fully fluid-structure interaction model for the left ventricle, the mitral valve and the flowing blood, and laboratory experiments are performed in order to cross validate the results. Moreover a parameter affecting the flow dynamics is the presence of a mitral valve. We model two cases, one with a natural mitral valve and another with a prosthetic mechanical one. Our aim is to understand their different effects on the flow inside the left ventricle in order to better investigate the process of valve replacement. We simulate two situations, one of a healthy left ventricle and another of a failing one. While in the first case the flow reaches the apex of the left ventricle and washout the stagnant fluid with both mechanical and natural valve, in the second case the disturbance generated by the mechanical leaflets destabilizes the mitral jet, thus further decreasing its capability to penetrate the ventricular region and originating heart attack or cardiac pathologies in general.

  20. Design, construction and characterization of fiber extensometer with heart shape structure for detection of displacement

    Science.gov (United States)

    Bayuwati, D.; Waluyo, T. B.

    2017-04-01

    This paper discusses the design, construction and characterization of an optical fiber extensometer with heart shape structure. The extensometer was made from a communication grade fiber loop arranged in a housing and pulling mechanism. As the light source, we used 1310 nm LED and a 1325 nm laser diode/LD. To characterize our extensometer, we used a motorized pulling system controlled by a personal computer. From the bending loss characterization using Fujikura fiber as the sensor, we obtained sensitivity of 0.04 dB/mm and measurement range of 28 mm when using the 1310 nm LED, whereas using the 1325 nm LD allowed us to obtain 0.06 dB/mm of sensitivity and 23 mm of measurement range. Using Thorlabs fiber as the sensor, we obtained sensitivity and measurement range of 0.09 dB/mm and 23 mm, respectively, when using the 1310 nm LED. When we used the 1325 nm LD, we obtained sensitivity of 0.03 dB/mm and 31 mm measurement range but with a noted whispering gallery mode/WGM effect. Compromise has to be considered amongst the high sensitivity, measurement range, WGM existence and noise properties to get best data reading for real application.

  1. Hypoplastic left heart syndrome is associated with structural and vascular placental abnormalities and leptin dysregulation.

    Science.gov (United States)

    Jones, Helen N; Olbrych, Stephanie K; Smith, Kathleen L; Cnota, James F; Habli, Mounira; Ramos-Gonzales, Osniel; Owens, Kathryn J; Hinton, Andrea C; Polzin, William J; Muglia, Louis J; Hinton, Robert B

    2015-10-01

    Hypoplastic left heart syndrome (HLHS) is a severe cardiovascular malformation (CVM) associated with fetal growth abnormalities. Genetic and environmental factors have been identified that contribute to pathogenesis, but the role of the placenta is unknown. The purpose of this study was to systematically examine the placenta in HLHS with and without growth abnormalities. HLHS term singleton births were identified from a larger cohort when placenta tissue was available. Clinical data were collected from maternal and neonatal medical records, including anthropometrics and placental pathology reports. Placental tissues from cases and controls were analyzed to assess parenchymal morphology, vascular architecture and leptin signaling. HLHS cases (n = 16) and gestational age-matched controls (n = 18) were analyzed. Among cases, the average birth weight was 2993 g, including 31% that were small for gestational age. When compared with controls, gross pathology of HLHS cases demonstrated significantly reduced placental weight and increased fibrin deposition, while micropathology showed increased syncytial nuclear aggregates, decreased terminal villi, reduced vasculature and increased leptin expression in syncytiotrophoblast and endothelial cells. Placentas from pregnancies complicated by fetal HLHS are characterized by abnormal parenchymal morphology, suggesting immature structure may be due to vascular abnormalities. Increased leptin expression may indicate an attempt to compensate for these vascular abnormalities. Further investigation into the regulation of angiogenesis in the fetus and placenta may elucidate the causes of HLHS and associated growth abnormalities in some cases. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Electrophysiologic study-guided amiodarone for sustained ventricular tachyarrhythmias associated with structural heart diseases.

    Science.gov (United States)

    Aiba, Takeshi; Yamagata, Kenichiro; Shimizu, Wataru; Taguchi, Atsushi; Satomi, Kazuhiro; Noda, Takashi; Okamura, Hideo; Suyama, Kazuhiro; Aihara, Naohiko; Kamakura, Shiro; Kurita, Takashi

    2008-01-01

    Although an electrophysiologic study (EPS) and Holter-monitoring are often helpful in evaluating the efficacy of antiarrhythmic drugs in patients with ventricular tachyarrhythmias (ventricular tachycardia/fibrillation (VT/VF)), the efficacy of EPS- or Holter-guided oral amiodarone therapy in Japanese patients is still unclear. EPS was performed 1 month after starting amiodarone, and Holter-monitoring was recorded before and 1 month after amiodarone in 188 patients with sustained VT/VF because of structural heart diseases. In spite of the judgment of EPS (n=89) or Holter (n=75), all patients continued amiodarone. Patients were followed up to 3 years and the primary endpoint was VT/VF recurrence and secondary endpoint was death by all cause. Kaplan-Meier estimated the risk of VT/VF recurrence was significantly smaller with EPS-guided amiodarone (pamiodarone. Multivariate Cox hazard analysis revealed that EPS-guided amiodarone was an independent factor suppressing the recurrence of VT/VF (pamiodarone was effective in patients with relatively well-preserved left ventricular ejection fraction (LVEF > or =0.30) but not in patients with lower LVEF (LVEF amiodarone was useful for preventing recurrence of VT/VF in patients with a relatively well-preserved LVEF, but not always beneficial in patients with a lower LVEF.

  3. APOE Genotypes Associate With Cognitive Performance but Not Cerebral Structure: Diabetes Heart Study MIND.

    Science.gov (United States)

    Palmer Allred, Nicholette D; Raffield, Laura M; Hardy, Joycelyn C; Hsu, Fang-Chi; Divers, Jasmin; Xu, Jianzhao; Smith, S Carrie; Hugenschmidt, Christina E; Wagner, Benjamin C; Whitlow, Christopher T; Sink, Kaycee M; Maldjian, Joseph A; Williamson, Jeff D; Bowden, Donald W; Freedman, Barry I

    2016-12-01

    Dementia is a debilitating illness with a disproportionate burden in patients with type 2 diabetes (T2D). Among the contributors, genetic variation at the apolipoprotein E locus (APOE) is posited to convey a strong effect. This study compared and contrasted the association of APOE with cognitive performance and cerebral structure in the setting of T2D. European Americans from the Diabetes Heart Study (DHS) MIND (n = 754) and African Americans from the African American (AA)-DHS MIND (n = 517) were examined. The cognitive battery assessed executive function, memory, and global cognition, and brain MRI was performed. In European Americans and African Americans, the APOE E4 risk haplotype group was associated with poorer performance on the modified Mini-Mental Status Examination (P cognition. In contrast to the literature, the APOE E2 haplotype group, which was overrepresented in these participants with T2D, was associated with poorer Rey Auditory Verbal Learning Test performance (P performed worse in the cognitive domains of memory and global cognition. Identification of genetic contributors remains critical to understanding new pathways to prevent and treat dementia in the setting of T2D. © 2016 by the American Diabetes Association.

  4. Effect of fatty acids on functional properties of normal wheat and waxy wheat starches: A structural basis.

    Science.gov (United States)

    Wang, Shujun; Wang, Jinrong; Yu, Jinglin; Wang, Shuo

    2016-01-01

    The effects of three saturated fatty acids on functional properties of normal wheat and waxy wheat starches were investigated. The complexing index (CI) of normal wheat starch-fatty acid complexes decreased with increasing carbon chain length. In contrast, waxy wheat starch-fatty acid complexes presented much lower CI. V-type crystalline polymorphs were formed between normal wheat starch and three fatty acids, with shorter chain fatty acids producing more crystalline structure. FTIR and Raman spectroscopy presented the similar results with XRD. The formation of amylose-fatty acid complex inhibited granule swelling, gelatinization progression, retrogradation and pasting development of normal wheat starch, with longer chain fatty acids showing greater inhibition. Amylopectin can also form complexes with fatty acids, but the amount of complex was too little to be detected by XRD, FTIR, Raman and DSC. As a consequence, small changes were observed in the functional properties of waxy wheat starch with the addition of fatty acids. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. The risk of heart failure and cardiometabolic complications in obesity may be masked by an apparent healthy status of normal blood glucose.

    Science.gov (United States)

    Tiwari, Shuchita; Mishra, Manish; Jadhav, Ashok; Gerger, Courtney; Lee, Paul; Weber, Lynn; Ndisang, Joseph Fomusi

    2013-01-01

    Although many obese individuals are normoglycemic and asymptomatic of cardiometabolic complications, this apparent healthy state may be a misnomer. Since heart failure is a major cause of mortality in obesity, we investigated the effects of heme-oxygenase (HO) on heart failure and cardiometabolic complications in obese normoglycemic Zucker-fatty rats (ZFs). Treatment with the HO-inducer, hemin, reduced markers of heart failure, such as osteopontin and osteoprotegerin, abated left-ventricular (LV) hypertrophy/fibrosis, extracellular matrix/profibrotic proteins including collagen IV, fibronectin, TGF-β1, and reduced cardiac lesions. Furthermore, hemin suppressed inflammation by abating macrophage chemoattractant protein-1, macrophage-inflammatory protein-1 alpha, TNF-α, IL-6, and IL-1β but enhanced adiponectin, atrial-natriuretic peptide (ANP), HO activity, insulin sensitivity, and glucose metabolism. Correspondingly, hemin improved several hemodynamic/echocardiographic parameters including LV-diastolic wall thickness, LV-systolic wall thickness, mean-arterial pressure, arterial-systolic pressure, arterial-diastolic pressure, LV-developed pressure, +dP/dt, and cardiac output. Contrarily, the HO-inhibitor, stannous mesoporphyrin nullified the hemin effect, exacerbating inflammatory/oxidative insults and aggravated insulin resistance (HOMA-index). We conclude that perturbations in insulin signaling and cardiac function may be forerunners to overt hyperglycemia and heart failure in obesity. Importantly, hemin improves cardiac function by suppressing markers of heart failure, LV hypertrophy, cardiac lesions, extracellular matrix/profibrotic proteins, and inflammatory/oxidative mediators, while concomitantly enhancing the HO-adiponectin-ANP axis.

  6. Effect of electron collecting metal oxide layer in normal and inverted structure polymer solar cells

    Energy Technology Data Exchange (ETDEWEB)

    Ng, A.; Liu, X.; Sun, Y. C.; Djurišić, A. B. [Department of Physics, The University of Hong Kong, Pokfulam Road, Hong Kong, P. R. (China); Ng, A. M. C. [Department of Physics, The University of Hong Kong, Pokfulam Road, Hong Kong, P. R. China and Nanostructure Institute for Energy and Environmental Research, Division of Physical Sciences, South University of Science and Technology of China, Shenzhen (China); Chan, W. K. [Department of Chemistry, The University of Hong Kong, Pokfulam Road, Hong Kong, P. R. (China)

    2013-12-04

    We performed a systematic study of the effect of electron collecting metal oxide layer on the performance of P3HT: PCBM solar cells. Zinc oxide (ZnO) or titanium dioxide (TiO{sub 2}) buffer layers were prepared by either e-beam evaporation or solution processing method. We also compared the photovoltaic performance of inserting the buffer layer between indium tin oxide (ITO) and the polymer layer for the inverted structure (ITO/ ZnO or TiO{sub 2}/P3HT:PCBM/V{sub 2}O{sub 5}/Au) as well as inserting the buffers layers between the polymer and the aluminum electrode for the conventional structure (ITO/V{sub 2}O{sub 5}/P3HT:PCBM/ZnO or TiO{sub 2}/Al). The results are shown in detail.

  7. Comparative study of normal and branched alkane monolayer films adsorbed on a solid surface. I. Structure

    DEFF Research Database (Denmark)

    Enevoldsen, Ann Dorrit; Hansen, Flemming Yssing; Diama, A.

    2007-01-01

    The structure of a monolayer film of the branched alkane squalane (C30H62) adsorbed on graphite has been studied by neutron diffraction and molecular dynamics (MD) simulations and compared with a similar study of the n-alkane tetracosane (n-C24H52). Both molecules have 24 carbon atoms along...... their backbone and squalane has, in addition, six methyl side groups. Upon adsorption, there are significant differences as well as similarities in the behavior of these molecular films. Both molecules form ordered structures at low temperatures; however, while the melting point of the two-dimensional (2D......) tetracosane film is roughly the same as the bulk melting point, the surface strongly stabilizes the 2D squalane film such that its melting point is 91 K above its value in bulk. Therefore, squalane, like tetracosane, will be a poor lubricant in those nanoscale devices that require a fluid lubricant at room...

  8. Magnetic flux structures in RNi{sub 2}B{sub 2}C single crystals in normal and superconducting states

    Energy Technology Data Exchange (ETDEWEB)

    Vinnikov, L Ya; Veshchunov, I S [Institute of Solid State Physics, RAS, Chernogolovka, Moscow region 142432 (Russian Federation); Bud' ko, S L; Canfield, P C; Kogan, V G, E-mail: vinnik@issp.ac.r [Ames Laboratory U.S. DOE, Iowa State University, Ames, Iowa 50011 (United States)

    2009-03-01

    RNi{sub 2}B{sub 2}C single crystals, where R = Lu, Y, Er, Ho and Tb have been studied by high-resolution Bitter decoration technique, over the wide range temperatures and magnetic fields up to 2 T. Diverse vortex lattice structures were investigated: transition from triangular to square lattice for LuNi{sub 2}B{sub 2}C single crystals; peculiar vortex structures associated with antiferromagnetic (AFM) and weak-ferromagnetic (WFM) states below T{sub c} for ErNi{sub 2}B{sub 2}C single crystals . In addition, Bitter decoration revealed structures associated with a long range magnetic order in the non-superconducting TbNi{sub 2}B{sub 2}C as well as ErNi{sub 2}B{sub 2}C in the normal but magnetically ordered state.

  9. Structural Stability of Functionalized Silicene Nanoribbons with Normal, Reconstructed, and Hybrid Edges

    OpenAIRE

    Sadegh Mehdi Aghaei; Ingrid Torres; Irene Calizo

    2016-01-01

    Silicene, a novel graphene-like material, has attracted a significant attention because of its potential applications for nanoelectronics. In this paper, we have theoretically investigated the structural stability of edge-hydrogenated and edge-fluorinated silicene nanoribbons (SiNRs) via first-principles calculations. Various edge forms of SiNRs including armchair edge, zigzag edge, Klein edge, reconstructed Klein edge, reconstructed pentagon-heptagon edge, and hybrid edges have been consider...

  10. The Correlation of PPARα Activity and Cardiomyocyte Metabolism and Structure in Idiopathic Dilated Cardiomyopathy during Heart Failure Progression

    Directory of Open Access Journals (Sweden)

    E. Czarnowska

    2016-01-01

    Full Text Available This study aimed to define relationship between PPARα expression and metabolic-structural characteristics during HF progression in hearts with DCM phenotype. Tissue endomyocardial biopsy samples divided into three groups according to LVEF ((I 45–50%, n=10; (II 30–40%, n=15; (III 60%, n=6 were investigated. The PPARα mRNA expression in the failing hearts was low in Group (I, high in Group (II, and comparable to that of the control in Group (III. There were analogous changes in the expression of FAT/CD36 and CPT-1 mRNA in contrast to continuous overexpression of GLUT-4 mRNA and significant increase of PDK-4 mRNA in Group (II. In addition, significant structural changes of cardiomyocytes with glycogen accumulation were accompanied by increased expression of PPARα. For the entire study population with HF levels of FAT/CD36 mRNA showed a strong tendency of negative correlation with LVEF. In conclusion, PPARα elevated levels may be a direct cause of adverse remodeling, both metabolic and structural. Thus, there is limited time window for therapy modulating cardiac metabolism and protecting cardiomyocyte structure in failing heart.

  11. Predictions of structural integrity of steam generator tubes under normal operating, accident, an severe accident conditions

    Energy Technology Data Exchange (ETDEWEB)

    Majumdar, S. [Argonne National Lab., IL (United States)

    1997-02-01

    Available models for predicting failure of flawed and unflawed steam generator tubes under normal operating, accident, and severe accident conditions are reviewed. Tests conducted in the past, though limited, tended to show that the earlier flow-stress model for part-through-wall axial cracks overestimated the damaging influence of deep cracks. This observation was confirmed by further tests at high temperatures, as well as by finite-element analysis. A modified correlation for deep cracks can correct this shortcoming of the model. Recent tests have shown that lateral restraint can significantly increase the failure pressure of tubes with unsymmetrical circumferential cracks. This observation was confirmed by finite-element analysis. The rate-independent flow stress models that are successful at low temperatures cannot predict the rate-sensitive failure behavior of steam generator tubes at high temperatures. Therefore, a creep rupture model for predicting failure was developed and validated by tests under various temperature and pressure loadings that can occur during postulated severe accidents.

  12. Numerical Study on Dynamic Response of a Horizontal Layered-Structure Rock Slope under a Normally Incident Sv Wave

    Directory of Open Access Journals (Sweden)

    Zhifa Zhan

    2017-07-01

    Full Text Available Several post-earthquake investigations have indicated that the slope structure plays a leading role in the stability of rock slopes under dynamic loads. In this paper, the dynamic response of a horizontal layered-structure rock slope under harmonic Sv wave is studied by making use of the Fast Lagrangian Analysis of Continua method (FLAC. The suitability of FLAC for studying wave transmission across rock joints is validated through comparison with analytical solutions. After parametric studies on Sv wave transmission across the horizontal layered-structure rock slope, it is found that the acceleration amplification coefficient η, which is defined as the ratio of the acceleration at the monitoring point to the value at the toe, wavily increases with an increase of the height along the slope surface. Meanwhile, the fluctuation weakens with normalized joint stiffness K increasing and enhances with normalized joint spacing ξ increasing. The acceleration amplification coefficient of the slope crest ηcrest does not monotonously increase with the increase of ξ, but decreases with the increase of K. Additionally, ηcrest is more sensitive to ξ compared to K. From the contour figures, it can also be found that the contour figures of η take on rhythm, and the effects of ξ on the acceleration amplification coefficient are more obvious compared to the effects on K.

  13. Investigation of ErBa2Cu3O7/Cu2O/normal metal tunnel structures

    Science.gov (United States)

    Thorpe, T. P.; Cukauskas, E. J.; Allen, L. H.; Reeves, M.

    1991-03-01

    Tunneling studies have been made using sputtered Cu2O as an insulating barrier between an EBCO thin film and a normal metallic layer. Cu2O was selected for its low potential for chemical reaction with the superconducting layer and for its photoconductive properties. Having a band gap in the visible (2 eV), Cu2O is a suitable candidate for photosensitive tunneling experiments. EBCO thin films were deposited in situ onto MgO substrates using an off-axis sputtering technique. Tc's of as-deposited films were between 80 and 85 K. Inductively measured Jc's ranged between 106 and 10 to the 7th A/sq cm at 4 K. A 5-20-nm layer of Cu2O was sputtered directly on top of the superconducting film. Room-temperature resistivities of the Cu2O layer were typically greater than 10 to the 6th ohm-cm. A normal metal layer (typically gold) was then deposited onto the Cu2O layer. Transport properties of the structure were measured at temperatures ranging above and below the Tc of the superconducting layer. Measurements of structures fabricated to date showed no tunneling effects. Measurements of the I-V characteristic of a Cu/EBCO bilayer exhibited nonohmic behavior at 85 K and 4 K, indicating the existence of an extraneous interfacial layer. Preliminary results on one such structure indicate possible tunneling effects.

  14. On the structure and normal modes of hydrogenated Ti-fullerene compounds

    Energy Technology Data Exchange (ETDEWEB)

    Tlahuice-Flores, Alfredo, E-mail: tlahuicef@yahoo.com [Universidad Nacional Autonoma de Mexico, Instituto de Fisica (Mexico); Mejia-Rosales, Sergio, E-mail: sergio.mejiars@uanl.edu.mx [Universidad Autonoma de Nuevo Leon, CICFIM-Facultad de Ciencias Fisico Matematicas, and Centro de Innovacion, Investigacion y Desarrollo en Ingenieria y Tecnologia (Mexico); Galvan, Donald H., E-mail: donald@cnyn.unam.mx [Centro de Nanociencias y Nanotecnologia-Universidad Nacional Autonoma de Mexico (Mexico)

    2012-08-15

    When titanium covers a C{sub 60} core, the metal atoms may suppress the fullerene's capacity of storing hydrogen, depending on the number of Ti atoms covering the C{sub 60} framework, the Ti-C binding energy, and diffusion barriers. In this article, we study the structural and vibrational properties of the C{sub 60}TiH{sub n} (n = 2, 4, 6, and 8) and C{sub 60}Ti{sub 6}H{sub 48} compounds. The IR spectra of C{sub 60}TiH{sub n} compounds have a maximum attributable to the Ti-H stretching mode, which shifts to lower values in the structures with n = 4, 8, while their Raman spectra show two peaks corresponding to the stretching modes of H{sub 2} molecules at apical and azimuthal positions. On the other hand, the IR spectrum of C{sub 60}Ti{sub 6}H{sub 48} shows an intense peak due to the Ti-H in-phase stretching mode, while its Raman spectrum has a maximum attributed to the pentagonal pinch of the C{sub 60} core. Finally, we have found that the presence of one apical H{sub 2} molecule enhances the pentagonal pinch mode, becoming the maximum in the Raman spectrum.Graphical Abstract.

  15. Sex-differences in grey-white matter structure in normal-reading and dyslexic adolescents.

    Science.gov (United States)

    Sandu, Anca-Larisa; Specht, Karsten; Beneventi, Harald; Lundervold, Arvid; Hugdahl, Kenneth

    2008-06-13

    MR images were used to look for brain structure irregularities in adolescent children with dyslexia by use of combined grey and white matter volume measurements and fractal dimension (FD) of the grey-white matter border. The data were collected from 13 dyslexic adolescent (8 boys and 5 girls) that were compared with 18 control subjects (8 boys and 10 girls). The MR images were first segmented, and the volume as well as the FD of the grey/white matter border for the whole brain and for each hemisphere was computed. Changes were found in the measured volumes of both grey and white matter and were best reflected in the ratio of grey/white matter and in FD values, especially in the left hemisphere. The results showed that, although dyslexia is less frequent in women, the structural differences in the brain are more pronounced in their case, pointing to an increased vulnerability of the female brain to morphological changes associated with dyslexia.

  16. Test-retest reliability of heart rate variability and respiration rate at rest and during light physical activity in normal subjects

    NARCIS (Netherlands)

    Guijt, Alida M.; Sluiter, Judith K.; Frings-Dresen, Monique H. W.

    2007-01-01

    BACKGROUND: A variable that remains stable over repeated measurements (in stable conditions) is ideal for tracking modifications of the clinical state. The aim of the present study is to examine test-retest reliability of time-domain heart rate variability and respiration rate measurements using a

  17. Ultra high-resolution gene centric genomic structural analysis of a non-syndromic congenital heart defect, Tetralogy of Fallot.

    Directory of Open Access Journals (Sweden)

    Douglas C Bittel

    Full Text Available Tetralogy of Fallot (TOF is one of the most common severe congenital heart malformations. Great progress has been made in identifying key genes that regulate heart development, yet approximately 70% of TOF cases are sporadic and nonsyndromic with no known genetic cause. We created an ultra high-resolution gene centric comparative genomic hybridization (gcCGH microarray based on 591 genes with a validated association with cardiovascular development or function. We used our gcCGH array to analyze the genomic structure of 34 infants with sporadic TOF without a deletion on chromosome 22q11.2 (n male = 20; n female = 14; age range of 2 to 10 months. Using our custom-made gcCGH microarray platform, we identified a total of 613 copy number variations (CNVs ranging in size from 78 base pairs to 19.5 Mb. We identified 16 subjects with 33 CNVs that contained 13 different genes which are known to be directly associated with heart development. Additionally, there were 79 genes from the broader list of genes that were partially or completely contained in a CNV. All 34 individuals examined had at least one CNV involving these 79 genes. Furthermore, we had available whole genome exon arrays from right ventricular tissue in 13 of our subjects. We analyzed these for correlations between copy number and gene expression level. Surprisingly, we could detect only one clear association between CNVs and expression (GSTT1 for any of the 591 focal genes on the gcCGH array. The expression levels of GSTT1 were correlated with copy number in all cases examined (r = 0.95, p = 0.001. We identified a large number of small CNVs in genes with varying associations with heart development. Our results illustrate the complexity of human genome structural variation and underscore the need for multifactorial assessment of potential genetic/genomic factors that contribute to congenital heart defects.

  18. Temporal Fine-Structure Coding and Lateralized Speech Perception in Normal-Hearing and Hearing-Impaired Listeners

    DEFF Research Database (Denmark)

    Locsei, Gusztav; Pedersen, Julie Hefting; Laugesen, Søren

    2016-01-01

    This study investigated the relationship between speech perception performance in spatially complex, lateralized listening scenarios and temporal fine-structure (TFS) coding at low frequencies. Young normal-hearing (NH) and two groups of elderly hearing-impaired (HI) listeners with mild or moderate...... gains to the stimuli, which were presented over headphones. The target and masker streams were lateralized to the same or to opposite sides of the head by introducing 0.7-ms interaural time differences between the ears. TFS coding was assessed by measuring frequency discrimination thresholds...

  19. Long thermal interactions of PAW with normal tooth structure and different dental biomaterials

    Science.gov (United States)

    Bostǎnaru, Andra-Cristina; Hnatiuc, Eugen; Roşca, Irina; Vasiliu, Ana Lavinia; Doroftei, Mirela; Ursu, Laura; Ailincǎi, Luminiţa Iuliana; Nǎstasǎ, Valentin; Mareş, Mihai

    2016-12-01

    Plasma activated water (PAW) has been widely considered to be an effective method for decontamination. Recently, numerous studies report that plasma-activated water (PAW) also has antibacterial ability to prevent or treat dental caries and periodontal related diseases. In this context, this study presents the first report to evaluate the plasma activated water effect on vital teeth enamel and different dental biomaterials. In this context, this study presents the first report to evaluate long thermal interactions of plasma activated water effect on vital teeth enamel and different dental biomaterials without organic substrate. The results suggest that the long-thermal of treatment with PAW of enamel without organic substrate can dissolve the apatite crystallites which are highly organized hierarchical structures.

  20. Comparative DNA methylation and gene expression analysis identifies novel genes for structural congenital heart diseases.

    Science.gov (United States)

    Grunert, Marcel; Dorn, Cornelia; Cui, Huanhuan; Dunkel, Ilona; Schulz, Kerstin; Schoenhals, Sophia; Sun, Wei; Berger, Felix; Chen, Wei; Sperling, Silke R

    2016-10-01

    For the majority of congenital heart diseases (CHDs), the full complexity of the causative molecular network, which is driven by genetic, epigenetic, and environmental factors, is yet to be elucidated. Epigenetic alterations are suggested to play a pivotal role in modulating the phenotypic expression of CHDs and their clinical course during life. Candidate approaches implied that DNA methylation might have a developmental role in CHD and contributes to the long-term progress of non-structural cardiac diseases. The aim of the present study is to define the postnatal epigenome of two common cardiac malformations, representing epigenetic memory, and adaption to hemodynamic alterations, which are jointly relevant for the disease course. We present the first analysis of genome-wide DNA methylation data obtained from myocardial biopsies of Tetralogy of Fallot (TOF) and ventricular septal defect patients. We defined stringent sets of differentially methylated regions between patients and controls, which are significantly enriched for genomic features like promoters, exons, and cardiac enhancers. For TOF, we linked DNA methylation with genome-wide expression data and found a significant overlap for hypermethylated promoters and down-regulated genes, and vice versa. We validated and replicated the methylation of selected CpGs and performed functional assays. We identified a hypermethylated novel developmental CpG island in the promoter of SCO2 and demonstrate its functional impact. Moreover, we discovered methylation changes co-localized with novel, differential splicing events among sarcomeric genes as well as transcription factor binding sites. Finally, we demonstrated the interaction of differentially methylated and expressed genes in TOF with mutated CHD genes in a molecular network. By interrogating DNA methylation and gene expression data, we identify two novel mechanism contributing to the phenotypic expression of CHDs: aberrant methylation of promoter CpG islands

  1. Heart Valve Diseases

    Science.gov (United States)

    Your heart has four valves. Normally, these valves open to let blood flow through or out of your heart, and then shut to keep it from flowing ... close tightly. It's one of the most common heart valve conditions. Sometimes it causes regurgitation. Stenosis - when ...

  2. VE/VCO2 slope in older heart failure patients with normal versus reduced ejection fraction compared with age-matched healthy controls.

    Science.gov (United States)

    Moore, Brian; Brubaker, Peter H; Stewart, Kathryn P; Kitzman, Dalane W

    2007-05-01

    Oxygen consumption (VO2) has previously been used for prognosis and risk stratification in patients with heart failure. More recent research has introduced VE/VCO2 slope as a prognostic measure. Risk of mortality is thought to increase when VE/VCO2 slope values are greater than 34. Therefore, the purpose of this study was to cross-sectionally examine VE/VCO2 slope in systolic heart failure (SHF) and diastolic heart failure (DHF) as well as age-matched healthy controls. Maximal graded exercise tests were conducted on 147 patients (59 DHF, 60 SHF, and 28 controls) using a bicycle ergometer. Breath-by-breath expired gas analysis was performed using a commercially available system with on-line computer calculations. VE/VCO2 slope was calculated from a regression line of minute ventilation and carbon dioxide production. One-way analysis of covariance with a Bonferroni post hoc test and Pearson correlations were used for statistical analysis. VE/VCO2 slope was significantly higher in SHF when compared to both DHF (37 +/- 8 vs. 34 +/- 7, P = .03) and controls (37 +/- 8 vs. 32 +/- 5, P = .002). No significant difference was observed between DHF and healthy controls (34 +/- 7 vs. 32 +/- 5, P = .52). Additional analysis resulted in significant correlations between VO2 and VE/VCO2 slope in systolic heart failure patients (r = -0.40, P = .002); however, there was no significant relationships in diastolic heart failure patients (r = -0.09, P = .49) or in controls (r = 0.13, P = .50). VE/VCO2 slope is significantly higher in patients with SHF compared with DHF and healthy controls.

  3. The Risk of Heart Failure and Cardiometabolic Complications in Obesity May Be Masked by an Apparent Healthy Status of Normal Blood Glucose

    Directory of Open Access Journals (Sweden)

    Shuchita Tiwari

    2013-01-01

    Full Text Available Although many obese individuals are normoglycemic and asymptomatic of cardiometabolic complications, this apparent healthy state may be a misnomer. Since heart failure is a major cause of mortality in obesity, we investigated the effects of heme-oxygenase (HO on heart failure and cardiometabolic complications in obese normoglycemic Zucker-fatty rats (ZFs. Treatment with the HO-inducer, hemin, reduced markers of heart failure, such as osteopontin and osteoprotegerin, abated left-ventricular (LV hypertrophy/fibrosis, extracellular matrix/profibrotic proteins including collagen IV, fibronectin, TGF-β1, and reduced cardiac lesions. Furthermore, hemin suppressed inflammation by abating macrophage chemoattractant protein-1, macrophage-inflammatory protein-1 alpha, TNF-α, IL-6, and IL-1β but enhanced adiponectin, atrial-natriuretic peptide (ANP, HO activity, insulin sensitivity, and glucose metabolism. Correspondingly, hemin improved several hemodynamic/echocardiographic parameters including LV-diastolic wall thickness, LV-systolic wall thickness, mean-arterial pressure, arterial-systolic pressure, arterial-diastolic pressure, LV-developed pressure, +dP/dt, and cardiac output. Contrarily, the HO-inhibitor, stannous mesoporphyrin nullified the hemin effect, exacerbating inflammatory/oxidative insults and aggravated insulin resistance (HOMA-index. We conclude that perturbations in insulin signaling and cardiac function may be forerunners to overt hyperglycemia and heart failure in obesity. Importantly, hemin improves cardiac function by suppressing markers of heart failure, LV hypertrophy, cardiac lesions, extracellular matrix/profibrotic proteins, and inflammatory/oxidative mediators, while concomitantly enhancing the HO-adiponectin-ANP axis.

  4. Influence of diurnal photosynthetic activity on the morphology, structure, and thermal properties of normal and waxy barley starch.

    Science.gov (United States)

    Goldstein, Avi; Annor, George; Vamadevan, Varatharajan; Tetlow, Ian; Kirkensgaard, Jacob J K; Mortensen, Kell; Blennow, Andreas; Hebelstrup, Kim H; Bertoft, Eric

    2017-05-01

    This study investigated the influence of diurnal photosynthetic activity on the morphology, molecular composition, crystallinity, and gelatinization properties of normal barley starch (NBS) and waxy barley starch (WBS) granules from plants cultivated in a greenhouse under normal diurnal (16h light) or constant light photosynthetic conditions. Growth rings were observed in all starch samples regardless of lighting conditions. The size distribution of whole and debranched WBS analyzed by gel-permeation chromatography did not appear to be influenced by the different lighting regimes, however, a greater relative crystallinity measured by wide-angle X-ray scattering and greater crystalline quality as judged by differential scanning calorimetry was observed under the diurnal lighting regime. NBS cultivated under the diurnal photosynthetic lighting regime displayed lower amylose content (18.7%), and shorter amylose chains than its counterpart grown under constant light. Although the relative crystallinity of NBS was not influenced by lighting conditions, lower onset, peak, and completion gelatinization temperatures were observed in diurnally grown NBS compared to constant light conditions. It is concluded that normal barley starch is less influenced by the diurnal photosynthetic lighting regime than amylose-free barley starch suggesting a role of amylose to prevent structural disorder and increase starch granule robustness against environmental cues. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Fluid-structure interaction of an aortic heart valve prosthesis driven by an animated anatomic left ventricle

    Science.gov (United States)

    Le, Trung Bao; Sotiropoulos, Fotis

    2013-07-01

    We develop a novel large-scale kinematic model for animating the left ventricle (LV) wall and use this model to drive the fluid-structure interaction (FSI) between the ensuing blood flow and a mechanical heart valve prosthesis implanted in the aortic position of an anatomic LV/aorta configuration. The kinematic model is of lumped type and employs a cell-based, FitzHugh-Nagumo framework to simulate the motion of the LV wall in response to an excitation wavefront propagating along the heart wall. The emerging large-scale LV wall motion exhibits complex contractile mechanisms that include contraction (twist) and expansion (untwist). The kinematic model is shown to yield global LV motion parameters that are well within the physiologic range throughout the cardiac cycle. The FSI between the leaflets of the mechanical heart valve and the blood flow driven by the dynamic LV wall motion and mitral inflow is simulated using the curvilinear immersed boundary (CURVIB) method (Ge and Sotiropoulos, 2007; Borazjani et al., 2008) [1,2] implemented in conjunction with a domain decomposition approach. The computed results show that the simulated flow patterns are in good qualitative agreement with in vivo observations. The simulations also reveal complex kinematics of the valve leaflets, thus, underscoring the need for patient-specific simulations of heart valve prosthesis and other cardiac devices.

  6. Roles of Sensory Nerves in the Regulation of Radiation-Induced Structural and Functional Changes in the Heart

    Energy Technology Data Exchange (ETDEWEB)

    Sridharan, Vijayalakshmi; Tripathi, Preeti [Department of Pharmaceutical Sciences, Division of Radiation Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas (United States); Sharma, Sunil [Department of Radiation Oncology, Division of Radiation Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas (United States); Moros, Eduardo G. [Department of Radiation Oncology, Moffitt Cancer Center and Research Institute, Tampa, Florida (United States); Zheng, Junying [Department of Pharmaceutical Sciences, Division of Radiation Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas (United States); Hauer-Jensen, Martin [Department of Pharmaceutical Sciences, Division of Radiation Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas (United States); Surgical Service, Central Arkansas Veterans Healthcare System, Little Rock, Arkansas (United States); Boerma, Marjan, E-mail: mboerma@uams.edu [Department of Pharmaceutical Sciences, Division of Radiation Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas (United States)

    2014-01-01

    Purpose: Radiation-induced heart disease (RIHD) is a chronic severe side effect of radiation therapy of intrathoracic and chest wall tumors. The heart contains a dense network of sensory neurons that not only are involved in monitoring of cardiac events such as ischemia and reperfusion but also play a role in cardiac tissue homeostasis, preconditioning, and repair. The purpose of this study was to examine the role of sensory nerves in RIHD. Methods and Materials: Male Sprague-Dawley rats were administered capsaicin to permanently ablate sensory nerves, 2 weeks before local image-guided heart x-ray irradiation with a single dose of 21 Gy. During the 6 months of follow-up, heart function was assessed with high-resolution echocardiography. At 6 months after irradiation, cardiac structural and molecular changes were examined with histology, immunohistochemistry, and Western blot analysis. Results: Capsaicin pretreatment blunted the effects of radiation on myocardial fibrosis and mast cell infiltration and activity. By contrast, capsaicin pretreatment caused a small but significant reduction in cardiac output 6 months after irradiation. Capsaicin did not alter the effects of radiation on cardiac macrophage number or indicators of autophagy and apoptosis. Conclusions: These results suggest that sensory nerves, although they play a predominantly protective role in radiation-induced cardiac function changes, may eventually enhance radiation-induced myocardial fibrosis and mast cell activity.

  7. Physical (centrifuge) modelling of localization of fold-thrust structures by normal faults, and implications for hydrocarbon exploration

    Energy Technology Data Exchange (ETDEWEB)

    Dixon, J.M. [Queen`s Univ., Kingston, ON (Canada). Dept. of Geological Sciences

    1997-09-01

    A study was conducted in which laboratory scale models of faults were constructed. The laminae was composed of plasticine to represent competent rock such as carbonates and coarse clastics, and of silicone putty to represent incompetent rock such as shale. The objective of the study was to determine the factors that affect the location and timing of nucleation of foreland fold-thrust structures as well as the amount of thrust displacement. It was suggested that folds and thrusts which were nucleated due to reactivation of normal faults could be prospective exploration targets because associated structural traps could have formed sufficiently early in the generation-migration sequence to have retained an early hydrocarbon charge.

  8. Structure and Dissipation Characteristics of an Electron Diffusion Region Observed by MMS During a Rapid, Normal-Incidence Magnetopause Crossing

    Science.gov (United States)

    Torbert, R. B.; Burch, J. L.; Argall, M. R.; Alm, L.; Farrugia, C. J.; Forbes, T. G.; Giles, B. L.; Rager, A.; Dorelli, J.; Strangeway, R. J.; Ergun, R. E.; Wilder, F. D.; Ahmadi, N.; Lindqvist, P.-A.; Khotyaintsev, Y.

    2017-12-01

    On 22 October 2016, the Magnetospheric Multiscale (MMS) spacecraft encountered the electron diffusion region (EDR) when the magnetosheath field was southward, and there were signatures of fast reconnection, including flow jets, Hall fields, and large power dissipation. One rapid, normal-incidence crossing, during which the EDR structure was almost stationary in the boundary frame, provided an opportunity to observe the spatial structure for the zero guide field case of magnetic reconnection. The reconnection electric field was determined unambiguously to be 2-3 mV/m. There were clear signals of fluctuating parallel electric fields, up to 6 mV/m on the magnetosphere side of the diffusion region, associated with a Hall-like parallel current feature on the electron scale. The width of the main EDR structure was determined to be 2 km (1.8 de). Although the MMS spacecraft were in their closest tetrahedral separation of 8 km, the divergences and curls for these thin current structures could therefore not be computed in the usual manner. A method is developed to determine these quantities on a much smaller scale and applied to compute the normal component of terms in the generalized Ohm's law for the positions of each individual spacecraft (not a barocentric average). Although the gradient pressure term has a qualitative dependence that follows the observed variation of E + Ve × B, the quantitative magnitude of these terms differs by more than a factor of 2, which is shown to be greater than the respective errors. Thus, future research is required to find the manner in which Ohm's law is balanced.

  9. Does 3T Fetal MRI Improve Image Resolution of Normal Brain Structures between 20 and 24 Weeks' Gestational Age?

    Science.gov (United States)

    Priego, G; Barrowman, N J; Hurteau-Miller, J; Miller, E

    2017-08-01

    Stronger magnetic fields have the potential to improve fetal image resolution. Our objective was to detect whether there was better anatomic resolution of brain structures in fetuses imaged with a 3T magnet compared with a 1.5T magnet. Multiple cerebral and facial anatomic structures were retrospectively assessed in 28 fetal MR imaging scans with normal findings (12 at 3T and 16 at 1.5T) with a 0-3 grading score. Fetuses were assessed during the second trimesters (gestational age, 20-24 weeks). The association between the quality ratings and magnetic field strengths (1.5T versus 3T) was evaluated by a linear mixed-effects model. A quantitative assessment of the signal intensity was also performed in the different layers of the developing brain. Comparative log-ratios were calculated across the different layers of the fetal brain. There was a statistically significant interaction between location and magnetic field strength (P magnet. Similarly, statistical significance was also obtained on the quantitative assessment of the multilayer appearance of the brain; the 3T magnet had a median factor of 8.38 higher than the 1.5T magnet (95% CI, 4.73-14.82). Other anatomic structures assessed in the supratentorial compartment of the brain showed higher values on the 3T magnet with no statistical significance. Both magnets depict cerebral and facial normal anatomic structures; however, our data indicates better anatomic detail on the 3T than on the 1.5T magnet. © 2017 by American Journal of Neuroradiology.

  10. Connexin 43 Channels are Essential for Normal Bone Structure and Osteocyte Viability

    Science.gov (United States)

    Xu, Huiyun; Gu, Sumin; Riquelme, Manuel A.; Burra, Sirisha; Callaway, Danielle; Cheng, Hongyun; Guda, Teja; Schmitz, James; Fajardo, Roberto J.; Werner, Sherry L.; Zhao, Hong; Shang, Peng; Johnson, Mark L.; Bonewald, Lynda F.; Jiang, Jean X.

    2014-01-01

    Connexin (Cx) 43 serves important roles in bone function and development. Targeted deletion of Cx43 in osteoblasts or osteocytes leads to increased osteocyte apoptosis, osteoclast recruitment, and reduced biomechanical properties. Cx43 forms both gap junction channels and hemichannels, which mediate the communication between adjacent cells or between cell and extracellular environments, respectively. Two transgenic mouse models driven by a DMP1 promoter with the overexpression of dominant negative Cx43 mutants were generated to dissect the functional contribution of Cx43 gap junction channels and hemichannels in osteocytes. The R76W mutant blocks gap junction channel, but not hemichannel function, and the Δ130-136 mutant inhibits activity of both types of channels. Δ130-136 mice showed a significant increase in bone mineral density compared to WT and R76W mice. MicroCT analyses revealed a significant increase in total tissue and bone area in midshaft cortical bone of Δ130-136 mice. The bone marrow cavity was expanded, whereas the cortical thickness was increased and associated with increased bone formation along the periosteal area. However, there is no significant alteration in the structure of trabecular bone. Histologic sections of the midshaft showed increased apoptotic osteocytes in Δ130-136, but not in WT and R76W, mice which correlated with altered biomechanical and estimated bone material properties. Osteoclasts were increased along the endocortical surface in both transgenic mice with a greater effect in Δ130-136 mice which likely contributed to the increased marrow cavity. Interestingly, the overall expression of serum bone formation and resorption markers were higher in R76W mice. These findings suggest that osteocytic Cx43 channels play distinctive roles in the bone; hemichannels play a dominant role in regulating osteocyte survival, endocortical bone resorption and periosteal apposition, and gap junction communication is involved in the process of

  11. Normal tissue tolerance to external beam radiation therapy: Cardiac structures; Dose de tolerance des tissus sains: le coeur

    Energy Technology Data Exchange (ETDEWEB)

    Doyen, J. [Service d' oncologie-radiotherapie, centre Antoine-Lacassagne, 06 - Nice (France); Giraud, P. [Universite Rene-Descartes Paris 5, 75 - Paris (France); Service d' oncologie-radiotherapie, hopital europeen Georges-Pompidou, 75 - Paris (France); Belkacemi, Y. [Faculte de medecine de Creteil, universite Paris 12, 94 - Creteil (France); Service d' oncologie-radiotherapie, CHU Henri-Mondor, 94 - Creteil (France)

    2010-07-15

    Radiation thoracic tumors may be associated with cardiac toxicity because of the central position of the heart in the thorax. The present review aims to describe the cardiotoxicity during radiotherapy of different tumor sites most associated with this complication and the risk factors of cardiotoxicity during radiation therapy. Medline literature searches were performed using the following cardiac - heart - radiotherapy - toxicity - cardiotoxicity - breast cancer - lymphoma. Cardiac toxicity after breast cancer and mediastinal lymphoma is the most reported radiation-induced complication. The most frequent clinical complications are pericarditis, congestive heart failure, and heart infarction. These events are mostly asymptomatic. Thus clinicians have to give particular attention to these complications. Anthracycline treatment is a major risk factor for additional cardiotoxicity during radiotherapy with a synergistic effect. Correction of cardiovascular risk is an important point of the prevention of heart complications. Total dose delivered to the planned target volume (PTV), the dose per fraction and the irradiated volume were correlated to the risk of cardiotoxicity. Volume of heart receiving 35 Gy must be inferior to 30% and dose per fraction should not exceed 2 Gy when dose of prescription exceeds 30 Gy. Maximum heart distance (maximal thickness of heart irradiated) must be less than 1 cm during irradiation of breast cancer. Modern irradiation techniques seem to be associated with a limited risk of heart complication. The use of anthracycline, other cardio-toxic chemotherapies and targeted therapies should incite for great caution by performing a careful treatment planning and optimisation. (authors)

  12. Heart Health - Brave Heart

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Cover Story Heart Health Brave Heart Past Issues / Winter 2009 Table of Contents For ... you can have a good life after a heart attack." Lifestyle Changes Surviving—and thriving—after such ...

  13. Tau and β-Amyloid Are Associated with Medial Temporal Lobe Structure, Function, and Memory Encoding in Normal Aging.

    Science.gov (United States)

    Marks, Shawn M; Lockhart, Samuel N; Baker, Suzanne L; Jagust, William J

    2017-03-22

    Normal aging is associated with a decline in episodic memory and also with aggregation of the β-amyloid (Aβ) and tau proteins and atrophy of medial temporal lobe (MTL) structures crucial to memory formation. Although some evidence suggests that Aβ is associated with aberrant neural activity, the relationships among these two aggregated proteins, neural function, and brain structure are poorly understood. Using in vivo human Aβ and tau imaging, we demonstrate that increased Aβ and tau are both associated with aberrant fMRI activity in the MTL during memory encoding in cognitively normal older adults. This pathological neural activity was in turn associated with worse memory performance and atrophy within the MTL. A mediation analysis revealed that the relationship with regional atrophy was explained by MTL tau. These findings broaden the concept of cognitive aging to include evidence of Alzheimer's disease-related protein aggregation as an underlying mechanism of age-related memory impairment. SIGNIFICANCE STATEMENT Alterations in episodic memory and the accumulation of Alzheimer's pathology are common in cognitively normal older adults. However, evidence of pathological effects on episodic memory has largely been limited to β-amyloid (Aβ). Because Aβ and tau often cooccur in older adults, previous research offers an incomplete understanding of the relationship between pathology and episodic memory. With the recent development of in vivo tau PET radiotracers, we show that Aβ and tau are associated with different aspects of memory encoding, leading to aberrant neural activity that is behaviorally detrimental. In addition, our results provide evidence linking Aβ- and tau-associated neural dysfunction to brain atrophy. Copyright © 2017 the authors 0270-6474/17/373192-10$15.00/0.

  14. ß-blocker timolol prevents arrhythmogenic Ca²⁺ release and normalizes Ca²⁺ and Zn²⁺ dyshomeostasis in hyperglycemic rat heart.

    Directory of Open Access Journals (Sweden)

    Erkan Tuncay

    Full Text Available Defective cardiac mechanical activity in diabetes results from alterations in intracellular Ca(2+ handling, in part, due to increased oxidative stress. Beta-blockers demonstrate marked beneficial effects in heart dysfunction with scavenging free radicals and/or acting as an antioxidant. The aim of this study was to address how β-blocker timolol-treatment of diabetic rats exerts cardioprotection. Timolol-treatment (12-week, one-week following diabetes induction, prevented diabetes-induced depressed left ventricular basal contractile activity, prolonged cellular electrical activity, and attenuated the increase in isolated-cardiomyocyte size without hyperglycemic effect. Both in vivo and in vitro timolol-treatment of diabetic cardiomyocytes prevented the altered kinetic parameters of Ca(2+ transients and reduced Ca(2+ loading of sarcoplasmic reticulum (SR, basal intracellular free Ca(2+ and Zn(2+ ([Ca(2+]i and [Zn(2+]i, and spatio-temporal properties of the Ca(2+ sparks, significantly. Timolol also antagonized hyperphosphorylation of cardiac ryanodine receptor (RyR2, and significantly restored depleted protein levels of both RyR2 and calstabin2. Western blot analysis demonstrated that timolol-treatment also significantly normalized depressed levels of some [Ca(2+]i-handling regulators, such as Na(+/Ca(2+ exchanger (NCX and phospho-phospholamban (pPLN to PLN ratio. Incubation of diabetic cardiomyocytes with 4-mM glutathione exerted similar beneficial effects on RyR2-macromolecular complex and basal levels of both [Ca(2+]i and [Zn(2+]i, increased intracellular Zn(2+ hyperphosphorylated RyR2 in a concentration-dependent manner. Timolol also led to a balanced oxidant/antioxidant level in both heart and circulation and prevented altered cellular redox state of the heart. We thus report, for the first time, that the preventing effect of timolol, directly targeting heart, seems to be associated with a normalization of macromolecular complex of RyR2 and

  15. Is Heart Period Variability Associated with the Administration of Lifesaving Interventions in Individual Prehospital Trauma Patients with Normal Standard Vital Signs?

    Science.gov (United States)

    2010-08-01

    lived from those who died, and those patients who died had average ISSs of 30. However, in these studies some standard vital signs were also different...less severe injuries, hence lower ISSs . The one preliminary study (27) performed on battlefield trauma patients to date presented individual heart period... ISSs were not included in this brief abstract, so it is not clear if these also distinguished the LSI and No-LSI patients, or if the battlefield

  16. Structure of the Notch1-negative regulatory region: implications for normal activation and pathogenic signaling in T-ALL

    Energy Technology Data Exchange (ETDEWEB)

    Gordon, Wendy R.; Roy, Monideepa; Vardar-Ulu, Didem; Garfinkel, Megan; Mansour, Marc R.; Aster, Jon C.; Blacklow, Stephen C.; (BWH); (Wellesley); (UCL)

    2009-09-02

    Proteolytic resistance of Notch prior to ligand binding depends on the structural integrity of a negative regulatory region (NRR) of the receptor that immediately precedes the transmembrane segment. The NRR includes the 3 Lin12/Notch repeats and the juxtamembrane heterodimerization domain, the region of Notch1 most frequently mutated in T-cell acute lymphoblastic leukemia lymphoma (T-ALL). Here, we report the x-ray structure of the Notch1 NRR in its autoinhibited conformation. A key feature of the Notch1 structure that maintains its closed conformation is a conserved hydrophobic plug that sterically occludes the metalloprotease cleavage site. Crystal packing interactions involving a highly conserved, exposed face on the third Lin12/Notch repeat suggest that this site may normally be engaged in intermolecular or intramolecular protein-protein interactions. The majority of known T-ALL-associated point mutations map to residues in the hydrophobic interior of the Notch1 NRR. A novel mutation (H1545P), which alters a residue at the crystal-packing interface, leads to ligand-independent increases in signaling in reporter gene assays despite only mild destabilization of the NRR, suggesting that it releases the autoinhibitory clamp on the heterodimerization domain imposed by the Lin12/Notch repeats. The Notch1 NRR structure should facilitate a search for antibodies or compounds that stabilize the autoinhibited conformation.

  17. Effects of structured heart failure disease management on mortality and morbidity depend on patients' mood: results from the Interdisciplinary Network for Heart Failure Study.

    Science.gov (United States)

    Gelbrich, Götz; Störk, Stefan; Kreißl-Kemmer, Sonja; Faller, Hermann; Prettin, Christiane; Heuschmann, Peter U; Ertl, Georg; Angermann, Christiane E

    2014-10-01

    Depression is common in heart failure (HF) and associated with adverse outcomes. Randomized comparisons of the effectiveness of HF care strategies by patients' mood are scarce. We therefore investigated in a randomized trial a structured collaborative disease management programme (HeartNetCare-HF™; HNC) recording mortality, morbidity, and symptoms in patients enrolled after hospitalization for decompensated systolic HF according to their responses to the 9-item Patient Health Questionnaire (PHQ-9) during an observation period of 180 days. Subjects scoring <12/≥12 were categorized as non-depressed/depressed, and those ignoring the questionnaire as PHQ-deniers. Amongst 715 participants (69 ± 12 years, 29% female), 141 (20%) were depressed, 466 (65%) non-depressed, and 108 (15%) PHQ-deniers. The composite endpoint of mortality and re-hospitalization was neutral overall and in all subgroups. However, HNC reduced mortality risk in both depressed and non-depressed patients [adjusted hazard ratios (HRs) 0.12, 95% confidence interval (CI) 0.03-0.56, P = 0.006, and 0.49, 95% CI 0.25-0.93, P = 0.03, respectively], but not in PHQ-deniers (HR 1.74, 95% CI 0.77-3.96, P = 0.19; P = 0.006 for homogeneity of HRs). Average frequencies of patient contacts in the HNC arm were 12.8 ± 7.9 in non-depressed patients, 12.4 ± 7.1 in depressed patients, and 5.5 ± 7.2 in PHQ-deniers (P < 0.001). Early after decompensation, HNC reduced mortality risk in non-depressed and even more in depressed subjects, but not in PHQ-deniers. This suggests that differential acceptability and chance of success of care strategies such as HNC might be predicted by appropriate assessment of patients' baseline characteristics including psychological disposition. These post-hoc results should be reassessed by prospective evaluation of HNC in larger HF populations. © 2014 The Authors. European Journal of Heart Failure © 2014 European Society of Cardiology.

  18. Fracture resistance of structurally compromised and normal endodontically treated teeth restored with different post systems: An in vitro study

    Directory of Open Access Journals (Sweden)

    Vajihesadat Mortazavi

    2012-01-01

    Full Text Available Background: With the aim of developing methods that could increase the fracture resistance of structurally compromised endodontically treated teeth, this study was conducted to compare the effect of three esthetic post systems on the fracture resistance and failure modes of structurally compromised and normal roots. Materials and Methods: Forty five extracted and endodontically treated maxillary central teeth were assigned to 5 experimental groups (n=9. In two groups, the post spaces were prepared with the corresponding drills of the post systems to be restored with double taper light posts (DT.Light-Post (group DT.N and zirconia posts (Cosmopost (group Zr.N. In other 3 groups thin wall canals were simulated to be restored with Double taper Light posts (DT.W, double taper Light posts and Ribbond fibers (DT+R.W and Zirconia posts (Zr.W. After access cavity restoration and thermocycling, compressive load was applied and the fracture strength values and failure modes were evaluated. Data were analyzed using two-way ANOVA, Tukey and Fisher exact tests (P<0.05. Results: The mean failure loads (N were 678.56, 638.22, 732.44, 603.44 and 573.67 for groups DT.N, Zr.N, DT.W, DT+R.W and Zr.w respectively. Group DT+R.W exhibited significantly higher resistance to fracture compared to groups Zr.N, DT.W and Zr.w (P<0.05. A significant difference was detected between groups DT.N and Zr.W (P=0.027. Zirconia posts showed significantly higher root fracture compared to fiber posts (P=0.004. Conclusion: The structurally compromised teeth restored with double taper light posts and Ribbond fibers showed the most fracture resistance and their strengths were comparable to those of normal roots restored with double taper light posts. More desirable fracture patterns were observed in teeth restored with fiber posts.

  19. HeartCycle: beyond building demonstrators. A structured approach to develop, implement and validate healthcare innovations in telemonitoring.

    Science.gov (United States)

    Reiter, Harald

    2010-01-01

    HeartCycle, running since March 2008, is an European Integrated Project aiming to provide innovations for the next generation of disease management solutions dedicated for cardiovascular disease patients. The appropriate remote management of such patients at home is seen as a promising solution to both, the delivery of innovative healthcare and the containment of future healthcare cost. Major challenges are the detection of negative health status trends in time, the appropriate decision support for professionals to react to such trends and supporting the motivation of patients to be compliant to treatment regimes and to adopt a beneficial lifestyle. In this paper an overview description of the HeartCycle process is presented which is a structured approach to develop, implement and validate healthcare innovations.

  20. Impact of recipient-related factors on structural dysfunction of xenoaortic bioprosthetic heart valves

    Directory of Open Access Journals (Sweden)

    Barbarash O

    2015-03-01

    Full Text Available Olga Barbarash, Natalya Rutkovskaya, Oksana Hryachkova, Olga Gruzdeva, Evgenya Uchasova, Anastasia Ponasenko, Natalya Kondyukova, Yuri Odarenko, Leonid Barbarash Federal State Budgetary Scientific Institution Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia Objective: To analyze the influence of recipient-related metabolic factors on the rate of structural dysfunction caused by the calcification of xenoaortic bioprostheses. Materials and methods: We retrospectively analyzed clinical status, calcium–phosphorus metabolism, and nonspecific markers of inflammatory response in bioprosthetic mitral valve recipients with calcific degeneration confirmed by histological and electron microscopic studies (group 1, n=22, and in those without degeneration (group 2, n=48. Results: Patients with confirmed calcification of bioprostheses were more likely to have a severe clinical state (functional class IV in 36% in group 1 versus 15% in group 2, P=0.03 and a longer cardiopulmonary bypass period (112.8±18.8 minutes in group 1 versus 97.2±23.6 minutes in group 2, P=0.02 during primary surgery. Patients in group 1 demonstrated moderate hypovitaminosis D (median 34.0, interquartile range [21.0; 49.4] vs 40 [27.2; 54.0] pmol/L, P>0.05, osteoprotegerin deficiency (82.5 [44.2; 115.4] vs 113.5 [65.7; 191.3] pg/mL, P>0.05 and osteopontin deficiency (4.5 [3.3; 7.7] vs 5.2 [4.1; 7.2] ng/mL, P>0.05, and significantly reduced bone-specific alkaline phosphatase isoenzyme (17.1 [12.2; 21.4] vs 22.3 [15.5; 30.5] U/L, P=0.01 and interleukin-8 levels (9.74 [9.19; 10.09] pg/mL vs 13.17 [9.72; 23.1] pg/mL, P=0.045 compared with group 2, with an overall increase in serum levels of proinflammatory markers. Conclusion: Possible predictors of the rate of calcific degeneration of bioprostheses include the degree of decompensated heart failure, the duration and invasiveness of surgery, and the characteristics of calcium–phosphorus homeostasis in

  1. Outcomes of ventricular tachycardia ablation in patients with structural heart disease: The impact of electrical storm.

    Directory of Open Access Journals (Sweden)

    Bashar Aldhoon

    Full Text Available To investigate predictors of long-term outcomes after catheter ablation (CA for ventricular tachycardia (VT and the impact of electrical storm (ES prior to index ablation procedures.We studied consecutive patients with structural heart disease and VT (n = 328; age: 63±12 years; 88% males; 72% ischaemic cardiomyopathy; LVEF: 32±12% who had undergone CA. According to presenting arrhythmia at baseline, they were divided into ES (n = 93, 28% and non-ES groups. Clinical predictors of all-cause mortality were investigated and a clinically useful risk score (SCORE was constructed.During a median follow-up of 927 days (IQR: 564-1626, 67% vs. 60% of patients (p = 0.05 experienced VT recurrence in the ES vs. the non-ES group, respectively; and 41% vs. 32% patients died (p = 0.02, respectively. Five factors were independently associated with mortality: age >70 years (hazard ratio (HR: 1.6, 95% confidence interval (CI: 1.1-2.4, p = 0.01, NYHA class ≥3 (HR: 1.9, 95% CI: 1.2-2.9, p = 0.005, a serum creatinine level >1.3 mg/dL (HR: 1.6, 95% CI: 1.1-2.3, p = 0.02, LVEF ≤25% (HR: 2.4, 95% CI: 1.6-3.5, p = 0.00004, and amiodarone therapy (HR: 1.5, 95% CI: 1.0-2.2, p = 0.03. A risk SCORE ranging from 0-4 (1 point for either high-risk age, NYHA, creatinine, or LVEF correlated with mortality. ES during index ablation independently predicted mortality only in patients with a SCORE ≤1.Advanced LV dysfunction, older age, higher NYHA class, renal dysfunction, and amiodarone therapy, but not ES, were predictors of poor outcomes after CA for VT in the total population. However, ES did predict mortality in a low-risk sub-group of patients.

  2. The relationship between heart rate recovery and brain natruretic Peptide in patients with chest discomfort: a study for relationship between heart rate recovery and pre-exercise, post-exercise levels of brain natruretic Peptide in patients with normal systolic function and chest discomfort.

    Science.gov (United States)

    Lee, Jae Eun; Kim, Bum Soo; Park, Wan; Huh, Jung Kwon; Kim, Byung Jin; Sung, Ki Chul; Kang, Jin Ho; Lee, Man Ho; Park, Jung Ro

    2010-04-01

    The correlation between brain natruretic peptide (BNP) level and cardiac autonomic function has been studied in type 2 diabetic patients. However, there is limited data from patients with normal systolic function. We evaluated the association between heart rate recovery (HRR) representing autonomic dysfunction and three plasma BNP levels: pre-exercise, post-exercise, and change during exercise in patients with normal systolic function. Subjects included 105 patients with chest pain and normal systolic function. HRR was defined as the difference between the peak heart rate and the rate measured two minutes after completion of a treadmill exercise test. We measured plasma BNP levels before exercise, 5 minutes after completion of exercise, and during exercise (absolute value of difference between pre- and post-exercise BNP levels). Patients with abnormal HRR values (heart rates, and higher pre- and post-exercise BNP levels than patients with normal HRR values. The patients with coronary artery disease (CAD) had abnormal HRR. However, no significant differences were found between the two groups in terms of history of hypertension (HTN), diabetes, and peak systolic blood pressure (SBP) and diastolic blood pressure (DBP). HRR was significantly associated with pre-exercise BNP (r=-0.36, p=0.004) and post-exercise BNP (r=-0.27, p=0.006), but not BNP changes. Further, pre-exercise BNP levels showed a greater association with HRR than post-exercise BNP levels. HRR is independently associated with pre-exercise and post-exercise BNP levels, even in patients with normal systolic function.

  3. Comparison of the Deep Optic Nerve Head Structure between Normal-Tension Glaucoma and Nonarteritic Anterior Ischemic Optic Neuropathy.

    Directory of Open Access Journals (Sweden)

    Eun Ji Lee

    Full Text Available To compare the deep optic nerve head (ONH structure between normal-tension glaucoma (NTG and nonarteritic anterior ischemic optic neuropathy (NAION and also in healthy subjects as a control using enhanced depth imaging (EDI spectral-domain optical coherence tomography (SD-OCT.This prospective cross-sectional study included 21 NAION patients who had been diagnosed as NAION at least 6 months prior to study entry, and 42 NTG patients and 42 healthy controls who were matched with NAION patients in terms of age, intraocular pressure (IOP, and optic disc area. The retinal nerve fiber layer (RNFL thickness in the affected sector was also matched between NAION and NTG patients. The ONH was imaged using SD-OCT with the EDI technique. The anterior lamina cribrosa surface depth (LCD and average prelaminar tissue (PT thickness were measured in a sector of interest in each eye and compared among the three groups.In the sector-matched comparison, LCD was largest in NTG patients, followed by NAION patients, while PT was thinner in NTG patients than in NAION patients (all P < 0.001. NAION patients had a comparable LCD and a thinner PT relative to normal controls (P = 0.170 and < 0.001, respectively.The deep ONH configuration is strikingly different between NTG and NAION. The differing features provide comparative insight into the pathophysiology of the two diseases, and may be useful for differential diagnosis.

  4. Heart MRI

    Science.gov (United States)

    Magnetic resonance imaging - cardiac; Magnetic resonance imaging - heart; Nuclear magnetic resonance - cardiac; NMR - cardiac; MRI of the heart; Cardiomyopathy - MRI; Heart failure - MRI; Congenital heart disease - MRI

  5. Heart beats rate indicators and structure of elite football referees’ and their assistants’ motor functioning in competition period

    Directory of Open Access Journals (Sweden)

    Chopilko T. G.

    2015-11-01

    Full Text Available Purpose: to analyze structure of motor functioning and heart beats rate indicators in elite football referees’ and their assistants’ competition activity. Material: in the research 15 referees and referees’ assistants of Ukrainian Prime League, 30 referees and referees’ assistants of first and second professional leagues of Ukraine participated. Observations over referees’ movements in 21 professional matches of Ukrainian professional leagues were fulfilled. Distance, passed by a referee in one match was determined. Results: It was found that during one match referee (depending on his functions - referee or referee’s assistant passes distance from 6000 to 12 000 meters. This scope of motor functioning depends also on motor activity of players and qualification level of teams-participants in the match. Motor actions of referees’ assistants change every 5 seconds during a match. During one match referee’s assistants fulfill about 20 sprints and 74 accelerations. A high temp of match total distance makes 1.2 km. Conclusions: Referees’ and referee assistants’ motor functioning and heart beats rate indicators can vary from aerobic-restoration to anaerobic-glycolytic zone. This fact shall be considered when planning program on special physical training. It should be noted that with heart beats rate of more than 180 bpm concentration of attention significantly weakens as well as ability to take prompt and correct decisions. In such cases probability of mistakes significantly increases.

  6. Cataracts, radiculomegaly, septal heart defects and hearing loss in two unrelated adult females with normal intelligence and similar facial appearance : Confirmation of a syndrome

    NARCIS (Netherlands)

    Aalfs, CM; Oosterwijk, JC; VanSchooneveld, MJ; Begeman, CJ; Wabeke, KB; Hennekam, RCM

    Two unrelated, adult females with normal intelligence are described. They show a similar clinical picture with a long and narrow face, congenital cataract, microphthalmia, microcornea, a high nasal bridge, a short nose, a broad nasal tip, a long philtrum, bilateral hearing loss, persistent primary

  7. Insuficiência cardíaca com fração de ejeção normal Insuficiencia cardíaca con fracción de eyección normal Heart failure with normal ejection fraction

    Directory of Open Access Journals (Sweden)

    Meliza Goi Roscani

    2010-05-01

    multifactoriales, involucrando la rigidez pasiva del miocardio, la geometría ventricular, la fuerza de contención pericárdica y la interacción entre los ventrículos. Los objetivos principales del tratamiento son reducir la congestión venosa pulmonar, la frecuencia cardíaca y controlar las comorbilidades. Todavía no hay evidencias de que el uso de medicaciones específicas, como inhibidores de la enzima de conversión o betabloqueadores, interfieran en la mortalidad. Los factores de peor pronóstico incluyen la edad avanzada, presencia de disfunción renal, diabetes, clase funcional III y IV (NYHA y estado avanzado de disfunción diastólica, con patrón restrictivo al llenado ventricular. Otro aspecto viene cobrando espacio en la bibliografía es el cuestionamiento del papel de la disfunción sistólica en los cuadros de ICFEN. Todos estos aspectos se abordan detalladamente en la presente revisión.Heart failure with normal ejection fraction (HFNEF is a complex syndrome that has been broadly studied since the last decade. It is caused by diastolic ventricular dysfunction demonstrated by complementary methods, such as hemodynamic study or echocardiogram, in the presence of a normal ejection fraction (EF. It affects primarily elderly individuals with comorbidities, such as systemic arterial hypertension, coronary failure and obesity. The physiopathological mechanisms are complex and multifactorial, involving the myocardial passive stiffness, the ventricular geometry, the pericardial restraint and the interaction between the ventricles. The main objectives of the treatment were to decrease the pulmonary venous congestion and the heart rate and control the comorbidities. There is no strong evidence that the use of specific medications, such as the angiotensin-converting enzyme inhibitors or beta-blockers can influence mortality. The poorer prognostic factors include advanced age, presence of kidney dysfunction, diabetes, functional class III and IV (NYHA and advanced

  8. DISTURBANCE OF THE CARDIOMYOCYTE’S MACROMOLECULAR STRUCTURE IN HEART ALLOGRAFTS AS A SIGN OF CHRONIC REJECTION

    Directory of Open Access Journals (Sweden)

    A. G. Kupriyanova

    2012-01-01

    Full Text Available Chronic rejection, especially cardiac allograft vasculopathy, is a major limiting factor for long-term transplant survival. This process affects not only the blood vessels, but also cardiomyocytes. However, there are extremely few reports on the evaluation of their macromolecular structure state. The aim of the study was to evaluate the structural proteins of cardiomyocytes (actin, myosin, troponin I, titin, desmin, vinculin of heart allografts in different periods after the operation (from 6 days to 15 years. Major changes of macromolecular structure were revealed in late period after transplantation (6 months – 15 years. The contribution of humoral immune response in the process of chronic cardiac allograft rejection was observed: in eight of twelve recipients episodes of acute humoral rejection had been repeatedly registered; disorders of the expression of 5 proteins out of 6 characterized were found in recipients with recurrent and persistent antibody-mediated rejection. 

  9. Is the bronchus-associated lymphoid tissue (BALT) an integral structure of the lung in normal mammals, including humans?

    Science.gov (United States)

    Pabst, R; Gehrke, I

    1990-08-01

    In the respiratory tract, lymphoid aggregates with a specialized epithelium have been called bronchus-associated lymphoid tissue (BALT) and compared to the organized lymphoid tissue of the gut (GALT), e.g., Peyer's patches. BALT might play a central role in antigen uptake, initiating immune responses and disseminating primed lymphoid cells in the respiratory tract. In the present study, lungs of mice, rats, guinea pigs, rabbits, pigs, cats, and humans have been studied with respect to the presence and number of BALT and the dependence of BALT on age and microbial stimulation. BALT is not a constitutive structure in all these species. Its frequency varies widely, from 100% in rabbits and rats, 50% in guinea pigs, 33% in pigs, to its absence in cats and all normal human lungs. BALT seems to be a lymphoid structure which is not present in all the species studied but can develop in the lung after stimulation. This is in contrast to lymphoid organs, such as lymph nodes or Peyer's patches, which can always be found. These species differences are of major importance in interpreting the clinical relevance of experiments in animal models on the lung immune system, e.g., antigen uptake, immunostimulation, or lung transplantation.

  10. Amino acid transamination is crucial for ischaemic cardioprotection in normal and preconditioned isolated rat hearts--focus on L-glutamate

    DEFF Research Database (Denmark)

    Løfgren, Bo; Povlsen, Jonas Agerlund; Rasmussen, Lars Ege

    2010-01-01

    We have found that cardioprotection by l-glutamate mimics protection by classical ischaemic preconditioning (IPC). We investigated whether the effect of IPC involves amino acid transamination and whether IPC modulates myocardial glutamate metabolism. In a glucose-perfused, isolated rat heart model...... subjected to 40 min global no-flow ischaemia and 120 min reperfusion, the effects of IPC (2 cycles of 5 min ischaemia and 5 min reperfusion) and continuous glutamate (20 mm) administration during reperfusion on infarct size and haemodynamic recovery were studied. The effect of inhibiting amino acid...... transamination was evaluated by adding the amino acid transaminase inhibitor amino-oxyacetate (AOA; 0.025 mm) during reperfusion. Changes in coronary effluent, interstitial (microdialysis) and intracellular glutamate ([GLUT](i)) concentrations were measured. Ischaemic preconditioning and postischaemic glutamate...

  11. Assessment of Structural and Functional Abnormalities of the Myocardium and the Ascending Aorta in Fetus with Hypoplastic Left Heart Syndrome

    Directory of Open Access Journals (Sweden)

    Yan Jiang

    2016-01-01

    Full Text Available Aims. To detect anatomical and intrinsic histopathological features of the ascending aorta and left ventricular (LV myocardium and evaluate right ventricular (RV function in fetuses with hypoplastic left heart syndrome (HLHS. Methods. Twenty-five fetuses diagnosed with HLHS were followed up in the antenatal and postpartum periods. 12 necropsy heart specimens were analyzed for morphological and histological changes. Results. Prenatal echocardiography and pathologic anatomy displayed the typical characteristics of HLHS as a severe underdevelopment of the LV in the form of mitral stenosis or atresia or as aortic atresia or stenosis, with a decreased ratio of aortic diameter to pulmonary artery diameter (median of 0.49 with a range of 0.24 to 0.69, p≤0.001 and a higher ratio of RV diameter to LV diameter (median of 2.44 with a range of 1.33 to 6.25, p≤0.001. The RV volume, stroke volume, and cardiac output in HLHS fetuses were increased compared with the gestational age-matched normal controls (p<0.01. Histological changes in the 12 HLHS specimens included LV myocardial fibrosis, aortic elastic fragmentation, and fibrosis. Conclusions. In addition to severe anatomical deformity, distinct histological abnormalities in the LV myocardium and aortic wall were identified in the fetuses with HLHS. RV function damage may be potentially exists.

  12. Assessment of Structural and Functional Abnormalities of the Myocardium and the Ascending Aorta in Fetus with Hypoplastic Left Heart Syndrome

    Science.gov (United States)

    Jiang, Yan; Xu, Yali; Tang, Jinliang; Xia, Hongmei

    2016-01-01

    Aims. To detect anatomical and intrinsic histopathological features of the ascending aorta and left ventricular (LV) myocardium and evaluate right ventricular (RV) function in fetuses with hypoplastic left heart syndrome (HLHS). Methods. Twenty-five fetuses diagnosed with HLHS were followed up in the antenatal and postpartum periods. 12 necropsy heart specimens were analyzed for morphological and histological changes. Results. Prenatal echocardiography and pathologic anatomy displayed the typical characteristics of HLHS as a severe underdevelopment of the LV in the form of mitral stenosis or atresia or as aortic atresia or stenosis, with a decreased ratio of aortic diameter to pulmonary artery diameter (median of 0.49 with a range of 0.24 to 0.69, p ≤ 0.001) and a higher ratio of RV diameter to LV diameter (median of 2.44 with a range of 1.33 to 6.25, p ≤ 0.001). The RV volume, stroke volume, and cardiac output in HLHS fetuses were increased compared with the gestational age-matched normal controls (p < 0.01). Histological changes in the 12 HLHS specimens included LV myocardial fibrosis, aortic elastic fragmentation, and fibrosis. Conclusions. In addition to severe anatomical deformity, distinct histological abnormalities in the LV myocardium and aortic wall were identified in the fetuses with HLHS. RV function damage may be potentially exists. PMID:26981527

  13. The polyphenols resveratrol and S17834 prevent the structural and functional sequelae of diet-induced metabolic heart disease in mice.

    Science.gov (United States)

    Qin, Fuzhong; Siwik, Deborah A; Luptak, Ivan; Hou, Xiuyun; Wang, Lei; Higuchi, Akiko; Weisbrod, Robert M; Ouchi, Noriyuki; Tu, Vivian H; Calamaras, Timothy D; Miller, Edward J; Verbeuren, Tony J; Walsh, Kenneth; Cohen, Richard A; Colucci, Wilson S

    2012-04-10

    Diet-induced obesity is associated with metabolic heart disease characterized by left ventricular hypertrophy and diastolic dysfunction. Polyphenols such as resveratrol and the synthetic flavonoid derivative S17834 exert beneficial systemic and cardiovascular effects in a variety of settings including diabetes mellitus and chronic hemodynamic overload. We characterized the structural and functional features of a mouse model of diet-induced metabolic syndrome and used the model to test the hypothesis that the polyphenols prevent myocardial hypertrophy and diastolic dysfunction. Male C57BL/6J mice were fed a normal diet or a diet high in fat and sugar (HFHS) with or without concomitant treatment with S17834 or resveratrol for up to 8 months. HFHS diet-fed mice developed progressive left ventricular hypertrophy and diastolic dysfunction with preservation of systolic function in association with myocyte hypertrophy and interstitial fibrosis. In HFHS diet-fed mice, there was increased myocardial oxidative stress with evidence of oxidant-mediated protein modification via tyrosine nitration and 4-OH-2-nonenol adduction. HFHS diet-fed mice also exhibited increases in plasma fasting glucose, insulin, and homeostasis model assessment of insulin resistance indicative of insulin resistance. Treatment with S17834 or resveratrol prevented left ventricular hypertrophy and diastolic dysfunction. For S17834, these beneficial effects were associated with decreases in oxidant-mediated protein modifications and hyperinsulinemia and increased plasma adiponectin. Resveratrol and S17834 administered concurrently with a HFHS diet prevent the development of left ventricular hypertrophy, interstitial fibrosis, and diastolic dysfunction. Multiple mechanisms may contribute to the beneficial effects of the polyphenols, including a reduction in myocardial oxidative stress and related protein modifications, amelioration of insulin resistance, and increased plasma adiponectin. The polyphenols

  14. Temporal Fine-Structure Coding and Lateralized Speech Perception in Normal-Hearing and Hearing-Impaired Listeners

    Directory of Open Access Journals (Sweden)

    Gusztáv Lőcsei

    2016-08-01

    Full Text Available This study investigated the relationship between speech perception performance in spatially complex, lateralized listening scenarios and temporal fine-structure (TFS coding at low frequencies. Young normal-hearing (NH and two groups of elderly hearing-impaired (HI listeners with mild or moderate hearing loss above 1.5 kHz participated in the study. Speech reception thresholds (SRTs were estimated in the presence of either speech-shaped noise, two-, four-, or eight-talker babble played reversed, or a nonreversed two-talker masker. Target audibility was ensured by applying individualized linear gains to the stimuli, which were presented over headphones. The target and masker streams were lateralized to the same or to opposite sides of the head by introducing 0.7-ms interaural time differences between the ears. TFS coding was assessed by measuring frequency discrimination thresholds and interaural phase difference thresholds at 250 Hz. NH listeners had clearly better SRTs than the HI listeners. However, when maskers were spatially separated from the target, the amount of SRT benefit due to binaural unmasking differed only slightly between the groups. Neither the frequency discrimination threshold nor the interaural phase difference threshold tasks showed a correlation with the SRTs or with the amount of masking release due to binaural unmasking, respectively. The results suggest that, although HI listeners with normal hearing thresholds below 1.5 kHz experienced difficulties with speech understanding in spatially complex environments, these limitations were unrelated to TFS coding abilities and were only weakly associated with a reduction in binaural-unmasking benefit for spatially separated competing sources.

  15. Temporal Fine-Structure Coding and Lateralized Speech Perception in Normal-Hearing and Hearing-Impaired Listeners.

    Science.gov (United States)

    Lőcsei, Gusztáv; Pedersen, Julie H; Laugesen, Søren; Santurette, Sébastien; Dau, Torsten; MacDonald, Ewen N

    2016-09-05

    This study investigated the relationship between speech perception performance in spatially complex, lateralized listening scenarios and temporal fine-structure (TFS) coding at low frequencies. Young normal-hearing (NH) and two groups of elderly hearing-impaired (HI) listeners with mild or moderate hearing loss above 1.5 kHz participated in the study. Speech reception thresholds (SRTs) were estimated in the presence of either speech-shaped noise, two-, four-, or eight-talker babble played reversed, or a nonreversed two-talker masker. Target audibility was ensured by applying individualized linear gains to the stimuli, which were presented over headphones. The target and masker streams were lateralized to the same or to opposite sides of the head by introducing 0.7-ms interaural time differences between the ears. TFS coding was assessed by measuring frequency discrimination thresholds and interaural phase difference thresholds at 250 Hz. NH listeners had clearly better SRTs than the HI listeners. However, when maskers were spatially separated from the target, the amount of SRT benefit due to binaural unmasking differed only slightly between the groups. Neither the frequency discrimination threshold nor the interaural phase difference threshold tasks showed a correlation with the SRTs or with the amount of masking release due to binaural unmasking, respectively. The results suggest that, although HI listeners with normal hearing thresholds below 1.5 kHz experienced difficulties with speech understanding in spatially complex environments, these limitations were unrelated to TFS coding abilities and were only weakly associated with a reduction in binaural-unmasking benefit for spatially separated competing sources. © The Author(s) 2016.

  16. Long-term efficacy of empirical chronic amiodarone therapy in patients with sustained ventricular tachyarrhythmia and structural heart disease.

    Science.gov (United States)

    Aiba, Takeshi; Kurita, Takashi; Taguchi, Atsushi; Shimizu, Wataru; Suyama, Kazuhiro; Aihara, Naohiko; Kamakura, Shiro

    2002-04-01

    The efficacy of empirical chronic oral amiodarone therapy in 129 patients with sustained ventricular tachyarrhythmia (VTNVF) and structural heart disease is evaluated. Twenty-nine patients were treated with class I drugs and monitored by electrophysiological study (EPS) and Holter electrocardiogram (ECG) (class I). The remaining 100 non-responders to the class I drugs were treated with oral amiodarone, of whom 70 were tolerant (AMD+) and 30 were intolerant (AMD-). Patients were followed up to 36 months. The primary and secondary end-points were recurrence of VT/VF and hypothetical death, respectively; whereby, hypothetical death was defined as actual death and the event of rapid VT.VF (heart rate >240beats/min) in patients with an implantable cardioverter defibrillator. Class I and AMD+ patients showed a better prognosis than AMD- patients. The VT/VF event free at 36 months in class I (64.8%) and AMD+ (56.1%) patients were significantly higher than that in AMD- (27.2%) (prates in class I (92.0%) and AMD+ (83.6%) patients were significantly higher than that in AMD- (57.0%) (prate among the 3 patient groups. The independent clinical factors suppressing the recurrence of VT/VF (Cox hazard) were treatment with amiodarone (p=0.02, 95% confidence interval (CI) =0.19-0.86) and EPS/Holter ECG-guided Class I drugs (p=0.04, 95% CI=0.14-0.94). The results demonstrate that empirical amiodarone has a substantial long-term benefit that is comparable to EPS/Holter ECG-guided class I drugs in the treatment of high-risk patients with VT/VF and structural heart disease.

  17. Actual management and prognosis of severe isolated tricuspid regurgitation associated with atrial fibrillation without structural heart disease.

    Science.gov (United States)

    Takahashi, Yusuke; Izumi, Chisato; Miyake, Makoto; Imanaka, Miyako; Kuroda, Maiko; Nishimura, Shunsuke; Yoshikawa, Yusuke; Amano, Masashi; Imamura, Sari; Onishi, Naoaki; Tamaki, Yodo; Enomoto, Soichiro; Tamura, Toshihiro; Kondo, Hirokazu; Kaitani, Kazuaki; Nakagawa, Yoshihisa

    2017-09-15

    Patients with atrial fibrillation (AF) without structural heart diseases can show severe tricuspid regurgitation (TR), especially among aged people. The aim of this study was to clarify the actual management, prognosis, and prognostic factors for severe isolated TR associated with AF without structural heart diseases. We retrospectively investigated actual management in 178 consecutive patients with severe isolated TR associated with AF between 1999 and 2011 in our institution. Prognosis and its predictors were also investigated in 115 patients (68 persistent TR and 47 transient TR) who were followed-up for >1year. During the follow-up period (mean: 5.9years), event free rate from death due to right-sided heart failure (RHF) was 97% at 5years. Persistent TR was associated with higher risk of hospitalization due to RHF than transient TR (log-rank P=0.048) and death due to RHF were all seen in patients with persistent TR who experienced hospitalization due to RHF. Among patients with persistent TR, right ventricular outflow tract dimension >35.3mm, right atrial area >40.3cm2, and tenting height >2.1mm were associated with higher risk of hospitalization due to RHF (adjusted hazard ratio: 3.32, 3.83, and 2.89, respectively; P=0.003, 0.002, and 0.009, respectively). The prognosis of severe isolated TR associated with AF was good with a focus on cardiac death. However, the incidence of cardiac death increased among patients who experienced hospitalization due to RHF. Larger right ventricular outflow tract dimension, right atrial area and tenting height were predictors of hospitalization due to RHF. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Aging-associated cardiovascular changes and their relationship to heart failure

    Science.gov (United States)

    Strait, James B.; Lakatta, Edward G.

    2011-01-01

    Synopsis Aging represents a convergence of declining cardioprotective systems and increasing disease processes that is fertile ground for the development of heart failure. With 50% of all heart failure diagnoses and 90% of all heart failure deaths occurring in the segment of the population over age 70, heart failure is largely a disease of the elderly. This review discusses the microscopic and macroscopic changes in cardiovascular structure, function, protective systems, and disease associated with aging. In addition to outlining important clinical considerations and conditions in older persons, the link between normal aging and the elevated risk for development of stage B heart failure is explained and potential therapeutic pathways highlighted. PMID:22108734

  19. Geochemistry, mineralization, structure, and permeability of a normal-fault zone, Casino mine, Alligator Ridge district, north central Nevada

    Science.gov (United States)

    Hammond, K. Jill; Evans, James P.

    2003-05-01

    We examine the geochemical signature and structure of the Keno fault zone to test its impact on the flow of ore-mineralizing fluids, and use the mined exposures to evaluate structures and processes associated with normal fault development. The fault is a moderately dipping normal-fault zone in siltstone and silty limestone with 55-100 m of dip-slip displacement in north-central Nevada. Across-strike exposures up to 180 m long, 65 m of down-dip exposure and 350 m of along-strike exposure allow us to determine how faults, fractures, and fluids interact within mixed-lithology carbonate-dominated sedimentary rocks. The fault changes character along strike from a single clay-rich slip plane 10-20 mm thick at the northern exposure to numerous hydrocarbon-bearing, calcite-filled, nearly vertical slip planes in a zone 15 m wide at the southern exposure. The hanging wall and footwall are intensely fractured but fracture densities do not vary markedly with distance from the fault. Fault slip varies from pure dip-slip to nearly pure strike-slip, which suggests that either slip orientations may vary on faults in single slip events, or stress variations over the history of the fault caused slip vector variations. Whole-rock major, minor, and trace element analyses indicate that Au, Sb, and As are in general associated with the fault zone, suggesting that Au- and silica-bearing fluids migrated along the fault to replace carbonate in the footwall and adjacent hanging wall rocks. Subsequent fault slip was associated with barite and calcite and hydrocarbon-bearing fluids deposited at the southern end of the fault. No correlation exists at the meter or tens of meter scale between mineralization patterns and fracture density. We suggest that the fault was a combined conduit-barrier system in which the fault provides a critical connection between the fluid sources and fractures that formed before and during faulting. During the waning stages of deposit formation, the fault behaved as

  20. Heart murmurs

    Science.gov (United States)

    Chest sounds - murmurs; Heart sounds - abnormal; Murmur - innocent; Innocent murmur; Systolic heart murmur; Diastolic heart murmur ... The heart has 4 chambers: Two upper chambers (atria) Two lower chambers (ventricles) The heart has valves that close ...

  1. Influence of socioeconomic factors on pregnancy outcome in women with structural heart disease.

    Science.gov (United States)

    van Hagen, Iris M; Baart, Sara; Fong Soe Khioe, Rebekah; Sliwa-Hahnle, Karen; Taha, Nasser; Lelonek, Malgorzata; Tavazzi, Luigi; Maggioni, Aldo Pietro; Johnson, Mark R; Maniadakis, Nikolaos; Fordham, Richard; Hall, Roger; Roos-Hesselink, Jolien W

    2017-11-01

    Cardiac disease is the leading cause of indirect maternal mortality. The aim of this study was to analyse to what extent socioeconomic factors influence the outcome of pregnancy in women with heart disease. The Registry of Pregnancy and Cardiac disease is a global prospective registry. For this analysis, countries that enrolled ≥10 patients were included. A combined cardiac endpoint included maternal cardiac death, arrhythmia requiring treatment, heart failure, thromboembolic event, aortic dissection, endocarditis, acute coronary syndrome, hospitalisation for cardiac reason or intervention. Associations between patient characteristics, country characteristics (income inequality expressed as Gini coefficient, health expenditure, schooling, gross domestic product, birth rate and hospital beds) and cardiac endpoints were checked in a three-level model (patient-centre-country). A total of 30 countries enrolled 2924 patients from 89 centres. At least one endpoint occurred in 645 women (22.1%). Maternal age, New York Heart Association classification and modified WHO risk classification were associated with the combined endpoint and explained 37% of variance in outcome. Gini coefficient and country-specific birth rate explained an additional 4%. There were large differences between the individual countries, but the need for multilevel modelling to account for these differences disappeared after adjustment for patient characteristics, Gini and country-specific birth rate. While there are definite interregional differences in pregnancy outcome in women with cardiac disease, these differences seem to be mainly driven by individual patient characteristics. Adjustment for country characteristics refined the results to a limited extent, but maternal condition seems to be the main determinant of outcome. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise

  2. Novel Variant in the ANK2 Membrane-Binding Domain Is Associated With Ankyrin-B Syndrome and Structural Heart Disease in a First Nations Population With a High Rate of Long QT Syndrome.

    Science.gov (United States)

    Swayne, Leigh Anne; Murphy, Nathaniel P; Asuri, Sirisha; Chen, Lena; Xu, Xiaoxue; McIntosh, Sarah; Wang, Chao; Lancione, Peter J; Roberts, Jason D; Kerr, Charles; Sanatani, Shubhayan; Sherwin, Elizabeth; Kline, Crystal F; Zhang, Mingjie; Mohler, Peter J; Arbour, Laura T

    2017-01-01

    Long QT syndrome confers susceptibility to ventricular arrhythmia, predisposing to syncope, seizures, and sudden death. While rare globally, long QT syndrome is ≈15× more common in First Nations of Northern British Columbia largely because of a known mutation in KCNQ1. However, 2 large multigenerational families were affected, but negative for the known mutation. Long QT syndrome panel testing was carried out in the index case of each family, and clinical information was collected. Cascade genotyping was performed. Biochemical and myocyte-based assays were performed to evaluate the identified gene variant for loss-of-function activity. Index cases in these 2 families harbored a novel ANK2 c.1937C>T variant (p.S646F). An additional 16 carriers were identified, including 2 with structural heart disease: one with cardiomyopathy resulting in sudden death and the other with congenital heart disease. For all carriers of this variant, the average QTc was 475 ms (±40). Although ankyrin-B p.S646F is appropriately folded and expressed in bacteria, the mutant polypeptide displays reduced expression in cultured H9c2 cells and aberrant localization in primary cardiomyocytes. Furthermore, myocytes expressing ankyrin-B p.S646F lack normal membrane targeting of the ankyrin-binding partner, the Na/Ca exchanger. Thus, ankyrin-B p.S646F is a loss-of-function variant. We identify the first disease-causing ANK2 variant localized to the membrane-binding domain resulting in reduced ankyrin-B expression and abnormal localization. Further study is warranted on the potential association of this variant with structural heart disease given the role of ANK2 in targeting and stabilization of key structural and signaling molecules in cardiac cells. © 2017 American Heart Association, Inc.

  3. Structural ambiguity of the Chinese version of the hospital anxiety and depression scale in patients with coronary heart disease

    Directory of Open Access Journals (Sweden)

    Thompson David

    2006-01-01

    Full Text Available Abstract Background The Hospital Anxiety and Depression Scale (HADS is a widely used screening tool designed as a case detector for clinically relevant anxiety and depression. Recent studies of the HADS in coronary heart disease (CHD patients in European countries suggest it comprises three, rather than two, underlying sub-scale dimensions. The factor structure of the Chinese version of the HADS was evaluated in patients with CHD in mainland China. Methods Confirmatory factor analysis (CFA was conducted on self-report HADS forms from 154 Chinese CHD patients. Results Little difference was observed in model fit between best performing three-factor and two-factor models. Conclusion The current observations are inconsistent with recent studies highlighting a dominant underlying tri-dimensional structure to the HADS in CHD patients. The Chinese version of the HADS may perform differently to European language versions of the instrument in patients with CHD.

  4. Permeability evolution of normal faults with clay smear: insights from structural observations in water saturated sandbox models and numerical simulations

    Science.gov (United States)

    Kettermann, Michael; Urai, Janos L.; Vrolijk, Peter J.

    2017-04-01

    Fault processes are complex phenomena that defy reliable prediction. Clay smear in particular is difficult to predict for sub-surface flow applications and would benefit from an improved understanding of controlling processes. In this study, we present a series of water-saturated sandbox experiments producing large clay smear surfaces up to 500 cm2. In these experiments, we couple across-fault flow measurements with structural analysis of post-mortem excavated clay smear surfaces. To develop a tool for evaluating the evolving fault structure during formation, we compare measured flow data to simplified numerical flow simulations. Results show diagnostic relationships between the observed fault structures and measured cross-fault flow. In experiments with one or two clay layers and a cumulative thickness of 10 mm and 100 mm displacement, we observe that normally consolidated clay, in a structural domain of graben faulting, initially yields in hybrid brittle/ductile failure. Characteristic for this type of failure is an early breaching of the clay layer by brittle fracturing causing increased cross-fault flow. However, the type of failure varies laterally and shear failure occurs as well. We observed that holes preferably form beneath extensional parts of the footwall cutoff. These can be identified in map-view as the fault curves towards the hanging wall. During the evolution of the fault, this is typically followed by fault back-stepping, formation of clay smears and reworking of clay fragments in the fault. These processes lead to slower increases of cross-fault flux. Holes that formed during the early breaching of the clay layer mostly remain open during the evolution of a fault, although there is some evidence for occasional resealing of holes. Fault zones are segmented by fault lenses, breached relays and clay smears in which sand and clay mix by deformation. Experiments with two clay layers show that holes rarely form at the same position on the fault planes

  5. Differential Effects of Dabigatran and Warfarin on Bone Volume and Structure in Rats with Normal Renal Function.

    Directory of Open Access Journals (Sweden)

    Maria Fusaro

    Full Text Available Warfarin, a widely used anticoagulant, is a vitamin K antagonist impairing the activity of vitamin K-dependent Bone Gla Protein (BGP or Osteocalcin and Matrix Gla Protein (MGP. Because dabigatran, a new anticoagulant, has no effect on vitamin K metabolism, the aim of this study was to compare the impact of warfarin and dabigatran administration on bone structure and vascular calcification.Rats with normal renal function received for 6 weeks warfarin, dabigatran or placebo. Bone was evaluated immuno-histochemically and hystomorphometrically after double labelling with declomycin and calcein. Aorta and iliac arteries were examined histologically.Histomorphometric analysis of femur and vertebrae showed significantly decreased bone volume and increased trabecular separation in rats treated with warfarin. Vertebra analysis showed that the trabecular number was higher in dabigatran treated rats. Osteoblast activity and resorption parameters were similar among groups, except for maximum erosion depth, which was higher in warfarin treated rats, suggesting a higher osteoclastic activity. Therefore, warfarin treatment was also associated with higher bone formation rate/bone surface and activation frequency. Warfarin treatment may cause an increased bone turnover characterized by increased remodelling cycles, with stronger osteoclast activity compared to the other groups. There were no differences among experimental groups in calcium deposition either in aortic or iliac arteries.These findings suggest for the first time that dabigatran has a better bone safety profile than warfarin, as warfarin treatment affects bone by reducing trabecular size and structure, increasing turnover and reducing mineralization. These differences could potentially result in a lower incidence of fractures in dabigatran treated patients.

  6. Thyroid hormone levels within reference range are associated with heart rate, cardiac structure, and function in middle-aged men and women.

    Science.gov (United States)

    Roef, Greet L; Taes, Youri E; Kaufman, Jean-Marc; Van Daele, Caroline M; De Buyzere, Marc L; Gillebert, Thierry C; Rietzschel, Ernst R

    2013-08-01

    Triiodothyronine (T3) has many effects on the heart, and marked changes in cardiac function and structure occur in patients with (subclinical) thyroid disease. We investigated whether between-subject variation in thyroid hormone levels within the euthyroid range is also associated with heart rate and echocardiographic heart function and structure. Subjects were selected from the Asklepios study (n=2524), a population-representative random sample of patients aged between 35 and 55 years, free from overt cardiovascular disease at baseline. Analyses were restricted to 2078 subjects (1013 women and 1065 men), not using antihypertensive or thyroid medication nor having antithyroperoxidase antibody levels above clinical cut-off or thyrotropin (TSH) levels outside the reference range. All subjects were phenotyped in-depth and underwent comprehensive echocardiography, including diastolic evaluation. Thyroid function parameters were determined by automated electrochemiluminescence. Heart rate was robustly positively associated with (quartiles of) free T3 (FT3) and T3, both in subjects with TSH levels within reference (0.27-4.2 μU/L) and in narrow TSH range (0.5-2.5 μU/L; plevels within the euthyroid range and heart rate, and more subtle effects on cardiac function and structure. More specifically, we suggest a smaller LV cavity size (with increased relative wall thickness), an enhanced atrial and ventricular contraction, and LV relaxation with higher circulating thyroid hormones. These results illustrate that variation in thyroid hormone levels, even within the reference range, exerts effects on the heart.

  7. Structural changes of waxy and normal maize starches modified by heat moisture treatment and their relationship with starch digestibility.

    Science.gov (United States)

    Chen, Yongzhi; Yang, Qingyu; Xu, Xiaojuan; Qi, Liang; Dong, Zhihong; Luo, Zhigang; Lu, Xuanxuan; Peng, Xichun

    2017-12-01

    In the present study, the variations in structure of waxy and normal maize starches modified by heat-moisture treatment (HMT) for different treating time (3h and 9h) were investigated. HMT caused the destruction of starch granules. The 1H NMR confirmed that glycosidic bonds were broken during HMT. The 13C NMR result suggested that HMT caused the transformation of starch granules from double and single helical components into amorphous components. Heat-moisture treated starches exhibited higher gelatinization temperature (To, Tp and Tc), narrower gelatinization temperature range (Tc-To) and lower gelatinization enthalpy (ΔH). HMT caused the rearrangement of starch molecules, degeneration of double helices and formation of new single helix. In addition, in vitro digestibility assessment indicated that the contents of rapidly digestible starch (RDS) and slowly digestible starch (SDS) were improved and resistant starch (RS) was reduced after HMT, which was related to the decrease of single and double helical components. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Effects of Continuous Triiodothyronine Infusion on Citric Acid Cycle in the Normal Immature Swine Heart under Extracorporeal Membrane Oxygenation in vivo

    Energy Technology Data Exchange (ETDEWEB)

    Kajimoto, Masaki [Seattle Children' s Research Inst., Seattle, WA (United States); O' Kelly-Priddy, Colleen M. [Seattle Children' s Research Inst., Seattle, WA (United States); Univ. of Washington, Seattle, WA (United States); Ledee, Dolena R. [Seattle Children' s Research Inst., Seattle, WA (United States); Xu, Chun [Seattle Children' s Research Inst., Seattle, WA (United States); Isern, Nancy G. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Olson, Aaron [Seattle Children' s Research Inst., Seattle, WA (United States); Univ. of Washington, Seattle, WA (United States); Portman, Michael A. [Seattle Children' s Research Inst., Seattle, WA (United States); Univ. of Washington, Seattle, WA (United States)

    2014-02-13

    Extracorporeal membrane oxygenation (ECMO) is frequently used in infants with postoperative cardiopulmonary failure. ECMO also suppresses circulating triiodothyronine (T3) levels and modifies myocardial metabolism. We assessed the hypothesis that T3 supplementation reverses ECMO induced metabolic abnormalities in the immature heart. Twenty-two male Yorkshire pigs (age 25-38 days) with ECMO were received [2-13C]lactate, [2,4,6,8-13C]octanoate (medium chain fatty acid) and [U-13C]long-chain fatty acids as metabolic tracers either systemically (totally physiological intracoronary concentration) or directly into the coronary artery (high substrate concentration) for the last 60 minutes of each protocol. Nuclear magnetic resonance (NMR) analysis of left ventricular tissue determined the fractional contribution (Fc) of these substrates to the citric acid cycle (CAC). Fifty percent of the pigs in each group received intravenous T3 supplement (bolus at 0.6 μg/kg and then continuous infusion at 0.2 μg/kg/hour) during ECMO. Under both substrate loading conditions T3 significantly increased lactate-Fc with a marginal increase in octanoate-Fc. Both T3 and high substrate provision increased myocardial energy status indexed by [Phosphocreatine]/[ATP]. In conclusion, T3 supplementation promoted lactate metabolism to the CAC during ECMO suggesting that T3 releases inhibition of pyruvate dehydrogenase. Manipulation of substrate utilization by T3 may be used therapeutically during ECMO to improve resting energy state and facilitate weaning.

  9. 3D multi-scale velocity structure of an active seismogenic normal fault zone (Central Apennines, Italy)

    Science.gov (United States)

    Fondriest, Michele; Mitchell, Tom; Vassallo, Maurizio; Di Giulio, Giuseppe; Balsamo, Fabrizio; Passelegue, Francois; Pischiutta, Marta; Di Toro, Giulio

    2017-04-01

    The characterization of physical properties of fault zones (e.g., ultrasonic velocities, elastic moduli, porosity and fracture intensity of the fault zone rocks) is a relevant topic in reservoir geology (exploration and exploitation) and fault mechanics, for the modelling of both long-term quasi-static and fast dynamic fault zone evolution with time. Here we characterized the shallow subsurface velocity-elastic structure of the active Vado di Corno normal fault zone (Campo Imperatore, Central Apennines, Italy) which is up to > 300 m thick. Based on a detailed structural mapping of the fault footwall block covering a 2 km long fault segment, four main structural units separated by principal fault strands were recognized: (i) cataclastic unit, (ii) breccia unit, (iii) high-strain damage zone, (iv) low-strain damage zone. The single units were systematically sampled along a transect ( 200 m) orthogonal to the average strike of the fault and characterized in the laboratory in terms of petrophysical properties (i.e., Vp, Vs, static and dynamic elastic moduli, porosity). The cataclastic and breccia units (Vp = 4.68±0.43 kms-1, Vs = 2.68±0.24 kms-1) were significantly "slower" compared to the damage zone units (Vp = 5.43±0.53 kms-1, Vs = 3.20±0.29 kms-1). A general negative correlation between ultrasonic velocity and porosity values was reported. Moreover three dimensional acoustic anisotropy was quantified within the different units with respect to the mapped fault strands, and related to the deformation fabrics (i.e., open fractures, veins) observed at the sample scale. A Vp - Vs seismic refraction tomography was then performed in the field along a profile ( 90 m) across the fault zone. The tomographic results clearly illuminated fault-bounded rock bodies characterized by different velocities (i.e., elastic properties) and geometries which match with the ones deduced from the structural analysis of the fault zone exposures. Fracture intensity measurements (both at

  10. Gender-specific changes in laboratory indexes and structural parameters of the left ventricle myocardium in chronic heart failure on the background of diabetes mellitus type 2 and obesity

    Directory of Open Access Journals (Sweden)

    P. P. Bidzilya

    2015-12-01

    Full Text Available Modern studies have shown that the prevalence of cardiovascular disease and chronic heart failure (CHF specifically, in patients with diabetes mellitus (DM is about 50%. Aim. To study gender-specific changes in laboratory indexes and structural myocardial parameters of left ventricle (LV in CHF on the background of diabetes mellitus (DM type 2. 111 patients with I–III functional class of disease with normal, overweight and abdominal obesity I–III degree were examined. Methods and results. Clinical and biochemical blood tests? glomerular filtration rate were used. Structural parameters of the myocardium were estimated with echocardiography. It is established that in CHF on the background of DM type 2 and obesity there is a tendency to develop anemia and renal dysfunction in women. Structural changes of the myocardium is more pronounced in men and presents the prevalence ofLV hypertrophy and dilatation of the heart cavities. Conclusion. This demonstrates different ways of negative impact of gender factor on the laboratory indexes and structural myocardial parameters in CHF on the background of DM type 2 and obesity.

  11. Metabolic and Lifestyle Predictors of Ischemic Heart Disease and All-Cause Mortality Among Normal Weight, Overweight, and Obese Men: A 16-Year Follow-up in the Copenhagen Male Study

    DEFF Research Database (Denmark)

    Suadicani, P.; Hein, H.O.; Eyben, F.E. von

    2009-01-01

    . Potential risk factors: These were blood pressure, diabetes, fasting serum triglycerides (TGs) and high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), glucosuria, cancer, body mass index (BMI), alcohol, tobacco, leisure-time physical activity, social class, and age......Aim: The aim of this study was to identify metabolic and lifestyle risk factors for ischemic heart disease (IHD) and all-cause mortality (ACM) among normal weight, overweight, and obese men. Methods: This was a 16-year follow up of 2982 men 53 to 75 years without overt cardiovascular disease....... Main outcome: This was to determine mortality during 16 years of follow-up. Results: A total of 194 men (6.5%) died due to IHD and 1184 (39.8%) from all causes. All lifestyle factors and clinical/metabolic risk factors were associated with BMI, positively or negatively. Risk of IHD and ACM increased...

  12. Ultra-structural effects of different low-level lasers on normal cultured human melanocytes: an in vitro comparative study.

    Science.gov (United States)

    AlGhamdi, Khalid M; Kumar, Ashok; A Al-Ghamdi, Attieh; Al-Rikabi, Ammar C; Mubarek, Mohammed; Ashour, Abdelkader E

    2016-12-01

    The aim of this study was to investigate the effects of the different types of low-level laser therapy (LLLT) on the ultra-structure and number of melanosomes in normal cultured human melanocytes. Specific effects of various types of LLLT on the ultra-structure of melanosomes have not yet been reported. Melanocytes were exposed to LLLT at an energy level of 2.0 J/cm(2), using a blue (457 nm), red (635 nm), or ultraviolet (UV) (355 nm) laser. After 72 h of irradiation, the melanocytes were fixed in 2.5 % glutaraldehyde (pH 7.2) phosphate buffer for 8 h and analyzed by transmission electron microscopy. Four developmental stages (I to IV) of melanosomes were observed, and their numbers were counted manually. The percentage of stages I, II, III, and IV melanosomes was 12.8, 14.2, 22.6, and 50.3 %, respectively, in the control (sham light). However, the melanosome percentages were 41.2, 5.4, 8.2, and 24.2 % in stages I, II, III, and IV, respectively, in the blue laser-treated group; 58.4, 6.1, 9.3, and 26.2 % for stages I, II, III, and IV, respectively, in the red laser-treated group; and 31.3, 11.1, 16.5, and 41.1 % for stages I, II, III, and IV, respectively, in the UV laser-treated group. The present data show that the amount of stage I is significantly higher (P < 0.0001) in the LLLT-treated cells compared to the control, which indicates significant stimulation of melanogenesis. The red laser was more effective than the other lasers. Moreover, the effects of LLLT on the ultra-structure of melanosomes need to be studied in a larger number of subject groups.

  13. Role of low angle normal faulting and basement thrusting on the structural architecture of the Northern Apennines (Italy)

    Science.gov (United States)

    Molli, Giancarlo; Carlini, Mirko; Vescovi, Paolo; Artoni, Andrea; Balsamo, Fabrizio; Camurri, Francesca; Clemenzi, Luca; Storti, Fabrizio; Torelli, Luigi

    2017-04-01

    The Northern Apennines of Italy are a classical site for studying fundamental issues in thrust wedges, such as ophiolite formation and emplacement, interplay between tectonics and sedimentation, role of out-of-sequence thrusting, syn-orogenic versus post-orogenic extension, along strike segmentation, etc. Accordingly, the Northern Apennines have been extensively studied since more than two centuries ago. Despite the huge amount of available data with different resolution, a 3D comprehensive regional view combining in a modern framework all available surface and subsurface information for contiguous sectors of the chain is still lacking. We performed such an attempt in the area framed between the Taro valley to the north and the northern termination of the Alpi Apuane to the south. The region includes the main morphostructural zones of the North-West Apennines from the Tyrrhenian coast West-Northwest of La Spezia, through the main topographic divide of the Apennines, to the external frontal part of the chain. The area has been investigated through a multidisciplinary approach that integrated: 1) surface geological data collected during the last two decades of structural and stratigraphic field works in the internal as well as external sectors of the chain; 2) subsurface geological data including: a) interpretation of 1200 Km of seismic reflection profiles tied to surface geology and b) analysis of 39 boreholes stratigraphies. The construction of two regional NE-SW trending cross-sections (the Levanto-Pontremoli-Parma to the North and the La Spezia-Sarzana-North Apuane-Cerreto to the South), connected by the NW-SE trending Taro River-Lunigiana Area-Alpi Apuane composite section, allowed us to illustrate (i) the role of out-of-sequence blind thrusting in the basement, (ii) the presence of low angle normal faulting and its relationships with recent to active high angle normal faulting. Both extensional and contractional systems have relevant implications for the

  14. A three-dimensional fluid structure interaction method for heart valve modelling

    Science.gov (United States)

    van Loon, Raoul; Anderson, Patrick D.; Baaijens, Frank P. T.; van de Vosse, Frans N.

    2005-12-01

    A method is presented for modelling fluid-solid interaction with large transformations of a slender solid body. The fluid flow is described by the unsteady Navier-Stokes equation, and the solid deformation is described by an incompressible hyperelastic Neo-Hookean model. Although the fluid and solid mesh are non-conformal with respect to each other, both domains can be coupled using a Lagrange multiplier. Accuracy and robustness are improved by a computationally inexpensive adaptive meshing scheme which is applied to the fluid mesh at the position of the solid interface. To illustrate the applicability of this method, 2D and 3D model problems are presented that are closely related to dynamical heart-valve computations. To cite this article: R. van Loon et al., C. R. Mecanique 333 (2005).

  15. Disfunção renal e anemia em pacientes com insuficiência cardíaca com fração de ejeção reduzida versus normal Renal dysfunction and anemia in patients with heart failure with reduced versus normal ejection fraction

    Directory of Open Access Journals (Sweden)

    Humberto Villacorta

    2010-03-01

    Full Text Available FUNDAMENTO: A presença de anemia e de disfunção renal confere mau prognóstico em pacientes com insuficiência cardíaca (IC e fração de ejeção reduzida (ICFER. O impacto em pacientes com IC e fração de ejeção normal (ICFEN é pouco estudado. OBJETIVOS: Estudar a prevalência e o prognóstico da anemia e da disfunção renal (DR em pacientes com IC de acordo com o tipo de disfunção ventricular. MÉTODOS: Foram estudados prospectivamente 209 pacientes com IC crônica estável. Pacientes com fração de ejeção BACKGROUND: The presence of anemia and renal dysfunction grants a bad prognosis for patients with heart failure and reduced ejection fraction (HFREF. The impact on patients with heart failure and normal ejection fraction (HFNEF is not widely studied. OBJECTIVES: To study the prevalence and the prognosis of anemia and renal dysfunction (RD in patients with heart failure according to the type of ventricular dysfunction. METHODS: A total of 209 patients with chronic and stable heart failure were prospectively studied. Individuals with ejection fraction <50% were considered as HFREF patients. Anemia was defined, based on WHO criteria, as hemoglobin <13 g/dl for men and <12 g/dl for women. Renal function was calculated by means of the Simplified Modified Diet Renal Disease (sMDRD formula. Hospitalizations, emergency admittances and obit by cardiac causes were considered as cardiac events. RESULTS: Ninety patients had HFREF and 119 had HFNEF. The glomerular filtration rate (GFR was smaller in HFREF group (57.6 ± 66.2 versus 94.8 ± 36.6 ml/min/1.73m²; p=0.01. There was no difference in the prevalence of anemia between groups (23.3% versus 18.5%; p=0.34. Moderate to severe RD prevalence was higher in HFREF group (32.2% versus 16.8%; p=0.01. RD was the only factor associated with anemia that was independently associated with cardiac events (HR 2.52; 95%CI=1.27-5.2; p=0.01. CONCLUSION: RD was less prevalent in HFNEF, while the

  16. High resolution structural evidence suggests the Sarcoplasmic Reticulum forms microdomains with Acidic Stores (lysosomes) in the heart.

    Science.gov (United States)

    Aston, Daniel; Capel, Rebecca A; Ford, Kerrie L; Christian, Helen C; Mirams, Gary R; Rog-Zielinska, Eva A; Kohl, Peter; Galione, Antony; Burton, Rebecca A B; Terrar, Derek A

    2017-01-17

    Nicotinic Acid Adenine Dinucleotide Phosphate (NAADP) stimulates calcium release from acidic stores such as lysosomes and is a highly potent calcium-mobilising second messenger. NAADP plays an important role in calcium signalling in the heart under basal conditions and following β-adrenergic stress. Nevertheless, the spatial interaction of acidic stores with other parts of the calcium signalling apparatus in cardiac myocytes is unknown. We present evidence that lysosomes are intimately associated with the sarcoplasmic reticulum (SR) in ventricular myocytes; a median separation of 20 nm in 2D electron microscopy and 3.3 nm in 3D electron tomography indicates a genuine signalling microdomain between these organelles. Fourier analysis of immunolabelled lysosomes suggests a sarcomeric pattern (dominant wavelength 1.80 μm). Furthermore, we show that lysosomes form close associations with mitochondria (median separation 6.2 nm in 3D studies) which may provide a basis for the recently-discovered role of NAADP in reperfusion-induced cell death. The trigger hypothesis for NAADP action proposes that calcium release from acidic stores subsequently acts to enhance calcium release from the SR. This work provides structural evidence in cardiac myocytes to indicate the formation of microdomains between acidic and SR calcium stores, supporting emerging interpretations of NAADP physiology and pharmacology in heart.

  17. Influence of Hypothyroidism on Separate Links of Metabolism, Structure and Function of the Heart in Insulin Resistance

    Directory of Open Access Journals (Sweden)

    T.Yu. Yuzvenko

    2014-07-01

    Full Text Available The article presents research findings of reduced thyroid function impact on the background of insulin resistance on the specific links of metabolism, structure and function of the heart. It is found that in thyroid dysfunction, the main nosological form of myocardial lesion in female patients without concomitant cardiovascular disease is the development of metabolic endocrine cardiomyopathy. Feature of cardiac lesion is the absence of cardiosclerotic, myocardial and ischemic processes in hypothyroidism. Obscure clinical symptoms of the heart both in apparent and subclinical hypothyroidism are detected. Features of clinical, instrumental and laboratory changes in female patients with impaired thyroid function are a trend to systolic blood pressure increase, the absence of significant dyslipidemia, dysglycemia, and cardiocytolysis and hepatocytolysis. Thyroid hormone deficiency is associated with increased myocardial repolarization heterogeneity: subclinical hypothyroidism is accompanied by violation of repolarization processes and the development of electrical heterogeneity of ventricular myocardium, and in the apparent hypothyroidism changes are more linked with the violation of the homogeneity of the electrical impulse to the atria.

  18. Heart bypass surgery - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100190.htm Heart bypass surgery - series—Normal anatomy To use the sharing ... Editorial team. Related MedlinePlus Health Topics Coronary Artery Bypass Surgery A.D.A.M., Inc. is accredited ...

  19. Heart transplant - slideshow

    Science.gov (United States)

    ... ency/presentations/100086.htm Heart transplant - series—Normal anatomy To use the sharing features on this page, ... Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page last updated: ...

  20. Influence of diurnal photosynthetic activity on the morphology, structure, and thermal properties of normal and waxy barley starch

    DEFF Research Database (Denmark)

    Goldstein, Avi; Annor, George; Vamadevan, Varatharajan

    2017-01-01

    This study investigated the influence of diurnal photosynthetic activity on the morphology, molecular composition, crystallinity, and gelatinization properties of normal barley starch (NBS) and waxy barley starch (WBS) granules from plants cultivated in a greenhouse under normal diurnal (16 h light...

  1. An investigation into pituitary gonadotrophic hormone synthesis, secretion, subunit gene expression and cell structure in normal and mutant male mice.

    Science.gov (United States)

    Abel, M H; Charlton, H M; Huhtaniemi, I; Pakarinen, P; Kumar, T R; Christian, H C

    2013-10-01

    To investigate brain-pituitary-gonadal inter-relationships, we have compared the effects of mutations that perturb the hypothalamic-pituitary-gonadal axis in male mice. Specifically, serum and pituitary gonadotrophin concentrations, gonadotrophin gene expression, and gonadotroph structure and number were measured. Follicle-stimulating hormone (FSH)β knockout (FSHβKO), FSH receptor knockout (FSHRKO), luteinising hormone (LH) receptor knockout (LuRKO), hypogonadal (hpg), testicular feminised (tfm) and gonadectomised mice were compared with control wild-type mice or heterozygotes. Serum levels of LH were similar in FSHβKO, FSHRKO and heterozygote males despite decreased androgen production in KO males. As expected, there was no detectable FSH in the serum or pituitary and an absence of expression of the FSHβ subunit gene in FSHβKO mice. However, there was a significant increase in expression of the common α and LHβ subunit genes in FSHRKO males. The morphology of FSHβKO and FSHRKO gonadotrophs was not significantly different from controls, except that the subpopulation of granules consisting of an electron-dense core and electron-lucent 'halo' was not observed in FSHβKO gonadotrophs and the granules were smaller in diameter. In the gonadotrophin-releasing hormone deficient hpg mouse, gonadotrophin mRNA and hormone levels were significantly lower compared to control mice and gonadotrophs were correspondingly smaller, with less abundant endoplasmic reticulum and reduced secretory granules. In LuRKO, tfm and gonadectomised mice, hyperstimulation of LHβ and FSHβ mRNA and serum protein concentrations was reflected by subcellular changes in gonadotroph morphology, including more dilated rough endoplasmic reticulum and more secretory granules distributed adjacent to the plasma membrane. In summary, major differences in pituitary content and serum concentrations of the gonadotrophins LH and FSH have been found between normal and mutant male mice. These changes are

  2. Usefulness of axonal tract-dependent OCT macular sectors for evaluating structural change in normal-tension glaucoma.

    Science.gov (United States)

    Omodaka, Kazuko; Kikawa, Tsutomu; Shiga, Yukihiro; Tsuda, Satoru; Yokoyama, Yu; Sato, Haruka; Ohuchi, Junko; Matsumoto, Akiko; Takahashi, Hidetoshi; Akiba, Masahiro; Nakazawa, Toru

    2017-01-01

    To identify sectors of the optical coherence tomography (OCT) macular map that could be used to effectively assess structural progression in patients with normal-tension glaucoma (NTG). This study examined 117 eyes of 117 NTG patients to establish axonal tract-dependent macular sectors, and also examined a separate group of 122 eyes of 81 NTG patients to evaluate the ability of these sectors to reveal glaucoma progression. Longitudinal data, including macular maps from at least 5 OCT examinations performed over at least 2 years, was available for all patients in this group. Circumpapillary retinal nerve fiber layer thickness (cpRNFLT), temporal clockwise sector scans (from 7 to 11 o'clock), macular retinal nerve fiber layer thickness (mRNFLT), and macular ganglion cell layer plus inner plexiform layer thickness (mGCIPLT) were measured with spectral-domain OCT (3D OCT-2000, TOPCON). The axonal tract-dependent macular sectors were identified by calculating Spearman's rank correlation coefficient for each point on a grid overlaid on the macular map and cpRNFLT in each clockwise scan sector. Trend and event analyses for the slope of progression in each sector and macular map were performed. Visual field progression in the macula was defined by the presence of more than 2 progressive test points in the 16 central test points of the Humphrey field analyzer SITA standard 24-2 program, evaluated with Progressor software. The slope of progression in the entire macular area was -0.22 ± 0.58 μm/year for mRNFLT and -0.35 ± 0.52 μm/year for mGCIPLT. The fastest-progressing mRNFLT sector (-1.00 ± 0.84 μm/year, p OCT macular sectors could effectively reveal structural change in patients with NTG. Furthermore, mRNFLT slope was consistent with visual field progression. This method promises to open new avenues for the OCT-based evaluation of glaucoma progression.

  3. Dose volume histogram analysis of normal structures associated with accelerated partial breast irradiation delivered by high dose rate brachytherapy and comparison with whole breast external beam radiotherapy fields.

    Science.gov (United States)

    Stewart, Alexandra J; O'Farrell, Desmond A; Cormack, Robert A; Hansen, Jorgen L; Khan, Atif J; Mutyala, Subhakar; Devlin, Phillip M

    2008-11-19

    To assess the radiation dose delivered to the heart and ipsilateral lung during accelerated partial breast brachytherapy using a MammoSite applicator and compare to those produced by whole breast external beam radiotherapy (WBRT). Dosimetric analysis was conducted on patients receiving MammoSite breast brachytherapy following conservative surgery for invasive ductal carcinoma. Cardiac dose was evaluated for patients with left breast tumors with a CT scan encompassing the entire heart. Lung dose was evaluated for patients in whom the entire lung was scanned. The prescription dose of 3400 cGy was 1 cm from the balloon surface. MammoSite dosimetry was compared to simulated WBRT fields with and without radiobiological correction for the effects of dose and fractionation. Dose parameters such as the volume of the structure receiving 10 Gy or more (V10) and the dose received by 20 cc of the structure (D20), were calculated as well as the maximum and mean doses received. Fifteen patients were studied, five had complete lung data and six had left-sided tumors with complete cardiac data. Ipsilateral lung volumes ranged from 925-1380 cc. Cardiac volumes ranged from 337-551 cc. MammoSite resulted in a significantly lower percentage lung V30 and lung and cardiac V20 than the WBRT fields, with and without radiobiological correction. This study gives low values for incidental radiation received by the heart and ipsilateral lung using the MammoSite applicator. The volume of heart and lung irradiated to clinically significant levels was significantly lower with the MammoSite applicator than using simulated WBRT fields of the same CT data sets.

  4. Dose volume histogram analysis of normal structures associated with accelerated partial breast irradiation delivered by high dose rate brachytherapy and comparison with whole breast external beam radiotherapy fields

    Directory of Open Access Journals (Sweden)

    Mutyala Subhakar

    2008-11-01

    Full Text Available Abstract Purpose To assess the radiation dose delivered to the heart and ipsilateral lung during accelerated partial breast brachytherapy using a MammoSite™ applicator and compare to those produced by whole breast external beam radiotherapy (WBRT. Materials and methods Dosimetric analysis was conducted on patients receiving MammoSite breast brachytherapy following conservative surgery for invasive ductal carcinoma. Cardiac dose was evaluated for patients with left breast tumors with a CT scan encompassing the entire heart. Lung dose was evaluated for patients in whom the entire lung was scanned. The prescription dose of 3400 cGy was 1 cm from the balloon surface. MammoSite dosimetry was compared to simulated WBRT fields with and without radiobiological correction for the effects of dose and fractionation. Dose parameters such as the volume of the structure receiving 10 Gy or more (V10 and the dose received by 20 cc of the structure (D20, were calculated as well as the maximum and mean doses received. Results Fifteen patients were studied, five had complete lung data and six had left-sided tumors with complete cardiac data. Ipsilateral lung volumes ranged from 925–1380 cc. Cardiac volumes ranged from 337–551 cc. MammoSite resulted in a significantly lower percentage lung V30 and lung and cardiac V20 than the WBRT fields, with and without radiobiological correction. Conclusion This study gives low values for incidental radiation received by the heart and ipsilateral lung using the MammoSite applicator. The volume of heart and lung irradiated to clinically significant levels was significantly lower with the MammoSite applicator than using simulated WBRT fields of the same CT data sets. Trial registration Dana Farber Trial Registry number 03-179

  5. Numerical investigation on effect of aortic root geometry on flow induced structural stresses developed in a bileaflet mechanical heart valve

    Science.gov (United States)

    Abbas, S. S.; Nasif, M. S.; Said, M. A. M.; Kadhim, S. K.

    2017-10-01

    Structural stresses developed in an artificial bileaflet mechanical heart valve (BMHV) due to pulsed blood flow may cause valve failure due to yielding. In this paper, von-Mises stresses are computed and compared for BMHV placed in two types of aortic root geometries that are aortic root with axisymmetric sinuses and with axisymmetric bulb, at different physiological blood flow rates. With BMHV placed in an aortic root with axisymmetric sinuses, the von-Mises stresses developed in the valve were found to be up to 47% higher than BMHV placed in aortic root with axisymmetric bulb under similar physiological conditions. High velocity vectors and therefore high von-Mises stresses have been observed for BMHV placed in aortic root with axisymmetric sinuses, that can lead to valve failure.

  6. Flow Structure Downstream of a Mechanical Heart Valve during Systole: Investigation Using High-Speed Particle Image Velocimetry

    Science.gov (United States)

    Oshkai, Peter; Haji-Esmaeili, Farida

    2007-11-01

    High speed digital particle image velocimetry is employed to study turbulent flow through a bileaflet mechanical heart valve during systolic and diastolic phases of a cardiac cycle. Unsteady vortex shedding from the valve's leaflets displays distinct characteristic frequencies, depending on the opening angle of each leaflet. Small- and large-scale transverse oscillations of the separated shear layers are studied using global quantitative flow imaging approach. Implementation of high-speed digital particle image velocimetry technique yields quantitative information about vortex shedding frequencies and trajectories of the shed vortices downstream of the valve. Turbulent flow structures including jet-like regions and shed vortices are characterized in terms of patterns of instantaneous and time-averaged velocity, vorticity, and streamline topology.

  7. Incidence and predictors of obstetric and fetal complications in women with structural heart disease.

    Science.gov (United States)

    van Hagen, Iris M; Roos-Hesselink, Jolien W; Donvito, Valentina; Liptai, Csilla; Morissens, Marielle; Murphy, Daniel J; Galian, Laura; Bazargani, Nooshin Mohd; Cornette, Jérôme; Hall, Roger; Johnson, Mark R

    2017-10-01

    Women with cardiac disease becoming pregnant have an increased risk of obstetric and fetal events. The aim of this study was to study the incidence of events, to validate the modified WHO (mWHO) risk classification and to search for event-specific predictors. The Registry Of Pregnancy And Cardiac disease is a worldwide ongoing prospective registry that has enrolled 2742 pregnancies in women with known cardiac disease (mainly congenital and valvular disease) before pregnancy, from January 2008 up to April 2014. Mean age was 28.2±5.5 years, 45% were nulliparous and 33.3% came from emerging countries. Obstetric events occurred in 231 pregnancies (8.4%). Fetal events occurred in 651 pregnancies (23.7%). The mWHO classification performed poorly in predicting obstetric (c-statistic=0.601) and fetal events (c-statistic=0.561). In multivariable analysis, aortic valve disease was associated with pre-eclampsia (OR=2.6, 95%CI=1.3 to 5.5). Congenital heart disease (CHD) was associated with spontaneous preterm birth (OR=1.8, 95%CI=1.2 to 2.7). Complex CHD was associated with small-for-gestational-age neonates (OR=2.3, 95%CI=1.5 to 3.5). Multiple gestation was the strongest predictor of fetal events: fetal/neonatal death (OR=6.4, 95%CI=2.5 to 16), spontaneous preterm birth (OR=5.3, 95%CI=2.5 to 11) and small-for-gestational age (OR=5.0, 95%CI=2.5 to 9.8). The mWHO classification is not suitable for prediction of obstetric and fetal events in women with cardiac disease. Maternal complex CHD was independently associated with fetal growth restriction and aortic valve disease with pre-eclampsia, potentially offering an insight into the pathophysiology of these pregnancy complications. The increased rates of adverse obstetric and fetal outcomes in women with pre-existing heart disease should be highlighted during counselling. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless

  8. A quantitative structural and morphometric analysis of the Purkinje network and the Purkinje-myocardial junctions in pig hearts.

    Science.gov (United States)

    Garcia-Bustos, V; Sebastian, R; Izquierdo, M; Molina, P; Chorro, F J; Ruiz-Sauri, A

    2017-05-01

    The morpho-functional properties of the distal section of the cardiac Purkinje network (PN) and the Purkinje-myocardial junctions (PMJs) are fundamental to understanding the sequence of electrical activation in the heart. The overall structure of the system has already been described, and several computational models have been developed to gain insight into its involvement in cardiac arrhythmias or its interaction with implantable devices, such as pacemakers. However, anatomical descriptions of the PN in the literature have not enabled enough improvements in the accuracy of anatomical-based electrophysiological simulations of the PN in 3D hearts models. In this work, we study the global distribution and morphological properties of the PN, with special emphasis on the cellular and architectural characterization of its intramural branching structure, mesh-like sub-endocardial network, and the PMJs in adult pig hearts by both histopathological and morphometric evaluation. We have defined three main patterns of PMJ: contact through cell bodies, contact through cell prolongations either thick or piliform, and contact through transitional cells. Moreover, from hundreds of micrographs, we quantified the density of PMJs and provided data for the basal/medial/apical regions, anterior/posterior/septal/lateral regions and myocardial/sub-endocardial distribution. Morphometric variables, such as Purkinje cell density and thickness of the bundles, were also analyzed. After combining the results of these parameters, a different septoanterior distribution in the Purkinje cell density was observed towards the cardiac apex, which is associated with a progressive thinning of the conduction bundles and the posterolateral ascension of intramyocardial terminal scattered fibers. The study of the PMJs revealed a decreasing trend towards the base that may anatomically explain the early apical activation. The anterolateral region contains the greatest number of contacts, followed by the

  9. STRUCTURAL CHANGES OF THE HEART DURING SEVERE SEPSIS OR SEPTIC SHOCK

    NARCIS (Netherlands)

    Smeding, Lonneke; Plotz, Frans B.; Groeneveld, A. B. Johan; Kneyber, Martin C. J.

    Cardiovascular dysfunction is common in severe sepsis or septic shock. Although functional alterations are often described, the elevated serum levels of cardiac proteins and autopsy findings of myocardial immune cell infiltration, edema, and damaged mitochondria suggest that structural changes to

  10. Twin pregnancy complicated by esophageal atresia, duodenal atresia, gastric perforation, and hypoplastic left heart structures in one twin: a case report and review of the literature.

    Science.gov (United States)

    Abou Chaar, Mohamad K; Meyers, Mariana L; Tucker, Bethany D; Galan, Henry L; Liechty, Kenneth W; Crombleholme, Timothy M; Marwan, Ahmed I

    2017-03-18

    The antenatal diagnosis of a combined esophageal atresia without tracheoesophageal fistula and duodenal atresia with or without gastric perforation is a rare occurrence. These diagnoses are difficult and can be suspected on ultrasound by nonspecific findings including a small stomach and polyhydramnios. Fetal magnetic resonance imaging adds significant anatomical detail and can aid in the diagnosis of these complicated cases. Upon an extensive literature review, there are no reports documenting these combined findings in a twin pregnancy. Therefore we believe this is the first case report of an antenatal diagnosis of combined pure esophageal and duodenal atresia in a twin gestation. We present a case of a 30-year-old G1P0 white woman at 22-week gestation with a monochorionic-diamniotic twin pregnancy discordant for esophageal atresia, duodenal atresia with gastric perforation, hypoplastic left heart structures, and significant early gestation maternal polyhydramnios. In this case, fetal magnetic resonance imaging was able to depict additional findings including area of gastric wall rupture, hiatal hernia, dilation of the distal esophagus, and area of duodenal obstruction and thus facilitated the proper diagnosis. After extensive counseling at our multidisciplinary team meeting, the parents elected to proceed with radiofrequency ablation of the anomalous twin to maximize the survival of the normal co-twin. The procedure was performed successfully with complete cessation of flow in the umbilical artery and complete cardiac standstill in the anomalous twin with no detrimental effects on the healthy co-twin. Prenatal diagnosis of complex anomalies in twin pregnancies constitutes a multitude of ethical, religious, and cultural factors that come into play in the management of these cases. Fetal magnetic resonance imaging provides detailed valuable information that can assist in management options including possible prenatal intervention. The combination of a cystic

  11. Heart Disease

    Science.gov (United States)

    ... type of heart disease you have. Symptoms of heart disease in your blood vessels (atherosclerotic disease) Cardiovascular disease ... can sometimes be found early with regular evaluations. Heart disease symptoms caused by abnormal heartbeats (heart arrhythmias) A ...

  12. Aging, telomeres and heart failure

    NARCIS (Netherlands)

    Wong, Liza S. M.; van der Harst, Pim; de Boer, Rudolf A.; Huzen, Jardi; van Gilst, Wiek H.; van Veldhuisen, Dirk J.

    During normal aging, the heart undergoes functional, morphological and cellular changes. Although aging per se does not lead to the expression of heart failure, it is likely that age-associated changes lower the threshold for the manifestation of signs and symptoms of heart failure. In patients, the

  13. The Assessment of Structural Changes in MS Plaques and Normal Appearing White Matter Using Quantitative Magnetization Transfer Imaging (MTI

    Directory of Open Access Journals (Sweden)

    Masoomeh Fooladi

    2007-12-01

    Full Text Available Introduction: Multiple sclerosis (MS is a demyelinating disease of the central nervous system (CNS, affecting mostly young people at a mean age of 30 years. Magnetic resonance imaging (MRI is one of the most specific and sensitive methods in diagnosing and detecting the evolution of multiple sclerosis disease. But it does not have the ability to differentiate between distinct histopathological heterogeneities that occur in MS lesions and brain tissue.Quantitative magnetization transfer imaging (qMTI is a relatively new MRI technique which can be used to examine the pathological processes of the brain parenchyma which occur in MS patients.This quantitative MRI technique can provide more complete information about the extent and nature of the brain tissue destruction in multiple sclerosis, which cannot be detected by conventional MRI. Material and Methods: In this study, twelve patients with relapsing-remitting MS and twelve healthy control subjects underwent conventional MR imaging including: T2-FSE, T1-SE and FLAIR sequences as well as quantitative magnetization transfer imaging. All the focal lesions were identified on T2-weighted images and were classified according to their signal hypointensity on T1-weighted scans. The white matter and MS lesions were segmented using a semi-automated system. MT ratio (MTR histogram analysis was performed for the brain white matter and the average MTR value was calculated for the classified MS lesions. Results: A significant reduction was found in MTR value of the normal appearing white matter (NAWM in patients with relapsing-remitting MS, suggesting that MS is a more diffuse disease, affecting the whole brain tissue. A wide range changes in MTR values can be observed in MS lesions. MTR reduction is correlated with the degree of lesion hypointensity on T1-weighted scans. The lower MTR values of lesions that appear progressively more hypointense on T1-weigted images reflect varying degrees of demyelination and

  14. [Exploring the three-dimensional structure of dermal tissues of normal skin and scar in rat with synchrotron radiation X-ray imaging technology].

    Science.gov (United States)

    Jiang, Yu-zhi; Tong, Ya-jun; Xiao, Ti-qiao; Xie, Hong-lan; Qing, Chun; DU, Guo-hao; Lu, Shu-liang

    2012-02-01

    To compare the morphological difference between dermal tissue of normal skin and that of scar in rat, and to explore its structural pattern. The full-thickness skin and the scar tissue formed 3 weeks after wound healing from SD rats were harvested as samples, which were prepared appropriately afterwards. Samples were scanned and imaged with synchrotron radiation technology, micro-CT, and phase-contrast imaging technology. The images were rebuilt with three-dimensional software. The micro-CT was materialized by using X-ray generated by synchrotron radiation light source. The structure of dermal tissues was clearly shown with the assistance of phase-contrast imaging technology in the process. It was demonstrated that the dermal tissues of normal skin of rat were mainly composed of collagenous fibers, which twined together to form an olive-like structure. These olive-like structures as basic units were arranged randomly in a certain way. The collagenous fibers in dermal tissue of the scar were arranged in a parallel manner, while some fibers were crooked and arranged in a disorderly manner. Dermal tissue of normal skin in rat has stable three-dimensional structure, and its basic structure and manner of composition are obviously different from those of scar dermal tissue.

  15. [The structure of myocardial nerve plexus of human auricle of the right atrium and its relation to myocardial ischemia, functional status of the heart, and age].

    Science.gov (United States)

    Burkauskiene, Ausra; Azelis, Vidmantas; Senikiene, Zibuokle; Linonis, Vitas; Ramanauskiene, Irina

    2008-01-01

    The aim of this study was to investigate and evaluate morphometrically the relationship between changes in the structure of myocardial nerve plexus of the right atrium auricle and myocardial ischemia, parameters reflecting functional status of the heart, and age. A total of 56 females and males aged 20-94 years were investigated. Ischemic heart disease group consisted of 39 persons (their mean age was 63.83+/-15.67 years). The control group comprised 17 persons (the mean age was 60.53+/-9.89 years). Control group consisted of deceased persons who according to the pathologic and anatomic examination were not diagnosed with cardiac pathology leading to heart lesions or overload. Ischemic heart disease group consisted of patients who underwent aorta-coronary artery bypass grafting surgery. In ischemic heart disease group, degree of coronary artery stenosis was evaluated as well as the major indicators reflecting the size of atria and formation of postinfarction scar. After examination, postinfarction scars were found in 18 (46.2%) persons; no scars were found in 21 (53.8%) persons. Neurohistochemical method and video microscopy were employed for the evaluation of quantitative changes in the structure of the myocardial nerve plexus. In ischemic heart disease group, the structures of nerve plexus occupied 5.0+/-1.0% of the area, perimeter was 10 488+/-2134 microm, and number of the structures was 2698+/-981; the same parameters in the control group were 6.0+/-1.4%, 13 008+/-443 microm, and 3469+/-1511, respectively. In persons with postinfarction scar, the number of nerve plexus structures was lower by 9.3%, area by 8.9%, perimeter by 9.7% on average as compared to ischemic heart disease group without a scar. Regression analysis did not reveal any statistically significant correlation between the degree of coronary artery stenosis and quantitative parameters of nerve plexus (P>0.05). Changes in quantitative parameters of nerve plexus were not related to compensatory

  16. Left ventricular mechanics in humans with high aerobic fitness: adaptation independent of structural remodelling, arterial haemodynamics and heart rate

    Science.gov (United States)

    Stöhr, Eric J; McDonnell, Barry; Thompson, Jane; Stone, Keeron; Bull, Tom; Houston, Rory; Cockcroft, John; Shave, Rob

    2012-01-01

    Individuals with high aerobic fitness have lower systolic left ventricular strain, rotation and twist (‘left ventricular (LV) mechanics’) at rest, suggesting a beneficial reduction in LV myofibre stress and more efficient systolic function. However, the mechanisms responsible for this functional adaptation are not known and the influence of aerobic fitness on LV mechanics during dynamic exercise has never been studied. We assessed LV mechanics, LV wall thickness and dimensions, central augmentation index (AIx), aortic pulse wave velocity (aPWV), blood pressure and heart rate in 28 males (age: 21 ± 2 years SD) with a consistent physical activity level (no change >6 months). Individuals were examined at rest and during exercise (40% peak exercise capacity) and separated post hoc into a moderate and high aerobic fitness group (: 49 ± 5 and 63 ± 7 ml kg−1 min−1, respectively, P 0.05). However, for the same AIx, the high group had significantly lower LV apical rotation (P = 0.002) and LV twist (P = 0.003) while basal rotation and strain indices did not differ between groups (P > 0.05). We conclude that young males with high aerobic fitness have lower LV apical rotation at rest and during submaximal exercise that can occur without changes in gross LV structure, arterial haemodynamics or heart rate. The findings suggest a previously unknown type of physiological adaptation of the left ventricle that may have important implications for exercise training in older individuals and patient populations in which exercise training has previously failed to show clear benefits for LV function. PMID:22431336

  17. Preparation of degradable porous structures based on 1,3-trimethylene carbonate and D,L-lactide (co)polymers for heart tissue engineering

    NARCIS (Netherlands)

    Pego, AP; Siebum, B; Van Luyn, MJA; Van Seijen, XJGY; Poot, AA; Grijpma, DW; Feijen, J

    2003-01-01

    Biodegradable porous scaffolds for heart tissue engineering were prepared from amorphous elastomeric (co)polymers of 1,3-trimethylene carbonate (TMC) and D,L-lactide (DLLA). Leaching of salt from compression-molded polymer-salt composites allowed the preparation of highly porous structures in a

  18. Early Detection of Heart Failure with Varying Prediction Windows by Structured and Unstructured Data in Electronic Health Records*

    Science.gov (United States)

    Wang, Yajuan; Ng, Kenney; Byrd, Roy J.; Hu, Jianying; Ebadollahi, Shahram; Daar, Zahra; deFilippi, Christopher; Steinhubl, Steven R.; Stewart, Walter F.

    2017-01-01

    Heart failure (HF) prevalence is increasing and is among the most costly diseases to society. Early detection of HF would provide the means to test lifestyle and pharmacologic interventions that may slow disease progression and improve patient outcomes. This study used structured and unstructured data from electronic health records (EHR) to predict onset of HF with a particular focus on how prediction accuracy varied in relation to time before diagnosis. EHR data were extracted from a single health care system and used to identify incident HF among primary care patients who received care between 2001 and 2010. A total of 1,684 incident HF cases were identified and 13,525 controls were selected from the same primary care practices. Models were compared by varying the beginning of the prediction window from 60 to 720 days before HF diagnosis. As the prediction window decreased, the performance [AUC (95% CIs)] of the predictive HF models increased from 65% (63%–66%) to 74% (73%–75%) for the unstructured, from 73% (72%–75%) to 81% (80%–83%) for the structured, and from 76% (74%–77%) to 83% (77%–85%) for the combined data. PMID:26736807

  19. Early detection of heart failure with varying prediction windows by structured and unstructured data in electronic health records.

    Science.gov (United States)

    Wang, Yajuan; Ng, Kenney; Byrd, Roy J; Hu, Jianying; Ebadollahi, Shahram; Daar, Zahra; deFilippi, Christopher; Steinhubl, Steven R; Stewart, Walter F

    2015-01-01

    Heart failure (HF) prevalence is increasing and is among the most costly diseases to society. Early detection of HF would provide the means to test lifestyle and pharmacologic interventions that may slow disease progression and improve patient outcomes. This study used structured and unstructured data from electronic health records (EHR) to predict onset of HF with a particular focus on how prediction accuracy varied in relation to time before diagnosis. EHR data were extracted from a single health care system and used to identify incident HF among primary care patients who received care between 2001 and 2010. A total of 1,684 incident HF cases were identified and 13,525 controls were selected from the same primary care practices. Models were compared by varying the beginning of the prediction window from 60 to 720 days before HF diagnosis. As the prediction window decreased, the performance [AUC (95% CIs)] of the predictive HF models increased from 65% (63%-66%) to 74% (73%-75%) for the unstructured, from 73% (72%-75%) to 81% (80%-83%) for the structured, and from 76% (74%-77%) to 83% (77%-85%) for the combined data.

  20. Clarifying Normalization

    Science.gov (United States)

    Carpenter, Donald A.

    2008-01-01

    Confusion exists among database textbooks as to the goal of normalization as well as to which normal form a designer should aspire. This article discusses such discrepancies with the intention of simplifying normalization for both teacher and student. This author's industry and classroom experiences indicate such simplification yields quicker…

  1. A shallow chest correlates with the aortic position in the normal spine: features resembling those observed in structural scoliosis.

    Science.gov (United States)

    Doi, Toshio; Matsumoto, Yoshihiro; Tono, Osamu; Tarukado, Kiyoshi; Harimaya, Katsumi; Okada, Seiji; Kubota, Kensuke; Hayashida, Mitsumasa; Iwamoto, Yukihide

    2014-01-01

    Right thoracic curvature, rib cage deformities and aortic left shift are features of adolescent idiopathic scoliosis that are correlated with each other. We recently reported that disturbance of ribcage development results in progressive thoracic scoliosis in mice. Recently, it has been confirmed that the normal spine exhibits right thoracic curvature and rib cage deformities and that these deformities worsen during the adolescent period. The purpose of this study was to examine whether rib cage deformities correlate with thoracic side curvature in the normal spine, as observed in scoliosis, which is important basic knowledge needed to elucidate the causative factors of adolescent idiopathic scoliosis. To examine the relationship between rib cage deformities and thoracic side curvature in the normal spine, CT scans of 148 consecutive adult females were examined. The anteroposterior chest dimension, aortic location and rib cage rotation were measured on CT scans obtained at the T8 level. The thoracic side curvature (T5-T12) was also measured on chest radiographs. The anteroposterior chest dimension exhibited a significant correlation with aortic left shift. The aortic location and rib cage rotation were correlated, and the rib cage rotation and thoracic side curvature were correlated. There was a significant correlation between a shallow chest and the aortic position, between the aortic position and the rib cage rotation and between the rib cage rotation and the thoracic side curvature in the normal spine. These findings suggest the possibility that rib cage development is one of the causative factors of adolescent idiopathic scoliosis.

  2. Framingham coronary heart disease risk score can be predicted from structural brain images in elderly subjects.

    Directory of Open Access Journals (Sweden)

    Jane Maryam Rondina

    2014-12-01

    Full Text Available Recent literature has presented evidence that cardiovascular risk factors (CVRF play an important role on cognitive performance in elderly individuals, both those who are asymptomatic and those who suffer from symptoms of neurodegenerative disorders. Findings from studies applying neuroimaging methods have increasingly reinforced such notion. Studies addressing the impact of CVRF on brain anatomy changes have gained increasing importance, as recent papers have reported gray matter loss predominantly in regions traditionally affected in Alzheimer’s disease (AD and vascular dementia in the presence of a high degree of cardiovascular risk. In the present paper, we explore the association between CVRF and brain changes using pattern recognition techniques applied to structural MRI and the Framingham score (a composite measure of cardiovascular risk largely used in epidemiological studies in a sample of healthy elderly individuals. We aim to answer the following questions: Is it possible to decode (i.e., to learn information regarding cardiovascular risk from structural brain images enabling individual predictions? Among clinical measures comprising the Framingham score, are there particular risk factors that stand as more predictable from patterns of brain changes? Our main findings are threefold: i we verified that structural changes in spatially distributed patterns in the brain enable statistically significant prediction of Framingham scores. This result is still significant when controlling for the presence of the APOE 4 allele (an important genetic risk factor for both AD and cardiovascular disease. ii When considering each risk factor singly, we found different levels of correlation between real and predicted factors; however, single factors were not significantly predictable from brain images when considering APOE4 allele presence as covariate. iii We found important gender differences, and the possible causes of that finding are discussed.

  3. EFSA NDA Panel (EFSA Panel on Dietetic Products, Nutrition and Allergies), 2014. Scientific Opinion on the substantiation of a health claim related to “Lactobacillus plantarum TENSIA® in the semi-hard Edam-type „heart cheese‟ of Harmony™” and maintenance of normal blood pressure pursuant to Article

    DEFF Research Database (Denmark)

    Tetens, Inge

    on the scientific substantiation of a health claim related to “Lactobacillus plantarum TENSIA® in the semi-hard Edam-type “heart cheese” of Harmony™” and maintenance of normal blood pressure (BP). The food constituent L. plantarum TENSIA®, which is the subject of the health claim, is sufficiently characterised....... The Panel considers that the maintenance of normal blood pressure is a beneficial physiological effect. The applicant provided 47 references which did not address the effects of L. plantarum TENSIA® on BP. The Panel considers that no conclusions can be drawn from these references for the scientific...... with important methodological limitations showed a BP-lowering effect of L. plantarum TENSIA® consumed in the Edam-type “heart cheese” of Harmony™ when consumed daily for eight weeks, and that no evidence was provided for a mechanism by which L. plantarum TENSIA® in the Edam-type “heart cheese” of Harmony™ could...

  4. The development of pacing induced ventricular dysfunction is influenced by the underlying structural heart defect in children with congenital heart disease.

    Science.gov (United States)

    Balaji, Seshadri; Sreeram, Narayanswami

    Right ventricular pacing can cause pacing-induced ventricular dysfunction (PIVD) correctable with biventricular pacing (BiVP). Factors associated with PIVD are poorly understood. We reviewed children receiving epicardial dual-chamber pacemakers for complete heart block (CHB) after congenital heart disease (CHD) surgery. PIVD was defined as% fractional shortening hearts and underwent epicardial dual chamber pacemaker implantation. Nine of the 47 (19%) developed PIVD. PIVD occurred in 0/10 with ventricular septal defect (VSD), 0/6 with tetralogy of Fallot, 2/6 with double outlet right ventricle, 2/6 with transposition and VSD, 3/9 with atrioventricular canal defect, 1/2 with mitral valve replacement; 1/3 with congenitally corrected TGA repair; and 0/3 with atrioventricular canal plus tetralogy of Fallot and 0/1 with subaortic membrane. QRS duration (QRSD) was 84-170 (median 135ms) in the non PIVD group and 100-168 (median 124) ms in the PIVD group. Percentage fractional shortening (%FS) while paced was 16-46, median 30% in the non-PIVD group and 6-15 (median 11%) in the PIVD group.%FS post upgrade to BiVP (with an epicardial LV lead) in the 9 patients with PIVD was 23-33 (median 29%). PIVD occurred in certain CHD but not others. Prolonged QRSD was not associated with PIVD. The predilection for RV pacing to result in PIVD in certain types of CHD needs further study. Copyright © 2016. Published by Elsevier B.V.

  5. The relationship of diurnal variability and level of glycemia with structural and functional parameters of heart in patients with chronic heart failure and diabetes mellitus type 2

    Directory of Open Access Journals (Sweden)

    Виктор Денисович Сиволап

    2016-01-01

    Full Text Available An important contribution in the development of diabetes mellitus (DM complications makes not only the chronic hyperglycemia but also the intense diurnal glycemia variability (GV. The aim of research was to assess systolic and diastolic heart functions in patients with chronic heart failure (CHF of ischemic genesis on the background of DM type 2 depending on GV profile and the mean level of glycemia during the last 3 month.Methods: There were examined 65 patients who were divided into groups twice on the different categoric indicators. The first indicator – an intensity of glycemia profile (GP variability, the second – the mean calculated level of glucose concentration in patients during the last 3 month. All patients underwent dopplerechocardiography, the standard declination and the coefficient of GP variations were calculated. An assessment of reliability of the results of statistic study was carried out by nonparametric method.Results: in patients with the high GP variability was detected the reliably greater size of the left atrium, decrease of the left ventricle output fraction, tendency to the transition of diastolic dysfunction from the I type to the II one comparing with the group with low GP variability. There was not revealed any reliable difference between groups or correlative connection of the mean level of glycemia with parameters that characterize contractility and diastolic myocardium function.Conclusions: There was revealed the negative influence of the high glycemia variability on systolic and diastolic heart functions, left atrium size and there was not revealed any reliable influence of the mean level of glycemia on cardiohemodynamics

  6. Oral structure nonspeech motor control in normal, dysarthric, aphasic and apraxic speakers: isometric force and static position control.

    Science.gov (United States)

    McNeil, M R; Weismer, G; Adams, S; Mulligan, M

    1990-06-01

    This study investigated the isometric force and static position control of the upper lip, lower lip, tongue, jaw, and finger in four subject groups (normal control, apraxia of speech, conduction aphasia, and ataxic dysarthria) at two force and displacement levels. Results from both the force and position tasks suggested that the apraxic and dysarthric groups tended to produce significantly greater instability than the normal group, although the pattern of instability across articulators was not systematic within or across the force and position experiments for subjects within or between groups. The conduction aphasic group produced force and position stability that typically was not significantly different from any of the remaining three groups, suggesting that their force and position stability as indexed in the present study fell somewhere between that of the normal group and the apraxic and dysarthric groups. It is suggested that other analyses of force and position control, such as descriptive accounts of the trial-by-trial time histories, might shed additional light on the speech and orofacial sensorimotor control deficits in persons with apraxia, dysarthria, and conduction aphasia.

  7. Temsirolimus induced structural transition of cancerous renal cystatin to normal form in rats: In vitro mechanistic approach underlying renal cancer prevention.

    Science.gov (United States)

    Shamsi, Anas; Ahmed, Azaj; Bano, Bilqees

    2017-03-01

    Globally, renal cell carcinomas (RCCs) represent a major portion of patients suffering from cancer. Temsirolimus is an anti-renal cancer drug that has already been approved in poor-risk metastatic RCC (mRCC) patients. In our present study, we have evaluated the in vitro effect of varying concentrations of temsirolimus on cancerous rat kidney cystatin; renal cancer was induced in rats making use of dimethylnitrosamine (DMN). It has already been reported that cancerous rat kidney cystatin performs its activity in an efficacious manner as compared to normal rat kidney cystatin, so here an attempt was made to see the effect of temsirolimus on this increased activity of cystatin in renal cancers. Anti-papain activity assay was utilized to see this effect and it was found that temsirolimus reduces the increased activity of cancerous rat kidney cystatin similar to that of normal rat kidney cystatin. Further, to have an insight into temsirolimus induced structural alterations in cancerous rat kidney cystatin; various spectroscopic assays viz. UV, Fluorescence, Circular dichroism (CD) and FTIR spectroscopy were employed. UV and Fluorescence spectroscopy shows cancerous rat kidney cystatin transformation to normal form in the presence of temsirolimus. FTIR and CD spectroscopy confirmed the complete structural reversion of cancerous rat kidney cystatin to normal form in the presence of 40μM temsirolimus. Thus, it can said that temsirolimus causes renal cystatin to revert to normal form; the increased activity of renal cystatin observed in incidences of renal cancer is restored back to normal thereby halting the progression of renal cancer. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Heart Failure

    Science.gov (United States)

    Heart failure is a condition in which the heart can't pump enough blood to meet the body's needs. Heart failure does not mean that your heart has stopped ... and shortness of breath Common causes of heart failure are coronary artery disease, high blood pressure and ...

  9. The comparison of Educable and Normal Primary Students’ Parents Using Mental Health, Self-esteem and Psychological Well-being Structure in Yazd

    Directory of Open Access Journals (Sweden)

    Ali Jafari Nodoushan

    2013-01-01

    Full Text Available Introduction: Presence of mentally retarded children in every family affects on the structure and mental health of family specially parents. The purpose of this research is the comparison of the mean of psychological well-being, mental health and self-esteem between parents of normal and educable students. Materials & Methods: This was causal- comparative and retrospective study and the instruments were three questionnaire of self-esteem, public mental health GHQ and psychological well-being. Self-esteem questionnaire is including three scales of academic performance, social evaluation and external evaluation. The GHQ questionnaire is consisted of 28 items while psychological well-being questionnaire include 19 item for life satisfaction, 13 item for happiness and optimism, 8 item for growth and development, 8 item for positive relationship with others and 10 item for autonomy. The results were analysed by SPSS software. Results: This research showed that normal students parents have more psychological well-being than educable students’ parents, moreover two groups of educable and normal students parents are equal in mental health and self-esteem structure and there isn't significant difference between them. Conclusion: This research showed that psychological well-being in educable students’ parents is lower than normal students’ parents. Thus it is suggested that educational organization of exceptional children arrange courses for improving psychological well-being of educable students’ parents.

  10. Genetic structure, mating system, and long-distance gene flow in heart of palm (Euterpe edulis Mart.).

    Science.gov (United States)

    Gaiotto, F A; Grattapaglia, D; Vencovsky, R

    2003-01-01

    We report a detailed analysis of the population genetic structure, mating system, and gene flow of heart of palm (Euterpe edulis Mart.-Arecaceae) in central Brazil. This palm is considered a keystone species because it supplies fruits for birds and rodents all year and is intensively harvested for culinary purposes. Two populations of this palm tree were examined, using 18 microsatellite loci. The species displays a predominantly outcrossed mating system (tm = 0.94), with a probability of full sibship greater than 70% within open-pollinated families. The following estimates of interpopulation genetic variation were calculated and found significant: FIT = 0.17, FIS = 0.12, FST = 0.06, and RST = 0.07. This low but significant level of interpopulation genetic variation indicates high levels of gene flow. Two adult trees were identified as likely seed parents (P > 99.9%) of juveniles located at a distance of 22 km. Gene flow over such distances has not been reported before for tropical tree species. The establishment and management of in situ genetic reserves or ex situ conservation and breeding populations for E. edulis should contemplate the collection of several hundreds open-pollinated maternal families from relatively few distant populations to maximize the genetic sampling of a larger number of pollen parents.

  11. Formation of highly organized intracellular structure and energy metabolism in cardiac muscle cells during postnatal development of rat heart.

    Science.gov (United States)

    Anmann, Tiia; Varikmaa, Minna; Timohhina, Natalja; Tepp, Kersti; Shevchuk, Igor; Chekulayev, Vladimir; Saks, Valdur; Kaambre, Tuuli

    2014-08-01

    Adult cardiomyocytes have highly organized intracellular structure and energy metabolism whose formation during postnatal development is still largely unclear. Our previous results together with the data from the literature suggest that cytoskeletal proteins, particularly βII-tubulin, are involved in the formation of complexes between mitochondria and energy consumption sites. The aim of this study was to examine the arrangement of intracellular architecture parallel to the alterations in regulation of mitochondrial respiration in rat cardiomyocytes during postnatal development, from 1 day to 6 months. Respirometric measurements were performed to study the developmental alterations of mitochondrial function. Changes in the mitochondrial arrangement and cytoarchitecture of βII- and αIV-tubulin were examined by confocal microscopy. Our results show that functional maturation of oxidative phosphorylation in mitochondria is completed much earlier than efficient feedback regulation is established between mitochondria and ATPases via creatine kinase system. These changes are accompanied by significant remodeling of regular intermyofibrillar mitochondrial arrays aligned along the bundles of βII-tubulin. Additionally, we demonstrate that formation of regular arrangement of mitochondria is not sufficient per se to provide adult-like efficiency in metabolic feed-back regulation, but organized tubulin networks and reduction in mitochondrial outer membrane permeability for ADP are necessary as well. In conclusion, cardiomyocytes in rat heart become mature on the level of intracellular architecture and energy metabolism at the age of 3 months. Copyright © 2014 Elsevier B.V. All rights reserved.

  12. Structural and functional characteristics of rat hearts with and without myocardial infarct. Initial experience with doppler echocardiography

    Directory of Open Access Journals (Sweden)

    Valdir A. Moisés

    2000-08-01

    Full Text Available OBJECTIVE: To assess by Doppler echocardiography the structural and functional alterations of rat heart with surgical induced extensive myocardial infarction. METHODS: Five weeks after surgical ligature of the left coronary artery, 38 Wistar-EPM rats of both sexes, 10 of them with extensive infarction, undergone anatomical and functional evaluation by Doppler echocardiography and then euthanized for anatomopathological analysis. RESULTS: Echocardiography was 100% sensible and specific to anatomopathological confirmed extensive miocardial infarction. Extensive infarction lead to dilatation of left ventricle (diastolic diameter: 0.89cm vs.0.64cm; systolic: 0.72cm vs. 0.33cm and left atrium (0.55cm vs. 0.33cm; thinning of left ventricular anterior wall (systolic: 0.14cm vs. 0.23cm, diastolic: 0.11cm vs. 0.14cm; increased mitral E/ A wave relation (6.45 vs. 1.95. Signals of increased end diastolic ventricle pressure, B point in mitral valve tracing in 62.5% and signs of pulmonary hypertension straightening of pulmonary valve (90% and notching of pulmonary systolic flow (60% were observed in animals with extensive infarction. CONCLUSION: Doppler echocardiography has a high sensitivity and specificity for detection of chronic extensive infarction. Extensive infarction caused dilatation of left cardiac chambers and showed in Doppler signals of increased end diastolic left ventricular pressure and pulmonary artery pressure.

  13. Evaluation of a new Implicit Coupling Algorithm for the Partitioned Fluid-Structure Interaction Simulation of Bileaflet Mechanical Heart Valves

    Science.gov (United States)

    Annerel, Sebastiaan; Degroote, Joris; Claessens, Tom; Vierendeels, Jan

    2010-06-01

    We present a newly developed Fluid-Structure Interaction coupling algorithm to simulate Bileaflet Mechanical Heart Valves dynamics in a partitioned way. The coupling iterations between the flow solver and the leaflet motion solver are accelerated by using the Jacobian with the derivatives of the pressure and viscous moments acting on the leaflets with respect to the leaflet acceleration. This Jacobian is used in the leaflet motion solver when new positions of the leaflets are computed during the coupling iterations. The Jacobian is numerically derived from the flow solver by applying leaflet perturbations. Instead of calculating this Jacobian every time step, the Jacobian is extrapolated from previous time steps and a recalculation of the Jacobian is only done when needed. The efficiency of our new algorithm is subsequently compared to existing algorithms which use fixed relaxation and dynamic Aitken Δ2 relaxation in the coupling iterations when the new positions of the leaflets are computed. Results show that dynamic Aitken Δ2 relaxation outperforms fixed relaxation. Moreover, during the opening phase of the valve, our new algorithm needs fewer subiterations per time step to achieve convergence than the method with Aitken Δ2 relaxation. Thus, our newly developed FSI coupling scheme outperforms the existing coupling schemes.

  14. The comparison of Educable and Normal Primary Students’ Parents Using Mental Health, Self-esteem and Psychological Well-being Structure in Yazd

    OpenAIRE

    Ali Jafari Nodoushan; Naser Mohammadi Ahmadabad; Tayyebe Barfe; Reza Jafari Nodoushan

    2013-01-01

    Introduction: Presence of mentally retarded children in every family affects on the structure and mental health of family specially parents. The purpose of this research is the comparison of the mean of psychological well-being, mental health and self-esteem between parents of normal and educable students. Materials & Methods: This was causal- comparative and retrospective study and the instruments were three questionnaire of self-esteem, public mental health GHQ and psychological well-being....

  15. Effects of Type 2 Diabetes on Brain Structure and Cognitive Function: African American-Diabetes Heart Study MIND.

    Science.gov (United States)

    Whitlow, C T; Sink, K M; Divers, J; Smith, S C; Xu, J; Palmer, N D; Hugenschmidt, C E; Williamson, J D; Bowden, D W; Freedman, B I; Maldjian, J A

    2015-09-01

    Rates of type 2 diabetes are higher among African Americans compared with individuals of European ancestry. The purpose of this investigation was to determine the relationship between MR imaging measures of brain structure (volume of GM, WM, WM lesions) and cognitive function in a population of African Americans with type 2 diabetes. These MR imaging measures of brain structure are affected by type 2 diabetes-associated macrovascular and microvascular disease and may be associated with performance on tasks of cognitive function in the understudied African American population. African Americans with type 2 diabetes enrolled in the African American-Diabetes Heart Study MIND study (n = 263) were evaluated across a broad range of cognitive domains and imaged with brain MR imaging. Associations between cognitive parameters and MR imaging measures of whole-brain GM, WM, and WM lesion volumes were assessed by using adjusted multivariate models. Lower GM volume was associated with poorer performance on measures of general cognitive function, working memory, and executive function. Higher WM lesion volume was associated with poorer performance on a smaller subset of cognitive domains compared with GM volume but included aspects of working memory and executive function. There were no statistically significant associations with WM volume. Markers of cortical atrophy and WM lesion volume are associated with cognitive function in African Americans with type 2 diabetes. These associations are described in an African American cohort with disease control similar to that of individuals of European ancestry, rather than underserved African Americans with poor access to health care. Interventions to reduce cortical atrophy and WM disease may improve cognitive outcomes in this understudied population. © 2015 by American Journal of Neuroradiology.

  16. Heart Anatomy

    Science.gov (United States)

    ... kilometers), which is far enough to circle the earth more than twice! See also on other sites: ... For the Public Heart Information Center Project Heart Women’s Heart Health Clinical Trials 6770 Bertner Avenue Houston, ...

  17. Heart Transplant

    Science.gov (United States)

    ... your transplanted heart. You should also have routine medical checkups to maintain overall health. Activity Restrictions Heart transplant recipients have no specific activity restrictions. Discuss activity ideas with your ... to some medical and dental procedures to prevent endocarditis, most heart ...

  18. Human antibody recognition of xenogeneic antigens (NeuGc and Gal) on porcine heart valves: could genetically modified pig heart valves reduce structural valve deterioration?

    Science.gov (United States)

    Lee, Whayoung; Long, Cassandra; Ramsoondar, Jagdeece; Ayares, David; Cooper, David K C; Manji, Rizwan A; Hara, Hidetaka

    2016-09-01

    Glutaraldehyde-fixed bioprosthetic heart valves (GBHVs) derived from wild-type (WT, genetically unmodified) pigs are widely used clinically for heart valve replacement. There is evidence that their failure is related to an immune response. The use of valves from genetically engineered pigs that do not express specific pig antigens may prolong GBHV survival. Our aims were to determine (i) expression of Gal and NeuGc on heart (aortic and pulmonary) valves and pericardium of WT, α1,3-galactosyltransferase gene knockout (GTKO) and GTKO/N-glycolylneuraminic acid gene-knockout (GTKO/NeuGcKO) pigs in comparison with three different commercially available GBHVs and (ii) to determine human antibody binding to these tissues. Wild-type, GTKO/CD46, and GTKO/CD46/NeuGcKO pig valves and pericardium were tested (i) fresh and (ii) after fixation with glutaraldehyde (0.02%, 0.2%, 2%). Sections of GBHVs, fresh and fixed valves, and pericardium were stained for Gal and NeuGc expression, and for human IgM and IgG antibody binding. Gal and NeuGc expression was high on all GBHVs and WT pig valves/pericardium, but was absent after antigen-specific-knockout. There was no difference in antigen expression or antibody binding among WT aortic, pulmonary valves, and pericardium as well as GBHVs. Glutaraldehyde fixation did not alter expression of Gal or NeuGc. After incubation with human serum, human IgM and IgG bound to all GBHVs and WT pig valves/pericardium. Valves from GTKO/CD46 pigs and, particularly, GTKO/CD46/NeuGcKO pigs (with/without glutaraldehyde fixation) showed less IgM and IgG binding. Compared to WT pigs, GTKO/CD46/NeuGcKO pigs would be preferable sources of GBHVs, because the absence of Gal/NeuGc expression reduces human antibody binding. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Birkhoff normalization

    NARCIS (Netherlands)

    Broer, H.; Hoveijn, I.; Lunter, G.; Vegter, G.

    2003-01-01

    The Birkhoff normal form procedure is a widely used tool for approximating a Hamiltonian systems by a simpler one. This chapter starts out with an introduction to Hamiltonian mechanics, followed by an explanation of the Birkhoff normal form procedure. Finally we discuss several algorithms for

  20. Mapping of treatment-induced apoptosis in normal structures: {sup 99m}Tc-Hynic-rh-annexin V SPECT and CT image fusion

    Energy Technology Data Exchange (ETDEWEB)

    Kartachova, Marina S.; Valdes Olmos, Renato A. [The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Department of Nuclear Medicine, CX Amsterdam (Netherlands); Haas, Rick L.M.; Hoebers, Frank J.P.; Herk, Marcel van; Verheij, Marcel [The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Department of Radiotherapy, Amsterdam (Netherlands); Brekel, Michiel W. van den [The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Department of Head and Neck Oncology and Surgery, Amsterdam (Netherlands); Zandwijk, Nico van [The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Department of Thoracic Oncology, Amsterdam (Netherlands)

    2006-08-15

    The purpose of this study was to map treatment-induced {sup 99m}Tc-Hynic-rh-annexin V uptake in normal tissues using co-registration of SPECT and CT. Nineteen patients (11 male, 8 female, mean age 57 years) with various malignant tumours (12 lymphomas, four non-small cell lung cancers and three head and neck squamous cell carcinomas) underwent {sup 99m}Tc-Hynic-rh-annexin V scintigraphy and CT before and within 48 h after the start of anticancer therapy. SPECT and CT were performed separately, with the patient in a reproducible position. Volume-based automated and manual methods were used to match functional and anatomical data. SPECT/CT co-registration was used to evaluate treatment-induced changes in the normal structures. A significant radiation field-related increase in early post-treatment {sup 99m}Tc-Hynic-rh-annexin V uptake in salivary glands and bone marrow was detected in eight of nine patients. Radiation field-related increase in bone marrow activity above the baseline value was detected in all 13 irradiated patients. A minimal, symmetrical increase in activity in the salivary glands was detected after the initial course of platinum-based chemotherapy, and a diffuse prominent increase in {sup 99m}Tc-Hynic-rh-annexin V in the bone marrow was detected in all cases. Precise delineation between the tumour and normal tissue tracer accumulation was accomplished in all cases using SPECT/CT co-registered volumes, enhanced by the ''colourwash'' technique. Mapping of early treatment-related changes in annexin V uptake by SPECT/CT co-registration permits accurate evaluation of tracer distribution in normal structures and precise delineation from tumour uptake. The associations between tracer distribution in the normal tissues and treatment regimen found in this study may contribute to the evaluation of dose-effect relations in various treatment schedules. (orig.)

  1. Combined heart-kidney transplantation after total artificial heart insertion.

    Science.gov (United States)

    Ruzza, A; Czer, L S C; Ihnken, K A; Sasevich, M; Trento, A; Ramzy, D; Esmailian, F; Moriguchi, J; Kobashigawa, J; Arabia, F

    2015-01-01

    We present the first single-center report of 2 consecutive cases of combined heart and kidney transplantation after insertion of a total artificial heart (TAH). Both patients had advanced heart failure and developed dialysis-dependent renal failure after implantation of the TAH. The 2 patients underwent successful heart and kidney transplantation, with restoration of normal heart and kidney function. On the basis of this limited experience, we consider TAH a safe and feasible option for bridging carefully selected patients with heart and kidney failure to combined heart and kidney transplantation. Recent FDA approval of the Freedom driver may allow outpatient management at substantial cost savings. The TAH, by virtue of its capability of providing pulsatile flow at 6 to 10 L/min, may be the mechanical circulatory support device most likely to recover patients with marginal renal function and advanced heart failure. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Structural Model of psychological risk and protective factors affecting on quality of life in patients with coronary heart disease: A psychocardiology model

    Science.gov (United States)

    Nekouei, Zohreh Khayyam; Yousefy, Alireza; Doost, Hamid Taher Neshat; Manshaee, Gholamreza; Sadeghei, Masoumeh

    2014-01-01

    Background: Conducted researches show that psychological factors may have a very important role in the etiology, continuity and consequences of coronary heart diseases. This study has drawn the psychological risk and protective factors and their effects in patients with coronary heart diseases (CHD) in a structural model. It aims to determine the structural relations between psychological risk and protective factors with quality of life in patients with coronary heart disease. Materials and Methods: The present cross-sectional and correlational studies were conducted using structural equation modeling. The study sample included 398 patients of coronary heart disease in the university referral Hospital, as well as other city health care centers in Isfahan city. They were selected based on random sampling method. Then, in case, they were executed the following questionnaires: Coping with stressful situations (CISS- 21), life orientation (LOT-10), general self-efficacy (GSE-10), depression, anxiety and stress (DASS-21), perceived stress (PSS-14), multidimensional social support (MSPSS-12), alexithymia (TAS-20), spiritual intelligence (SQ-23) and quality of life (WHOQOL-26). Results: The results showed that protective and risk factors could affect the quality of life in patients with CHD with factor loadings of 0.35 and −0.60, respectively. Moreover, based on the values of the framework of the model such as relative chi-square (CMIN/DF = 3.25), the Comparative Fit Index (CFI = 0.93), the Parsimony Comparative Fit Index (PCFI = 0.68), the Root Mean Square Error of Approximation (RMSEA = 0.07) and details of the model (significance of the relationships) it has been confirmed that the psychocardiological structural model of the study is the good fitting model. Conclusion: This study was among the first to research the different psychological risk and protective factors of coronary heart diseases in the form of a structural model. The results of this study have

  3. Structural Model of psychological risk and protective factors affecting on quality of life in patients with coronary heart disease: A psychocardiology model

    Directory of Open Access Journals (Sweden)

    Zohreh Khayyam Nekouei

    2014-01-01

    Full Text Available Background: Conducted researches show that psychological factors may have a very important role in the etiology, continuity and consequences of coronary heart diseases. This study has drawn the psychological risk and protective factors and their effects in patients with coronary heart diseases (CHD in a structural model. It aims to determine the structural relations between psychological risk and protective factors with quality of life in patients with coronary heart disease. Materials and Methods: The present cross-sectional and correlational studies were conducted using structural equation modeling. The study sample included 398 patients of coronary heart disease in the university referral Hospital, as well as other city health care centers in Isfahan city. They were selected based on random sampling method. Then, in case, they were executed the following questionnaires: Coping with stressful situations (CISS- 21, life orientation (LOT-10, general self-efficacy (GSE-10, depression, anxiety and stress (DASS-21, perceived stress (PSS-14, multidimensional social support (MSPSS-12, alexithymia (TAS-20, spiritual intelligence (SQ-23 and quality of life (WHOQOL-26. Results: The results showed that protective and risk factors could affect the quality of life in patients with CHD with factor loadings of 0.35 and −0.60, respectively. Moreover, based on the values of the framework of the model such as relative chi-square (CMIN/DF = 3.25, the Comparative Fit Index (CFI = 0.93, the Parsimony Comparative Fit Index (PCFI = 0.68, the Root Mean Square Error of Approximation (RMSEA = 0.07 and details of the model (significance of the relationships it has been confirmed that the psychocardiological structural model of the study is the good fitting model. Conclusion: This study was among the first to research the different psychological risk and protective factors of coronary heart diseases in the form of a structural model. The results of this study have

  4. [Computer tomographic differentiation of lymph nodes in the retroperitoneum and lower mediastinum, with special reference to normal anatomic structures].

    Science.gov (United States)

    König, R; van Kaick, G

    1982-12-01

    Ct assessment of the lymphatic system in the area of the retroperitoneum and the lower mediastinum had so far been limited to pathologically enlarged lymphatic nodes of more than 2 cm diameter. Improvements in apparatus construction and increased clinical experience have made it possible to include lymphatic nodes of smaller size, although it is often difficult to distinguish them clearly from the other formations in those regions. The following article deals with the structures recognisable via CT, such as arteries, veins, lymphatic chains and crura of the diaphragm, systematically and by means of relevant illustrations. The possibilities of identifying these structures by means of a suitable examination technique are discussed.

  5. Inhibition of HER-2(neu/ErbB2) restores normal function and structure to polycystic kidney disease (PKD) epithelia.

    Science.gov (United States)

    Wilson, Samantha J; Amsler, Kurt; Hyink, Deborah P; Li, Xiaohong; Lu, Weining; Zhou, Jing; Burrow, Christopher R; Wilson, Patricia D

    2006-07-01

    Autosomal Dominant Polycystic Kidney Disease (ADPKD) is a very common lethal monogenetic disease with significant morbidities and a high likelihood of progression to renal failure for which there is no proven disease-specific therapy currently available for clinical use. Human ADPKD cystic epithelia have proliferative abnormalities mediated by EGFR over-expression and mispolarization leading autocrine response to EGF family ligands. We now show that apical localization of EGFR complexes in normal fetal and ADPKD epithelia is associated with heterodimerization of EGFR(HER-1) with HER-2(neu/ErbB2), while basal membrane localization in normal adult renal epithelia is associated with EGFR(HER-1) homodimers. Since ADPKD epithelial cells have reduced migratory function, this was used as a bioassay to evaluate the ability of compounds to rescue the aberrant human ADPKD phenotype. General tyrosine kinase inhibition by herbimycin and specific inhibition of HER-2(neu/ErbB2) by AG825 or pretreatment with ErbB2 siRNA reversed the migration defect of ADPKD epithelia. Selective inhibition of EGFR(HER-1) showed partial rescue. Increased ADPKD cell migration after inhibition of p38MAP kinase but not of PI3-kinase implicated p38MAPK downstream of HER-2(neu/ErbB2) stimulation. Daily administration of AG825 to PKD1 null heterozygous mice significantly inhibited the development of renal cysts. These studies implicate HER2(neu/ErbB2) as an effector of apical EGFR complex mispolarization and that its inhibition should be considered a candidate for clinical therapy of ADPKD.

  6. Acute heart failure syndrome

    African Journals Online (AJOL)

    Heart failure can be defined as a clinical syndrome in which a structural or functional cardiac abnormality impairs the capacity of the ventricle to fill or eject enough blood for the requirements of the body. Acute heart failure syndrome represents a complex, heterogeneous set of clinical conditions, all with the common.

  7. Hyperthyroidism and the Heart.

    Science.gov (United States)

    Osuna, Patricia Mejia; Udovcic, Maja; Sharma, Morali D

    2017-01-01

    Thyroid hormones have a significant impact on cardiac function and structure. Excess thyroid hormone affects cardiovascular hemodynamics, leading to high-output heart failure and, in late stages, dilated cardiomyopathy. In this review, we discuss how hyperthyroidism affects cardiovascular pathophysiology and molecular mechanisms and examine the complications caused by excess thyroid hormone, such as heart failure and atrial fibrillation.

  8. Insuficiência cardíaca com fração de ejeção normal: novos critérios diagnósticos e avanços fisiopatológicos Insuficiencia cardiaca con fracción de eyección normal: nuevos criterios diagnósticos y avances fisiopatológicos Heart failure with normal ejection fraction: new diagnostic criteria and pathophysiological advances

    Directory of Open Access Journals (Sweden)

    Evandro Tinoco Mesquita

    2009-08-01

    ñales de IC presentan FE normal (mayor que el 50%. La gran dificultad de los médicos estaría en la identificación de esos pacientes que presentan insuficiencia cardiaca con fracción de eyección normal (ICFEN. Esta dificultad parece estar relacionada principalmente a alta complejidad del síndrome y la falta de un método estándar para que se confirme o excluya el diagnóstico que pudiera utilizarse rutinariamente en la práctica clínica. Diferentemente de la insuficiencia cardiaca con fracción de eyección reducida (ICFER, en la que un único parámetro - la FE menor que el 50%- confirma el diagnóstico del síndrome, en la ICFEN diferentes índices diastólicos se han empleado para que se caracterice la presencia o no de la disfunción diastólica (DD. Esta revisión tiene el propósito de revelar nuevos conceptos relacionados a la función diastólica que auxiliarán la comprensión de la fisiopatología cardiovascular presente en la ICFEN. El presente trabajo tiene también por objeto que se discuta la nueva directriz de la Sociedad Europea de Cardiología para el diagnóstico y exclusión de la ICFEN, basada en los índices de función cardiaca obtenidos por el ecocardiograma con Doppler tisular (EDT y en la dosificación del péptido natriurético.Heart failure (HF is a highly prevalent complex cardiovascular syndrome, and its clinical presentation is usually associated with ventricular dilatation, decreased contractility and reduced left ventricular ejection fraction (EF. However, in the past two decades studies have demonstrated that many patients with signs and symptoms of HF have normal EF (higher than 50%. The great challenge for doctors lies in the identification of patients presenting heart failure with normal ejection fraction (HFNEF and this challenge seems to be mainly related to the high complexity of the syndrome and to the lack of a standardized method to confirm or exclude the diagnosis that could be used in the daily clinical practice. Unlike in

  9. Fylla Bank: structure and evolution of a normal-to-shear rifted margin in the northern Labrador Sea

    DEFF Research Database (Denmark)

    Døssing, Arne

    2011-01-01

    of the Moho topography and crustal thickness which were compiled from results of pseudo‐3‐D gravity modelling. The maps show minimum crustal thicknesses (11 km) and maximum Moho uplifts in areas where the NNW‐/NW‐ and NNE‐striking structures interact. Moreover, a strong correlation is found between Moho...

  10. iPhone 4s photoplethysmography: which light color yields the most accurate heart rate and normalized pulse volume using the iPhysioMeter Application in the presence of motion artifact?

    Directory of Open Access Journals (Sweden)

    Kenta Matsumura

    Full Text Available Recent progress in information and communication technologies has made it possible to measure heart rate (HR and normalized pulse volume (NPV, which are important physiological indices, using only a smartphone. This has been achieved with reflection mode photoplethysmography (PPG, by using a smartphone's embedded flash as a light source and the camera as a light sensor. Despite its widespread use, the method of PPG is susceptible to motion artifacts as physical displacements influence photon propagation phenomena and, thereby, the effective optical path length. Further, it is known that the wavelength of light used for PPG influences the photon penetration depth and we therefore hypothesized that influences of motion artifact could be wavelength-dependant. To test this hypothesis, we made measurements in 12 healthy volunteers of HR and NPV derived from reflection mode plethysmograms recorded simultaneously at three different spectral regions (red, green and blue at the same physical location with a smartphone. We then assessed the accuracy of the HR and NPV measurements under the influence of motion artifacts. The analyses revealed that the accuracy of HR was acceptably high with all three wavelengths (all rs > 0.996, fixed biases: -0.12 to 0.10 beats per minute, proportional biases: r =  -0.29 to 0.03, but that of NPV was the best with green light (r = 0.791, fixed biases: -0.01 arbitrary units, proportional bias: r = 0.11. Moreover, the signal-to-noise ratio obtained with green and blue light PPG was higher than that of red light PPG. These findings suggest that green is the most suitable color for measuring HR and NPV from the reflection mode photoplethysmogram under motion artifact conditions. We conclude that the use of green light PPG could be of particular benefit in ambulatory monitoring where motion artifacts are a significant issue.

  11. Effect of Coarse Aggregate and Slag Type on the Mechanical Behavior of High and Normal Weight Concrete Used at Barrage Structure

    Directory of Open Access Journals (Sweden)

    Muhammad Sanaullah

    2017-04-01

    Full Text Available Present study is an effort to assess the composite effect of limestone aggregate and blast furnace slag on the mechanical characteristics of normal and high weight concrete at various structural units (barrage girders, main weir and block apron of New Khanki Barrage Project, Punjab. Mix designs for different concrete classes falling under the domain of high and normal weight concrete were prepared after aggregate quality testing. On attaining satisfactory results of quality testing nine concrete mixes were designed (three for each class: A1, A and B by absolute volume method (ACI- 211.1. The required compressive strength of normal and high strength was set at 6200, 5200 and 4200 Psi for the concrete types A1, A and B respectively after 28 days (ACI -318. For compressive strength assessment, a total 27 concrete cylinders were casted (9-cylinders for each mix and were water cured. The achieved average UCS of cylinder concrete specimens at 3, 7 and 28 days are 5170, 6338 and 7320 Psi for A1 – type, 3210, 4187 and 5602 Psi for A-type and 2650, 3360 and 4408 Psi for B- type mix. It has been found that all concrete mixes for suggested classes attained target strength at age of 7-days. The coarse aggregate (Margala Hill limestone and fine aggregates (from Lawrancepur /Qibla Bandi quarries used in all concrete mix designs have demonstrated a sound mechanical suitability for high and normal weight concrete.

  12. Production of an in Vitro Low-Digestible Starch via Hydrothermal Treatment of Amylosucrase-Modified Normal and Waxy Rice Starches and Its Structural Properties.

    Science.gov (United States)

    Kim, Ji Hyung; Kim, Ha Ram; Choi, Seung Jun; Park, Cheon-Seok; Moon, Tae Wha

    2016-06-22

    We investigated dual modification of normal and waxy rice starch, focusing on digestibility. Amylosucrase (AS) was applied to maximize the slowly digestible and resistant starch fractions. AS-modified starches were adjusted to 25-40% moisture levels and heated at 100 °C for 40 min. AS-modified starches exhibited a B-type crystalline structure, and hydrothermal treatment (HTT) significantly (p modified starches were also affected by the moisture level. The contents of rapidly digestible starch fraction in AS-modified normal and waxy starches (43.3 ± 3.9 and 18.1 ± 0.6%) decreased to 13.0 ± 1.0 and 0.3 ± 0.3% after HTT, accordingly increasing the low digestible fractions. Although the strengthened crystalline structures of AS-modified starches by HTT were not stable enough to maintain their rigidity under cooking, application of AS and HTT was more effective in waxy rice starch than normal rice starch when lowering digestibility.

  13. Fast nonclinical ventricular tachycardia inducible after ablation in patients with structural heart disease: Definition and clinical implications.

    Science.gov (United States)

    Watanabe, Masaya; de Riva, Marta; Piers, Sebastiaan R D; Dekkers, Olaf M; Ebert, Micaela; Venlet, Jeroen; Trines, Serge A; Schalij, Martin J; Pijnappels, Daniël A; Zeppenfeld, Katja

    2018-01-08

    Noninducibility of ventricular tachycardia (VT) with an equal or longer cycle length (CL) than the clinical VT is considered the minimum ablation endpoint in patients with structural heart disease (SHD). Since their clinical relevance remains unclear, fast nonclinical VTs are often not targeted. However, an accepted definition for fast VT is lacking. The shortest possible CL of a monomorphic reentrant VT is determined by the ventricular refractory period (VRP). We propose a patient-specific definition for fast VT based on the individual VRP (fVTVRP) and assess the prognostic significance of persistent inducibility after ablation of fVTVRP for VT recurrence. Out of 191 patients with prior myocardial infarction or with nonischemic cardiomyopathy undergoing VT ablation, 70 (63±13 years, 64% ischemic) remained inducible for a nonclinical VT and comprised the study population. A fVTVRP was defined as any VT with CL ≤VRP400 +30ms. Patients were followed for VT recurrence. After ablation, 30 patients (43%) remained inducible exclusively for fVTVRP and 40 (57%) for any slower VT. Patients with only fVTVRP had a 3-year VT free-survival of 64% (CI95%:46-82%) compared to 27% (CI95%:14-48%) for patients with any slower remaining VT (P=0.013). Inducibility of only fVTVRP was independently associated with lower VT recurrence (HR:0.38, CI95%:0.19-0.86; P=0.019). Within 36 patients inducible for any fVTVRP, only one recurred with a fVTVRP. In patients with SHD, inducibility of exclusively fVTVRP after ablation is associated with low VT recurrence. Copyright © 2018. Published by Elsevier Inc.

  14. Effect of diurnal photosynthetic activity on the fine structure of amylopectin from normal and waxy barley starch

    DEFF Research Database (Denmark)

    Goldstein, Avi; Annor, George; Blennow, Andreas

    2017-01-01

    , respectively. Regardless of lighting conditions, no structural effects were found when comparing both the amylopectin side-chain distribution and the internal chain fragments of these amylopectins. However, the diurnally grown NBS and WBS both showed larger amylopectin clusters and these had lower branching...... growing conditions. The amylopectin fine structures were analysed by characterizing its unit chain length profiles after enzymatic debranching as well as its φ,β-limit dextrins and its clusters and building blocks after their partial and complete hydrolysis with α-amylase from Bacillus amyloliquefaciens...... density and longer average chain lengths than clusters derived from plants grown under constant light conditions. Amylopectin clusters from diurnally grown plants also consisted of a greater number of building blocks, and shorter inter-block chain lengths compared to clusters derived from plants grown...

  15. Single-subject independent component analysis-based intensity normalization in non-quantitative multi-modal structural MRI.

    Science.gov (United States)

    Papazoglou, Sebastian; Würfel, Jens; Paul, Friedemann; Brandt, Alexander U; Scheel, Michael

    2017-04-22

    Non-quantitative MRI is prone to intersubject intensity variation rendering signal intensity level based analyses limited. Here, we propose a method that fuses non-quantitative routine T1-weighted (T1w), T2w, and T2w fluid-saturated inversion recovery sequences using independent component analysis and validate it on age and sex matched healthy controls. The proposed method leads to consistent and independent components with a significantly reduced coefficient-of-variation across subjects, suggesting potential to serve as automatic intensity normalization and thus to enhance the power of intensity based statistical analyses. To exemplify this, we show that voxelwise statistical testing on single-subject independent components reveals in particular a widespread sex difference in white matter, which was previously shown using, for example, diffusion tensor imaging but unobservable in the native MRI contrasts. In conclusion, our study shows that single-subject independent component analysis can be applied to routine sequences, thereby enhancing comparability in-between subjects. Unlike quantitative MRI, which requires specific sequences during acquisition, our method is applicable to existing MRI data. Hum Brain Mapp, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  16. Construction of a trophically complex near-shore Antarctic food web model using the Conservative Normal framework with structural coexistence

    Science.gov (United States)

    Bates, Michael L.; Bengtson Nash, Susan M.; Hawker, Darryl W.; Norbury, John; Stark, Jonny S.; Cropp, Roger A.

    2015-05-01

    The analysis of trophically complex mathematical ecosystem models is typically carried out using numerical techniques because it is considered that the number and nonlinear nature of the equations involved makes progress using analytic techniques virtually impossible. Exploiting the properties of systems that are written in Kolmogorov form, the conservative normal (CN) framework articulates a number of ecological axioms that govern ecosystems. Previous work has shown that trophically simple models developed within the CN framework are mathematically tractable, simplifying analysis. By exploiting the properties of Kolmogorov ecological systems it is possible to design particular properties, such as the property that all populations remain extant, into an ecological model. Here we demonstrate the usefulness of these results to construct a trophically complex ecosystem model. We also show that the properties of Kolmogorov ecological systems can be exploited to provide a computationally efficient method for the refinement of model parameters which can be used to precondition parameter values used in standard optimisation techniques, such as genetic algorithms, to significantly improve convergence towards a target equilibrium state.

  17. Cellulose structure and lignin distribution in normal and compression wood of the Maidenhair tree (Ginkgo biloba L.).

    Science.gov (United States)

    Andersson, Seppo; Wang, Yurong; Pönni, Raili; Hänninen, Tuomas; Mononen, Marko; Ren, Haiqing; Serimaa, Ritva; Saranpää, Pekka

    2015-04-01

    We studied in detail the mean microfibril angle and the width of cellulose crystals from the pith to the bark of a 15-year-old Maidenhair tree (Ginkgo biloba L.). The orientation of cellulose microfibrils with respect to the cell axis and the width and length of cellulose crystallites were determined using X-ray diffraction. Raman microscopy was used to compare the lignin distribution in the cell wall of normal/opposite and compression wood, which was found near the pith. Ginkgo biloba showed a relatively large mean microfibril angle, varying between 19° and 39° in the S2 layer, and the average width of cellulose crystallites was 3.1-3.2 nm. Mild compression wood without any intercellular spaces or helical cavities was observed near the pith. Slit-like bordered pit openings and a heavily lignified S2L layer confirmed the presence of compression wood. Ginkgo biloba showed typical features present in the juvenile wood of conifers. The microfibril angle remained large over the 14 annual rings. The entire stem disc, with a diameter of 18 cm, was considered to consist of juvenile wood. The properties of juvenile and compression wood as well as the cellulose orientation and crystalline width indicate that the wood formation of G. biloba is similar to that of modern conifers. © 2015 Institute of Botany, Chinese Academy of Sciences.

  18. Heart Diseases

    Science.gov (United States)

    ... you're like most people, you think that heart disease is a problem for others. But heart disease is the number one killer in the ... of disability. There are many different forms of heart disease. The most common cause of heart disease ...

  19. Heart Transplantation

    Science.gov (United States)

    A heart transplant removes a damaged or diseased heart and replaces it with a healthy one. The healthy heart comes from a donor who has died. It is the last resort for people with heart failure when all other treatments have failed. The ...

  20. Heart Attack

    Science.gov (United States)

    Each year almost 800,000 Americans have a heart attack. A heart attack happens when blood flow to the heart suddenly ... it's important to know the symptoms of a heart attack and call 9-1-1 if you or ...

  1. Factor Structure, Validity, Reliability and Normalization of the Adult Attention Deficit/Hyperactivity Disorder Scale in Iranian Sample

    Directory of Open Access Journals (Sweden)

    Nafiseh Tabatabaei

    2016-08-01

    Full Text Available Background and Objectives: Researches on attention deficit and hyperactivity disorder indicated that this common disorder would not be resolved with age and continues into adulthood. This study was carried out with the objective of validation and normalization of diagnostic scale of adult attention deficit/hyperactivity disorder scale in Iranian sample. Methods: This study was performed as a psychometric study on the patients (1400 to 1600 cases referred to two psychiatry and neurology clinics in Tehran in the autumn and winter of 2014. Among these patients, 301 persons were selected by purposeful non-random sampling according to the sample size formula based on ratio or two-value variable (patient and non-patient and related questionnaire was administered to them. Cronbach's alpha, Spearman- Brown, and Guttmann’s coefficients was used to evaluate concurrent validity and reliability and exploratory and confirmatory factor analysis in order to assess the construct validity. Results: In this study, Cronbach's alpha of the total scale was 0.88 and for the subscales of inattention, hyperactivity, and impulsivity were 0.82, 0.72, 0.67, respectively. The correlation coefficients between the mentioned scale and adult attention deficit/hyperactivity questionnaire (Wender Utah was obtained 0.59, and between the subscales and the Wender Utah questionnaire, were 0.56, 0.49, and 0.40, respectively, which all three were significant (p<0/01. Confirmatory factor analysis results showed that this scale has three factors and two goodness-of-fit indices. Conclusion: The results of this study revealed that specialists can diagnose and treat the patients using this diagnostic scale.

  2. The influence of molecular structure and aerosol phase on the heterogeneous oxidation of normal and branched alkanes by OH.

    Science.gov (United States)

    Ruehl, Christopher R; Nah, Theodora; Isaacman, Gabriel; Worton, David R; Chan, Arthur W H; Kolesar, Katheryn R; Cappa, Christopher D; Goldstein, Allen H; Wilson, Kevin R

    2013-05-16

    Insights into the influence of molecular structure and thermodynamic phase on the chemical mechanisms of hydroxyl radical-initiated heterogeneous oxidation are obtained by identifying reaction products of submicrometer particles composed of either n-octacosane (C28H58, a linear alkane) or squalane (C30H62, a highly branched alkane) and OH. A common pattern is observed in the positional isomers of octacosanone and octacosanol, with functionalization enhanced toward the end of the molecule. This suggests that relatively large linear alkanes are structured in submicrometer particles such that their ends are oriented toward the surface. For squalane, positional isomers of first-generation ketones and alcohols also form in distinct patterns. Ketones are favored on carbons adjacent to tertiary carbons, while hydroxyl groups are primarily found on tertiary carbons but also tend to form toward the end of the molecule. Some first-generation products, viz., hydroxycarbonyls and diols, contain two oxygen atoms. These results suggest that alkoxy radicals are important intermediates and undergo both intramolecular (isomerization) and intermolecular (chain propagation) hydrogen abstraction reactions. Oxidation products with carbon number less than the parent alkane's are observed to a much greater extent for squalane than for n-octacosane oxidation and can be explained by the preferential cleavage of bonds involving tertiary carbons.

  3. Identification of high-permeability subsurface structures with multiple point geostatistics and normal score ensemble Kalman filter

    Science.gov (United States)

    Zovi, Francesco; Camporese, Matteo; Hendricks Franssen, Harrie-Jan; Huisman, Johan Alexander; Salandin, Paolo

    2017-05-01

    Alluvial aquifers are often characterized by the presence of braided high-permeable paleo-riverbeds, which constitute an interconnected preferential flow network whose localization is of fundamental importance to predict flow and transport dynamics. Classic geostatistical approaches based on two-point correlation (i.e., the variogram) cannot describe such particular shapes. In contrast, multiple point geostatistics can describe almost any kind of shape using the empirical probability distribution derived from a training image. However, even with a correct training image the exact positions of the channels are uncertain. State information like groundwater levels can constrain the channel positions using inverse modeling or data assimilation, but the method should be able to handle non-Gaussianity of the parameter distribution. Here the normal score ensemble Kalman filter (NS-EnKF) was chosen as the inverse conditioning algorithm to tackle this issue. Multiple point geostatistics and NS-EnKF have already been tested in synthetic examples, but in this study they are used for the first time in a real-world case study. The test site is an alluvial unconfined aquifer in northeastern Italy with an extension of approximately 3 km2. A satellite training image showing the braid shapes of the nearby river and electrical resistivity tomography (ERT) images were used as conditioning data to provide information on channel shape, size, and position. Measured groundwater levels were assimilated with the NS-EnKF to update the spatially distributed groundwater parameters (hydraulic conductivity and storage coefficients). Results from the study show that the inversion based on multiple point geostatistics does not outperform the one with a multiGaussian model and that the information from the ERT images did not improve site characterization. These results were further evaluated with a synthetic study that mimics the experimental site. The synthetic results showed that only for a much

  4. Linear dimensions of normal upper airway structure by magnetic resonance imaging in Chinese Han infants and preschool children.

    Science.gov (United States)

    Yi, Xiaoli; Yao, Linyin; Yuan, Xinyu; Wei, Yongxiang; Wang, Zhenchang

    2017-09-01

    To establish normative data of upper airway structure in Chinese Han infants and preschool children. Magnetic resonance imaging (MRI) scans of 521 Chinese Han infants and preschool children (225 girls, 296 boys) aged from 1 day to 72 months were selected from the children who underwent head MRI at the Capital Institute of Pediatrics Affiliated Children Hospital, Beijing, China. No subjects had sleep-disordered breathing or associated conditions that may have affected the upper airway anatomy. The upper airway dimensions and surrounding soft tissue sizes were measured along the mid-sagittal and axial images. On images from the mid-sagittal image, the normative values of the following were obtained for all age group: thickness of the adenoid and nasopharyngeal area, length and thickness of the soft palate, length and height of the tongue, length of upper airway, distance between the mental spine and clivus, and the adenoid oblique width, soft palate oblique width, and tongue oblique width along the mental spine-clivus line. Normative values of the mean tonsillar width and intertonsillar space on the axial images were also obtained. There were no differences in any measurements between boys and girls in either infants or preschool children. Older children had larger airway dimensions, as expected. Normative values for upper airway structure in Chinese Han infants and preschool children assessed by MRI were established. The upper airway dimension and surrounding soft tissues size, including soft palate, adenoid, tongue, and tonsils, were increased with age. There were no gender differences during the first six years of life. These data may prove useful when studying airway disease in Chinese Han children. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Partial IGF-1 deficiency is sufficient to reduce heart contractibility, angiotensin II sensibility, and alter gene expression of structural and functional cardiac proteins.

    Directory of Open Access Journals (Sweden)

    José Luis González-Guerra

    Full Text Available Circulating levels of IGF-1 may decrease under several circumstances like ageing, metabolic syndrome, and advanced cirrhosis. This reduction is associated with insulin resistance, dyslipidemia, progression to type 2 diabetes, and increased risk for cardiovascular diseases. However, underlying mechanisms between IGF-1 deficiency and cardiovascular disease remain elusive. The specific aim of the present work was to study whether the partial IGF-1 deficiency influences heart and/or coronary circulation, comparing vasoactive factors before and after of ischemia-reperfusion (I/R. In addition, histology of the heart was performed together with cardiac gene expression for proteins involved in structure and function (extracellular matrix, contractile proteins, active peptides; carried out using microarrays, followed by RT-qPCR confirmation of the three experimental groups. IGF-1 partial deficiency is associated to a reduction in contractility and angiotensin II sensitivity, interstitial fibrosis as well as altered expression pattern of genes involved in extracellular matrix proteins, calcium dynamics, and cardiac structure and function. Although this work is descriptive, it provides a clear insight of the impact that partial IGF-1 deficiency on the heart and establishes this experimental model as suitable for studying cardiac disease mechanisms and exploring therapeutic options for patients under IGF-1 deficiency conditions.

  6. Infinitary normalization

    NARCIS (Netherlands)

    J.W. Klop (Jan Willem); R. de Vrijer

    2005-01-01

    textabstractIn infinitary orthogonal first-order term rewriting the properties confluence (CR), Uniqueness of Normal forms (UN), Parallel Moves Lemma (PML) have been generalized to their infinitary versions CR-inf, UN-inf, PML-inf, and so on. Several relations between these properties have been

  7. Late Results of Cox Maze III Procedure in Patients with Atrial Fibrillation Associated with Structural Heart Disease.

    Science.gov (United States)

    Gomes, Gustavo Gir; Gali, Wagner Luis; Sarabanda, Alvaro Valentim Lima; Cunha, Claudio Ribeiro da; Kessler, Iruena Moraes; Atik, Fernando Antibas

    2017-07-01

    Cox-Maze III procedure is one of the surgical techniques used in the surgical treatment of atrial fibrillation (AF). To determine late results of Cox-Maze III in terms of maintenance of sinus rhythm, and mortality and stroke rates. Between January 2006 and January 2013, 93 patients were submitted to the cut-and-sew Cox-Maze III procedure in combination with structural heart disease repair. Heart rhythm was determined by 24-hour Holter monitoring. Procedural success rates were determined by longitudinal methods and recurrence predictors by multivariate Cox regression models. Thirteen patients that obtained hospital discharge alive were excluded due to lost follow-up. The remaining 80 patients were aged 49.9 ± 12 years and 47 (58.7%) of them were female. Involvement of mitral valve and rheumatic heart disease were found in 67 (83.7%) and 63 (78.7%) patients, respectively. Seventy patients (87.5%) had persistent or long-standing persistent AF. Mean follow-up with Holter monitoring was 27.5 months. There were no hospital deaths. Sinus rhythm maintenance rates were 88%, 85.1% and 80.6% at 6 months, 24 months and 36 months, respectively. Predictors of late recurrence of AF were female gender (HR 3.52; 95% CI 1.21-10.25; p = 0.02), coronary artery disease (HR 4.73 95% CI 1.37-16.36; p = 0.01) and greater left atrium diameter (HR 1.05; 95% CI 1.01-1.09; p = 0.02). Actuarial survival was 98.5% at 12, 24 and 48 months and actuarial freedom from stroke was 100%, 100% and 97.5% in the same time frames. The Cox-Maze III procedure, in our experience, is efficacious for sinus rhythm maintenance, with very low late mortality and stroke rates. A operação de Cox-Maze III é uma das variantes técnicas no tratamento cirúrgico da fibrilação atrial (FA). Estudar os resultados tardios da operação de Cox-Maze III, quanto à eficácia na manutenção de ritmo sinusal e taxas de mortalidade e acidente vascular cerebral (AVC). Entre janeiro de 2006 a janeiro de 2013, 93 pacientes

  8. Vein of Galen Aneurysmal Malformation in Neonates Presenting With Congestive Heart Failure

    Directory of Open Access Journals (Sweden)

    Andjenie Madhuban MD

    2016-03-01

    Full Text Available The authors report the case of a neonate presenting with signs of a congenital cardiac disease. Echocardiography showed a structural normal heart, right-to-left ductal flow, a dilated superior caval vein, and reversed diastolic flow in the proximal descending aorta. Brain magnetic resonance imaging showed a vein of Galen arteriovenous malformation. This highlights the importance of considering an intracranial cause in the differential diagnosis of neonatal congestive heart failure.

  9. The thymidine kinase-1 as a potential tumor marker: structure, function, activity in normal and malignant tissues

    Directory of Open Access Journals (Sweden)

    N. S. Sergeeva

    2017-01-01

    Full Text Available In the review the role of the thymidine kinase (TK to ensure the replication of DNA de novo and spare (salvage the way in health and activate alternate ways in carcinogenesis is described. The structure of cytoplasmic TK (TК-1, also called fetal, and the level of regulation of its activity in the cells and their change during the cell cycle is described. Considering the data about the absence of TK-1 in resting (G0 cells, TK-1 is positioned as a marker of proliferating cells, which activity is recorded from late G1 phase, peaking in S-phase, it is stored in the G2 and mitosis, quickly decreasing to undetectable levels in the early G1 phase. Data on the expression TK-1 (as compared with Ki-67 and PCNA (proliferating cell nuclear antigen in tumor tissues (colorectal, breast, cervical, lung, renal, prostate and ovarian cancer, as well as some benign and precancerous pathological processes in relation to the clinical and diagnostic features of these processes are systemized. These data suggest that the proliferative index studies on TK-1 (antibody to the domain HRA-210 should be used together with Ki-67 and PCNA, for a more complete assessment of the proliferative status of malignant tumors and pre-cancerous and benign conditions, with the aim of prognosis of the tumor process and treatment planning.

  10. Normal reconstruction of DNA supercoiling and chromatin structure in cockayne syndrome cells during repair of damage from ultraviolet light.

    Science.gov (United States)

    Cleaver, J E

    1982-07-01

    The chromatin of human cells undergoes structural rearrangements during excision repair of ultraviolet damage in DNA that were detected by transient relaxation of DNA supercoiling and increased staphylococcal nuclease digestibility of repaired sites. Inhibition of polymerization and/or ligation of repaired regions with inhibitors of DNA polymerase alpha (cytosine arabinoside and aphidicolin) resulted in the accumulation of single-strand breaks, delayed reconstruction of DNA supercoiling, and maintenance of the staphylococcal nuclease digestibility. These observations suggest that reconstruction of the native chromatin state requires completion of repaired regions with covalent ligation into the DNA strands. Although previous claims have been made that a late stage associated with ligation of repaired regions may be defective in cells from patients with Cockayne syndrome, complete reconstruction of the native chromatin occurred in cells from three unrelated patients after ultraviolet irradiation. No abnormality in repair was therefore detected in Cockayne syndrome cells. The hypersensitivity of cell survival and semiconservative DNA replication to damage by ultraviolet light in this human disorder must therefore be regarded as features of a primary defect in DNA metabolism unrelated to DNA repair.

  11. The effect of high moisture heat-acid treatment on the structure and digestion property of normal maize starch.

    Science.gov (United States)

    Liu, Huan; Liang, Rong; Antoniou, John; Liu, Fei; Shoemaker, Charles F; Li, Yue; Zhong, Fang

    2014-09-15

    The objective of this study was to analyze the influence of thermal-acid treatment on the formation of resistant starch (RS). The maximum RS content in citric acid-heat treated starches (CAHT) reached 36.55%, which was 7 times higher of that in native starch. According to HPSEC-MALLS-RI analysis, amylopectin was more susceptible to hydrolysis than amylose during citric acid-heat treatment (CAH). X-ray measurement revealed that even though the starch crystalline pattern was changed from A-type to a more resistant B-type after CAH, the fraction of crystalline region decreased from 21.16% to 8.37%. The hydroxyls on the starch chains were substituted by the citric acid anhydrides during CAH according to FT-IR analysis, which led to the formation of ester bond cross-linking structures in starch granules, and it could be the main contribution to the increase of RS content in CAHT samples. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Long-term statin therapy in patients with systolic heart failure and normal cholesterol: effects on elevated serum markers of collagen turnover, inflammation, and B-type natriuretic peptide.

    LENUS (Irish Health Repository)

    Abulhul, Esam

    2012-01-01

    The role of statin therapy in heart failure (HF) is unclear. The amino-terminal propeptide of procollagen type III (PIIINP) predicts outcome in HF, and yet there are conflicting reports of statin therapy effects on PIIINP.

  13. Human neural progenitor cells decrease photoreceptor degeneration, normalize opsin distribution and support synapse structure in cultured porcine retina.

    Science.gov (United States)

    Mollick, Tanzina; Mohlin, Camilla; Johansson, Kjell

    2016-09-01

    Retinal neurodegenerative disorders like retinitis pigmentosa, age-related macular degeneration, diabetic retinopathy and retinal detachment decrease retinal functionality leading to visual impairment. The pathological events are characterized by photoreceptor degeneration, synaptic disassembly, remodeling of postsynaptic neurons and activation of glial cells. Despite intense research, no effective treatment has been found for these disorders. The current study explores the potential of human neural progenitor cell (hNPC) derived factors to slow the degenerative processes in adult porcine retinal explants. Retinas were cultured for 3 days with or without hNPCs as a feeder layer and investigated by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL), immunohistochemical, western blot and quantitative real time-polymerase chain reaction (qRT-PCR) techniques. TUNEL showed that hNPCs had the capacity to limit photoreceptor cell death. Among cone photoreceptors, hNPC coculture resulted in better maintenance of cone outer segments and reduced opsin mislocalization. Additionally, maintained synaptic structural integrity and preservation of second order calbindin positive horizontal cells was also observed. However, Müller cell gliosis only seemed to be alleviated in terms of reduced Müller cell density. Our observations indicate that at 3 days of coculture, hNPC derived factors had the capacity to protect photoreceptors, maintain synaptic integrity and support horizontal cell survival. Human neural progenitor cell applied treatment modalities may be an effective strategy to help maintain retinal functionality in neurodegenerative pathologies. Whether hNPCs can independently hinder Müller cell gliosis by utilizing higher concentrations or by combination with other pharmacological agents still needs to be determined. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Effect of inspiratory oxygen fraction and perfusion pressure on 3D functional structures during hypoxia and reoxygenation in isolated perfused pig heart

    Science.gov (United States)

    Rauh, Robert; Boehnert, Markus; Kessler, Manfred D.

    2001-05-01

    Subcellular structures are mainly responsible for light scattering in tissue. Since these structures change their outer shape during hypoxia, backscattered light intensity should be useful in monitoring of tissue in hypoxic or ischemic situations. In a new model of isolated perfused pig heart we investigated the relation between three-dimensional functional structures caused by tissue light scattering and the perfusion pressure during reoxygenation after hypoxia. By use of EMPHO-Oxyscan we could see that there is a clear relation between the perfusion pressure and the level of 3D structures. At very low perfusion pressures there is a delay in recovery of myocardium. Increase in perfusion pressure accelerates the recovery. With functional 3D images created by use of EMPHO-Oxyscan, we now have an instrument for depicting these processes. This technique will be useful in clinical monitoring in cardiac surgery, intraoperative as well as postoperative.

  15. Potent influence of obesity on suppression of plasma B-type natriuretic peptide levels in patients with acute heart failure: An approach using covariance structure analysis.

    Science.gov (United States)

    Kinoshita, Koji; Kawai, Makoto; Minai, Kosuke; Ogawa, Kazuo; Inoue, Yasunori; Yoshimura, Michihiro

    2016-07-15

    Plasma B-type natriuretic peptide (BNP) levels may vary widely among patients with similar stages of heart failure, in whom obesity might be the only factor reducing plasma BNP levels. We investigated the effect of obesity and body mass index (BMI) on plasma BNP levels using serial measurements before and after treatment (pre- and post-BNP and pre- and post-BMI) in patients with acute heart failure. Multiple regression analysis and covariance structure analysis were performed to study the interactions between clinical factors in 372 patients. The pre-BMI was shown as a combination index of obesity and fluid accumulation, whereas the post-BMI was a conventional index of obesity. There was a significant inverse correlation between BMI and BNP in each condition before and after treatment for heart failure. The direct significant associations of the log pre-BNP with the log post-BNP (β: 0.387), the post-BMI (β: -0.043), and the pre-BMI (β: 0.030) were analyzed by using structural equation modeling. The post-BMI was inversely correlated, but importantly, the pre-BMI was positively correlated, with the log pre-BNP, because the pre-BMI probably entailed an element of fluid accumulation. There were few patients with extremely high levels of pre-BNP among those with high post-BMI, due to suppressed secretion of BNP. The low plasma BNP levels in true obesity patients with acute heart failure are of concern, because plasma BNP cannot increase in such patients. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  16. Semi-analytical quasi-normal mode theory for the local density of states in coupled photonic crystal cavity-waveguide structures

    DEFF Research Database (Denmark)

    de Lasson, Jakob Rosenkrantz; Kristensen, Philip Trøst; Mørk, Jesper

    2015-01-01

    We present and validate a semi-analytical quasi-normal mode (QNM) theory for the local density of states (LDOS) in coupled photonic crystal (PhC) cavity-waveguide structures. By means of an expansion of the Green's function on one or a few QNMs, a closed-form expression for the LDOS is obtained, ......-trivial spectrum with a peak and a dip is found, which is reproduced only when including both the two relevant QNMs in the theory. In both cases, we find relative errors below 1% in the bandwidth of interest.......We present and validate a semi-analytical quasi-normal mode (QNM) theory for the local density of states (LDOS) in coupled photonic crystal (PhC) cavity-waveguide structures. By means of an expansion of the Green's function on one or a few QNMs, a closed-form expression for the LDOS is obtained......, and for two types of two-dimensional PhCs, with one and two cavities side-coupled to an extended waveguide, the theory is validated against numerically exact computations. For the single cavity, a slightly asymmetric spectrum is found, which the QNM theory reproduces, and for two cavities a non...

  17. The effect of treatment with bisoprolol-first versus enalapril-first on cardiac structure and function in heart failure

    NARCIS (Netherlands)

    Van de Ven, Louis L. M.; van Veldhuisen, Dirk J.; Goulder, Michael; Zilahi, Zsolt; Meyer, Wilfried R.; Willenheimer, Ronnie

    2010-01-01

    Background: In CIBIS III, initiating chronic heart failure (CHF) treatment with bisoprolol (target dose 10 mg q.d.) followed by combination therapy with enalapril (target dose 10 mg b.i.d.), compared to the opposite order, showed similar effects on survival and hospitalization. By echocardiography,

  18. Malware Normalization

    OpenAIRE

    Christodorescu, Mihai; Kinder, Johannes; Jha, Somesh; Katzenbeisser, Stefan; Veith, Helmut

    2005-01-01

    Malware is code designed for a malicious purpose, such as obtaining root privilege on a host. A malware detector identifies malware and thus prevents it from adversely affecting a host. In order to evade detection by malware detectors, malware writers use various obfuscation techniques to transform their malware. There is strong evidence that commercial malware detectors are susceptible to these evasion tactics. In this paper, we describe the design and implementation of a malware normalizer ...

  19. Heart transplantation.

    Science.gov (United States)

    Cheng, Allen; Slaughter, Mark S

    2014-08-01

    Heart failure remains a major global problem with approximately 6 million individuals suffering from heart failure in the United States alone. The surgical technique of heart transplantation, popularized by Dr. Norman Shumway, has led to its success and currently remains the best treatment options for patients with end-stage. However, with the continued limitation of donor organs and the rapid development of ventricular assist device technology, the number of patients bridged to transplant with mechanical circulatory support has increased significantly. This has created some new technical challenges for heart transplantation. Therefore, it is now important to be familiar with multiple new technical challenges associated with the surgical techniques of heart transplantation with an ultimate goal in reducing donor heart ischemic time, recipient cardiopulmonary bypass time and post-operative complications. In this review, we described our technique of heart transplantation including the timing of the operation, recipient cardiectomy and donor heart implantation.

  20. Enlarged Heart

    Science.gov (United States)

    ... the valves are damaged by conditions such as rheumatic fever, a heart defect, infections (infectious endocarditis), connective tissue disorders, certain medications or radiation treatments for cancer, your heart may ...

  1. Heart Truth

    Science.gov (United States)

    ... health! Get a free badge or banner to post to your website or blog. Are you at risk for heart disease? Here's how to find out . Planning to use The Heart Truth logo? Check out our logo guidelines and downloads. ...

  2. Heart Failure

    Science.gov (United States)

    ... heart failure due to systolic dysfunction. http://www.uptodate.com/home. Accessed Sept. 26, 2014. Colucci WS. ... patient with heart failure or cardiomyopathy. http://www.uptodate.com/home. Accessed Sept. 26, 2014. Colucci WS. ...

  3. Competitive sports and the heart: benefit or risk?

    Science.gov (United States)

    Scharhag, Jürgen; Löllgen, Herbert; Kindermann, Wilfried

    2013-01-01

    Controversy surrounds the cardiac effects of competitive sports and the athlete's heart. In this review, we present and discuss the main cardiological findings in competitive athletes. Selective review of pertinent literature retrieved by a search with the keywords "athlete's heart," "ECG," "echocardiography," "endurance exercise," "longevity," and others. Regular exercise leads to functional and structural adaptations that improve cardiac function. Athlete's heart, which develops rarely, is a typical finding in endurance athletes. This condition is characterized by physiological, harmonically eccentric hypertrophy of all cardiac chambers. The athlete's ECG can be used to distinguish physiological, training-related changes from pathological training-unrelated changes. The athlete's heart function is normal at rest and increases appropriately during exercise. The cardiac markers troponin and B-type natriuretic peptide are within the normal range in healthy athletes at rest, but can temporarily be mildly elevated after exhausting endurance-exercise, without evidence of myocardial damage. The epidemiological data suggest that participation in competitive sports increases life expectancy. Competitive exercise does not induce cardiac damage in individuals with healthy hearts, but does induce physiological functional and structural cardiac adaptations which have positive effects on life expectancy.

  4. Heart Failure

    DEFF Research Database (Denmark)

    Jorsal, Anders; Wiggers, Henrik; McMurray, John J V

    2018-01-01

    This article briefly discusses the epidemiology of heart failure and diabetes and summarizes the key findings from the recent cardiovascular outcome trials in patients with type 2 diabetes, with a focus on heart failure as an endpoint.......This article briefly discusses the epidemiology of heart failure and diabetes and summarizes the key findings from the recent cardiovascular outcome trials in patients with type 2 diabetes, with a focus on heart failure as an endpoint....

  5. Structural characterization of alpha1,3-galactosyltransferase knockout pig heart and kidney glycolipids and their reactivity with human and baboon antibodies.

    Science.gov (United States)

    Diswall, Mette; Angström, Jonas; Karlsson, Hasse; Phelps, Carol J; Ayares, David; Teneberg, Susann; Breimer, Michael E

    2010-01-01

    alpha1,3-galactosyltranferase knockout (GalT-KO) pigs have been established to avoid hyperacute rejection in GalT-KO pig-to-human xenotransplantation. GalT-KO pig heart and kidney glycolipids were studied focusing on elimination of Gal-antigens and whether novel antigens would appear. Non-human primates are used as pre-clinical transplantation experimental models. Therefore, sera from baboons transplanted with GalT-KO hearts were compared with human serum regarding reactivity with pig glycolipids. Neutral and acidic glycolipids were isolated from GalT-KO and WT pig hearts and kidneys. Glycolipid immune reactivity was tested on TLC plates using human affinity-purified anti-Gal Ig, anti-blood group monoclonal antibodies, lectins, and human serum as well as baboon serum collected before and after GalT-KO pig heart transplantations. Selected glycolipid fractions, isolated by HPLC, were structurally characterized by mass spectrometry and proton NMR spectroscopy. GalT-KO heart and kidney lacked alpha3Gal-terminated glycolipids completely. Levels of uncapped N-acetyllactosamine precursor compounds, blood group H type 2 core chain compounds, the P1 antigen and the x(2) antigen were increased. Human serum antibodies reacted with Gal-antigens and N-glycolylneuraminic acid (NeuGc) in WT organs of which only the NeuGc reactivity remained in the GalT-KO tissues. A clear difference in reactivity between baboon and human antibodies with pig glycolipids was found. This was most pronounced for acidic, not yet identified, compounds in GalT-KO organs which were less abundant or lacking in the corresponding WT tissues. GalT-KO pig heart and kidney completely lacked Gal glycolipid antigens whilst glycolipids synthesized by competing pathways were increased. Baboon and human serum antibodies showed a different reactivity pattern to pig glycolipid antigens indicating that non-human primates have limitations as a human pre-clinical model for immune rejection studies.

  6. Cyclic stress-strain behavior of polymeric nonwoven structures for the use as artificial leaflet material for transcatheter heart valve prostheses

    Directory of Open Access Journals (Sweden)

    Arbeiter Daniela

    2017-09-01

    Full Text Available Xenogenic leaflet material, bovine and porcine pericardium, is widely used for the fabrication of surgically implanted and transcatheter heart valve prostheses. As a biological material, long term durability of pericardium is limited due to calcification, degeneration and homogeneity. Therefore, polymeric materials represent a promising approach for a next generation of artificial heart valve leaflets with improved durability. Within the current study we analyzed the mechanical performance of polymeric structures based on elastomeric materials. Polymeric cast films were prepared and nonwovens were manufactured in an electrospinning process. Analysis of cyclic stress-strain behavior was performed, using a universal testing machine. The uniaxial cyclic tensile experiments of the elastomeric samples yielded a non-linear elastic response due to viscoelastic behavior with hysteresis. Equilibrium of stress-strain curves was found after a specific number of cycles, for cast films and nonwovens, respectively. In conclusion, preconditioning was found obligatory for the evaluation of the mechanical performance of polymeric materials for the use as artificial leaflet material for heart valve prostheses.

  7. The phenomenon of “QT stunning”: The abnormal QT prolongation provoked by standing persists even as the heart rate returns to normal in patients with long QT syndrome

    Science.gov (United States)

    Adler, Arnon; van der Werf, Christian; Postema, Pieter G.; Rosso, Raphael; Bhuiyan, Zahir A.; Kalman, Jonathan M.; Vohra, Jitendra K.; Guevara-Valdivia, Milton E.; Marquez, Manlio F.; Halkin, Amir; Benhorin, Jesaia; Antzelevitch, Charles; Wilde, Arthur A.M.; Viskin, Sami

    2012-01-01

    BACKGROUND Patients with long QT syndrome (LQTS) have inadequate shortening of the QT interval in response to the sudden heart rate accelerations provoked by standing—a phenomenon of diagnostic value. We now validate our original observations in a cohort twice as large. We also describe that this abnormal QT-interval response persists as the heart rate acceleration returns to baseline. OBJECTIVES To describe a novel observation, termed “QT stunning” and to validate previous observations regarding the “QT-stretching” phenomenon in patients with LQTS by using our recently described “standing test.” METHODS The electrocardiograms of 108 patients with LQTS and 112 healthy subjects were recorded in the supine position. Subjects were then instructed to stand up quickly and remain standing for 5 minutes during continuous electrocardiographic recording. The corrected QT interval was measured at baseline (QTcbase), when heart rate acceleration without appropriate QT-interval shortening leads to maximal QT stretching (QTcstretch) and upon return of heart rate to baseline (QTcreturn). RESULTS QTcstretch lengthened significantly more in patients with LQTS (103 ± 80 ms vs 66 ± 40 ms in controls; P QT interval in response to standing in patients with LQTS. Our study also shows that this abnormal response persists even after the heart rate slows back to baseline. PMID:22300664

  8. Normalizing Rejection.

    Science.gov (United States)

    Conn, Vicki S; Zerwic, Julie; Jefferson, Urmeka; Anderson, Cindy M; Killion, Cheryl M; Smith, Carol E; Cohen, Marlene Z; Fahrenwald, Nancy L; Herrick, Linda; Topp, Robert; Benefield, Lazelle E; Loya, Julio

    2016-02-01

    Getting turned down for grant funding or having a manuscript rejected is an uncomfortable but not unusual occurrence during the course of a nurse researcher's professional life. Rejection can evoke an emotional response akin to the grieving process that can slow or even undermine productivity. Only by "normalizing" rejection, that is, by accepting it as an integral part of the scientific process, can researchers more quickly overcome negative emotions and instead use rejection to refine and advance their scientific programs. This article provides practical advice for coming to emotional terms with rejection and delineates methods for working constructively to address reviewer comments. © The Author(s) 2015.

  9. Numerical investigation on effect of leaflet thickness on structural stresses developed in a bileaflet mechanical heart valve for its sustainable manufacturing

    Directory of Open Access Journals (Sweden)

    Abbas Syed Samar

    2017-01-01

    Full Text Available Flow induced structural stresses can cause mechanical prosthetic aortic valve to fail due to yielding. In this study, we have performed the structural analysis, especially the effect of leaflet thickness on equivalent stresses developed in a Bileaflet mechanical heart valve (BMHV due to blood flow through it has been investigated. The leaflet thickness varies from 0.5mm to 0.7mm, by 0.1mm. A fluid-structure interaction approach based on Arbitrary Lagrangian Eulerian (ALE technique has been employed with the aid of an user defined function (UDF. Results of the analysis show that high von Mises stresses are developed in BMHV with leaflet thickness of 0.5mm and 0.6mm, being 75% and 13% higher than allowable equivalent stress respectively. Such thinner leaflets are therefore, not sustainable to be replaced with diseased aortic valve.

  10. Endothelial Function as a Possible Significant Determinant of Cardiac Function during Exercise in Patients with Structural Heart Disease

    Directory of Open Access Journals (Sweden)

    Bonpei Takase

    2009-01-01

    Full Text Available This study was investigated the role that endothelial function and systemic vascular resistance (SVR play in determining cardiac function reserve during exercise by a new ambulatory radionuclide monitoring system (VEST in patients with heart disease. The study population consisted of 32 patients. The patients had cardiopulmonary stress testing using the treadmill Ramp protocol and the VEST. The anaerobic threshold (AT was autodetermined using the V-slope method. The SVR was calculated by determining the mean blood pressure/cardiac output. Flow-mediated vasodilation (FMD was measured in the brachial artery to evaluate endotheilial function. FMD and the percent change f'rom rest to AT in SVR correlated with those from rest to AT in ejection fraction and peak ejection ratio by VEST, respectively. Our findings suggest that FMD in the brachial artery and the SVR determined by VEST in patients with heart disease can possibly reflect cardiac function reserve during aerobic exercise.

  11. The total artificial heart.

    Science.gov (United States)

    Cook, Jason A; Shah, Keyur B; Quader, Mohammed A; Cooke, Richard H; Kasirajan, Vigneshwar; Rao, Kris K; Smallfield, Melissa C; Tchoukina, Inna; Tang, Daniel G

    2015-12-01

    The total artificial heart (TAH) is a form of mechanical circulatory support in which the patient's native ventricles and valves are explanted and replaced by a pneumatically powered artificial heart. Currently, the TAH is approved for use in end-stage biventricular heart failure as a bridge to heart transplantation. However, with an increasing global burden of cardiovascular disease and congestive heart failure, the number of patients with end-stage heart failure awaiting heart transplantation now far exceeds the number of available hearts. As a result, the use of mechanical circulatory support, including the TAH and left ventricular assist device (LVAD), is growing exponentially. The LVAD is already widely used as destination therapy, and destination therapy for the TAH is under investigation. While most patients requiring mechanical circulatory support are effectively treated with LVADs, there is a subset of patients with concurrent right ventricular failure or major structural barriers to LVAD placement in whom TAH may be more appropriate. The history, indications, surgical implantation, post device management, outcomes, complications, and future direction of the TAH are discussed in this review.

  12. Structural and molecular regulation of lung maturation by intratracheal vascular endothelial growth factor administration in the normally grown and placentally restricted fetus.

    Science.gov (United States)

    McGillick, Erin V; Orgeig, Sandra; Morrison, Janna L

    2016-03-01

    Inhibition of hypoxia signalling leads to respiratory distress syndrome (RDS), whereas administration of vascular endothelial growth factor (VEGF), the most widely characterized hypoxia responsive factor, protects from RDS. In the lung of the chronically hypoxaemic placentally restricted (PR) fetus, there is altered regulation of hypoxia signalling. This leads to reduced surfactant maturation in late gestation and provides evidence for the increased risk of RDS in growth restricted neonates at birth. We evaluated the effect of recombinant human VEGF administration with respect to bypassing the endogenous regulation of hypoxia signalling in the lung of the normally grown and PR sheep fetus. There was no effect of VEGF administration on fetal blood pressure or fetal breathing movements. We examined the effect on the expression of genes regulating VEGF signalling (FLT1 and KDR), angiogenesis (ANGPT1, AQP1, ADM), alveolarization (MMP2, MMP9, TIMP1, COL1A1, ELN), proliferation (IGF1, IGF2, IGF1R, MKI67, PCNA), inflammation (CCL2, CCL4, IL1B, TNFA, TGFB1, IL10) and surfactant maturation (SFTP-A, SFTP-B, SFTP-C, SFTP-D, PCYT1A, LPCAT, LAMP3, ABCA3). Despite the effects of PR on the expression of genes regulating airway remodelling, inflammatory signalling and surfactant maturation, there were very few effects of VEGF administration on gene expression in the lung of both the normally grown and PR fetus. There were, however, positive effects of VEGF administration on percentage tissue, air space and numerical density of SFTP-B positive alveolar epithelial cells in fetal lung tissue. These results provide evidence for the stimulatory effects of VEGF administration on structural maturation in the lung of both the normally grown and PR fetus. © 2015 The Authors. The Journal of Physiology © 2015 The Physiological Society.

  13. Prediction of two-dimensional d-block elemental materials with normal honeycomb, triangular-dodecagonal, and square-octagonal structures from first principles

    Science.gov (United States)

    Zhou, Baozeng; Dong, Shengjie; Wang, Xiaocha; Zhang, Kailiang

    2017-10-01

    By first-principles calculations, we investigated the electronic structures and magnetic properties of several tetravalent transition-metal monolayers with normal honeycomb, triangular-dodecagonal, and square-octagonal structures by considering the effects of spin-orbit coupling and electronic strong correlation of d orbitals. For both standard and corrected approaches, spin-polarized Dirac points contributed by d states appear in the monolayers with hexagonal lattice (honeycomb and 3-12 lattices), but for 4-8 lattices, Dirac points disappear, demonstrating that specific symmetries are required for forming Dirac cones. By adding the on-site Coulomb repulsion, the electronic correlation of d orbital is enhanced and thus the electronic localization increases, aggravating the spin splitting. For Hf3-12, the coexistence of massless Dirac fermions and massive heavy fermions is found. Moreover, the spin-orbit coupling destroys the degeneracy of two bands at K points, and the largest gap opening of 214 meV appears in Hf4-8 due to both Coulomb repulsion and spin-orbit coupling. Our results demonstrate that the spin splitting and gap opening depend on the lattice symmetry, bond length, electronic strong correlation, and spin-orbit coupling. These predicted structures provide new choices in synthesizing two-dimensional transition-metal materials, which has the potential applications in spintronic devices, quantum computation, hydrogen storage, and catalytic chemistry.

  14. HEART RETRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    R. Sh. Saitgareev

    2016-01-01

    Full Text Available The number of patients with transplanted heart is continuously increasing; therefore, the number of patients requiring heart retransplantation grows. Analysis of the results of published studies focused on safety of cardiac retransplantation and risk factors for adverse events in perioperative, early and late postoperative periods is presented in our review. The results of published studies suggest that heart retransplantation is the main radical treatment option for cardiac allograft dysfunction, but the results of heart retransplantation are slightly worse than those of primary cardiac transplantation. On the other hand, the favorable long-term prognosis after heart retransplantation should be expected in carefully selected recipients. 

  15. The heart remembers : observations of cardiac memory in the Dorper sheep heart

    Directory of Open Access Journals (Sweden)

    J. Ker

    2003-11-01

    Full Text Available Memory is a property common to a diverse range of tissues. Cardiac memory has been demonstrated in the human, dog, rat and rabbit. This is a peculiar phenomenon, reflected in the T wave of the electrocardiogram. The heart is able to remember periods of alterations in the sequence of ventricular activation and once there is a return to a normal sequence of ventricular activation the T waves may manifest memory. Cardiac memory is noted when the T wave during normal ventricular activation retains the vector of the previous abnormal QRS complex, caused by a period of altered ventricular activation. Possible mechanisms of memory in the heart are alterations of the transient outward potassium current (Ito in ventricular myocytes and new protein synthesis inside myocytes. These two mechanisms operate in short- and long-term cardiac memory respectively. Currently, it is unknown whether memory may have adverse structural consequences in the heart. We were able to demonstrate memory in the hearts of Dorper wethers and this is the first report of cardiac memory in Dorper sheep.

  16. Platelet-derived growth factor B retention is essential for development of normal structure and function of conduit vessels and capillaries

    DEFF Research Database (Denmark)

    Nyström, Henrik C.; Lindblom, Per; Wickman, Anna

    2006-01-01

    : Passive and active properties of conduit vessels were studied using myograph techniques and histological examination. Capillary structure and function was studied using measurements of capillary density in skeletal muscle and by assessing aerobic physical performance in a treadmill setup. Cardiac function....... This outward eutrophic remodelling of the aorta was accompanied by endothelial dysfunction. RetKO showed decreased capillary density in skeletal muscle and signs of a defective delivery of capillary oxygen to skeletal muscle, as shown by a decreased physical performance. In RetKO mice, echocardiography...... for a normal oxygen delivery to skeletal muscle. The lack of primary effects on cardiac function supports the redundant role of PDGF-B in cardiac development....

  17. Heart transplantation in adult congenital heart disease.

    Science.gov (United States)

    Burchill, Luke J

    2016-12-01

    Heart failure (HF) in adult congenital heart disease (ACHD) is vastly different to that observed in acquired heart disease. Unlike acquired HF in which pharmacological strategies are the cornerstone for protecting and improving ventricular function, ACHD-related HF relies heavily upon structural and other interventions to achieve these aims. patients with ACHD constitute a small percentage of the total adult heart transplant population (∼3%), although the number of ACHD heart transplant recipients is growing rapidly with a 40% increase over the last two decades. The worldwide experience to date has confirmed heart transplantation as an effective life-extending treatment option in carefully selected patients with ACHD with end-stage cardiac disease. Opportunities for improving outcomes in patients with ACHD-related HF include (i) earlier recognition and referral to centres with combined expertise in ACHD and HF, (ii) increased awareness of arrhythmia and sudden cardiac death risk in this population, (iii) greater collaboration between HF and ACHD specialists at the time of heart transplant assessment, (iv) expert surgical planning to reduce ischaemic time and bleeding risk at the time of transplant, (v) tailored immunosuppression in the post-transplant period and (vi) development and validation of ACHD-specific risk scores to predict mortality and guide patient selection. The purpose of this article is to review current approaches to diagnosing and treating advanced HF in patients with ACHD including indications, contraindications and clinical outcomes after heart transplantation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  18. Pursuing Normality

    DEFF Research Database (Denmark)

    Madsen, Louise Sofia; Handberg, Charlotte

    2018-01-01

    semistructured interviews with 9 lymphoma survivors. Interpretive description methodology and social practice theory guided the analytical framework. RESULTS: "Pursuing normality" was an overall finding and was comprised of 2 overarching patterns, "future prospects" and "survivorship care perceptions," both......BACKGROUND: The present study explored the reflections on cancer survivorship care of lymphoma survivors in active treatment. Lymphoma survivors have survivorship care needs, yet their participation in cancer survivorship care programs is still reported as low. OBJECTIVE: The aim of this study...... was to understand the reflections on cancer survivorship care of lymphoma survivors to aid the future planning of cancer survivorship care and overcome barriers to participation. METHODS: Data were generated in a hematological ward during 4 months of ethnographic fieldwork, including participant observation and 46...

  19. Reconstructing Normality

    DEFF Research Database (Denmark)

    Gildberg, Frederik Alkier; Bradley, Stephen K.; Fristed, Peter Billeskov

    2012-01-01

    Forensic psychiatry is an area of priority for the Danish Government. As the field expands, this calls for increased knowledge about mental health nursing practice, as this is part of the forensic psychiatry treatment offered. However, only sparse research exists in this area. The aim of this study...... was to investigate the characteristics of forensic mental health nursing staff interaction with forensic mental health inpatients and to explore how staff give meaning to these interactions. The project included 32 forensic mental health staff members, with over 307 hours of participant observations, 48 informal...... interviews, and seven semistructured interviews. The findings show that staff interaction is typified by the use of trust and relationship-enabling care, which is characterized by the establishment and maintenance of an informal, trusting relationship through a repeated reconstruction of normality...

  20. Used Nuclear Fuel Loading and Structural Performance Under Normal Conditions of Transport - Modeling, Simulation and Experimental Integration RD&D Plan

    Energy Technology Data Exchange (ETDEWEB)

    Adkins, Harold E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2013-04-01

    Under current U.S. Nuclear Regulatory Commission regulation, it is not sufficient for used nuclear fuel (UNF) to simply maintain its integrity during the storage period, it must maintain its integrity in such a way that it can withstand the physical forces of handling and transportation associated with restaging the fuel and moving it to treatment or recycling facilities, or a geologic repository. Hence it is necessary to understand the performance characteristics of aged UNF cladding and ancillary components under loadings stemming from transport initiatives. Researchers would like to demonstrate that enough information, including experimental support and modeling and simulation capabilities, exists to establish a preliminary determination of UNF structural performance under normal conditions of transport (NCT). This research, development and demonstration (RD&D) plan describes a methodology, including development and use of analytical models, to evaluate loading and associated mechanical responses of UNF rods and key structural components. This methodology will be used to provide a preliminary assessment of the performance characteristics of UNF cladding and ancillary components under rail-related NCT loading. The methodology couples modeling and simulation and experimental efforts currently under way within the Used Fuel Disposition Campaign (UFDC). The methodology will involve limited uncertainty quantification in the form of sensitivity evaluations focused around available fuel and ancillary fuel structure properties exclusively. The work includes collecting information via literature review, soliciting input/guidance from subject matter experts, performing computational analyses, planning experimental measurement and possible execution (depending on timing), and preparing a variety of supporting documents that will feed into and provide the basis for future initiatives. The methodology demonstration will focus on structural performance evaluation of

  1. Music determines heart rate variability of singers

    Directory of Open Access Journals (Sweden)

    Björn eVickhoff

    2013-07-01

    Full Text Available Choir singing is known to promote wellbeing. One reason for this may be that singing demands a slower than normal respiration which may in turn affect heart activity. Coupling of heart rate variability (HRV to respiration is called Respiratory sinus arrhythmia (RSA. This coupling has a subjective as well as a biologically soothing effect, and it is beneficial for cardiovascular function. RSA is seen to be more marked during slow-paced breathing and at lower respiration rates (0.1 Hz and below. In this study, we investigate how singing, which is a form of guided breathing, affects HRV and RSA. The study comprises a group of healthy 18 year olds of mixed gender. The subjects are asked to; (1 hum a single tone and breathe whenever they need to; (2 sing a hymn with free, unguided breathing; and (3 sing a slow mantra and breathe solely between phrases. Heart rate (HR is measured continuously during the study. The study design makes it possible to compare above three levels of song structure. In a separate case study, we examine five individuals performing singing tasks (1-(3. We collect data with more advanced equipment, simultaneously recording HR, respiration, skin conductance and finger temperature. We show how song structure, respiration and heart rate are connected. Unison singing of regular song structures makes the hearts of the singers accelerate and decelerate simultaneously. Implications concerning the effect on wellbeing and health are discussed as well as the question how this inner entrainment may affect perception and behavior.

  2. Comparison of structured and unstructured physical activity training on predicted VO2max and heart rate variability in adolescents - a randomized control trial.

    Science.gov (United States)

    Sharma, Vivek Kumar; Subramanian, Senthil Kumar; Radhakrishnan, Krishnakumar; Rajendran, Rajathi; Ravindran, Balasubramanian Sulur; Arunachalam, Vinayathan

    2017-05-01

    Physical inactivity contributes to many health issues. The WHO-recommended physical activity for adolescents encompasses aerobic, resistance, and bone strengthening exercises aimed at achieving health-related physical fitness. Heart rate variability (HRV) and maximal aerobic capacity (VO2max) are considered as noninvasive measures of cardiovascular health. The objective of this study is to compare the effect of structured and unstructured physical training on maximal aerobic capacity and HRV among adolescents. We designed a single blinded, parallel, randomized active-controlled trial (Registration No. CTRI/2013/08/003897) to compare the physiological effects of 6 months of globally recommended structured physical activity (SPA), with that of unstructured physical activity (USPA) in healthy school-going adolescents. We recruited 439 healthy student volunteers (boys: 250, girls: 189) in the age group of 12-17 years. Randomization across the groups was done using age and gender stratified randomization method, and the participants were divided into two groups: SPA (n=219, boys: 117, girls: 102) and USPA (n=220, boys: 119, girls: 101). Depending on their training status and gender the participants in both SPA and USPA groups were further subdivided into the following four sub-groups: SPA athlete boys (n=22) and girls (n=17), SPA nonathlete boys (n=95) and girls (n=85), USPA athlete boys (n=23) and girls (n=17), and USPA nonathlete boys (n=96) and girls (n=84). We recorded HRV, body fat%, and VO2 max using Rockport Walk Fitness test before and after the intervention. Maximum aerobic capacity and heart rate variability increased significantly while heart rate, systolic blood pressure, diastolic blood pressure, and body fat percentage decreased significantly after both SPA and USPA intervention. However, the improvement was more in SPA as compared to USPA. SPA is more beneficial for improving cardiorespiratory fitness, HRV, and reducing body fat percentage in terms of

  3. Low-dose dynamic myocardial perfusion CT image reconstruction using pre-contrast normal-dose CT scan induced structure tensor total variation regularization

    Science.gov (United States)

    Gong, Changfei; Han, Ce; Gan, Guanghui; Deng, Zhenxiang; Zhou, Yongqiang; Yi, Jinling; Zheng, Xiaomin; Xie, Congying; Jin, Xiance

    2017-04-01

    Dynamic myocardial perfusion CT (DMP-CT) imaging provides quantitative functional information for diagnosis and risk stratification of coronary artery disease by calculating myocardial perfusion hemodynamic parameter (MPHP) maps. However, the level of radiation delivered by dynamic sequential scan protocol can be potentially high. The purpose of this work is to develop a pre-contrast normal-dose scan induced structure tensor total variation regularization based on the penalized weighted least-squares (PWLS) criteria to improve the image quality of DMP-CT with a low-mAs CT acquisition. For simplicity, the present approach was termed as ‘PWLS-ndiSTV’. Specifically, the ndiSTV regularization takes into account the spatial-temporal structure information of DMP-CT data and further exploits the higher order derivatives of the objective images to enhance denoising performance. Subsequently, an effective optimization algorithm based on the split-Bregman approach was adopted to minimize the associative objective function. Evaluations with modified dynamic XCAT phantom and preclinical porcine datasets have demonstrated that the proposed PWLS-ndiSTV approach can achieve promising gains over other existing approaches in terms of noise-induced artifacts mitigation, edge details preservation, and accurate MPHP maps calculation.

  4. Internal structure, fault rocks, and inferences regarding deformation, fluid flow, and mineralization in the seismogenic Stillwater normal fault, Dixie Valley, Nevada

    Science.gov (United States)

    Caine, Jonathan S.; Bruhn, R.L.; Forster, C.B.

    2010-01-01

    Outcrop mapping and fault-rock characterization of the Stillwater normal fault zone in Dixie Valley, Nevada are used to document and interpret ancient hydrothermal fluid flow and its possible relationship to seismic deformation. The fault zone is composed of distinct structural and hydrogeological components. Previous work on the fault rocks is extended to the map scale where a distinctive fault core shows a spectrum of different fault-related breccias. These include predominantly clast-supported breccias with angular clasts that are cut by zones containing breccias with rounded clasts that are also clast supported. These are further cut by breccias that are predominantly matrix supported with angular and rounded clasts. The fault-core breccias are surrounded by a heterogeneously fractured damage zone. Breccias are bounded between major, silicified slip surfaces, forming large pod-like structures, systematically oriented with long axes parallel to slip. Matrix-supported breccias have multiply brecciated, angular and rounded clasts revealing episodic deformation and fluid flow. These breccias have a quartz-rich matrix with microcrystalline anhedral, equant, and pervasively conformable mosaic texture. The breccia pods are interpreted to have formed by decompression boiling and rapid precipitation of hydrothermal fluids whose flow was induced by coseismic, hybrid dilatant-shear deformation and hydraulic connection to a geothermal reservoir. The addition of hydrothermal silica cement localized in the core at the map scale causes fault-zone widening, local sealing, and mechanical heterogeneities that impact the evolution of the fault zone throughout the seismic cycle. ?? 2010.

  5. Virtual histology of the human heart using optical coherence tomography

    Science.gov (United States)

    Ambrosi, Christina M.; Moazami, Nader; Rollins, Andrew M.; Efimov, Igor R.

    2009-09-01

    Optical coherence tomography (OCT) allows for the visualization of micron-scale structures within nontransparent biological tissues. For the first time, we demonstrate the use of OCT in identifying components of the cardiac conduction system and other structures in the explanted human heart. Reconstructions of cardiac structures up to 2 mm below the tissue surface were achieved and validated with Masson Trichrome histology in atrial, ventricular, sinoatrial nodal, and atrioventricular nodal preparations. The high spatial resolution of OCT provides visualization of cardiac fibers within the myocardium, as well as elements of the cardiac conduction system; however, a limiting factor remains its depth penetration, demonstrated to be ~2 mm in cardiac tissues. Despite its currently limited imaging depth, the use of OCT to identify the structural determinants of both normal and abnormal function in the intact human heart is critical in its development as a potential aid to intracardiac arrhythmia diagnosis and therapy.

  6. Structure of the human-heart fatty-acid-binding protein 3 in complex with the fluorescent probe 1-anilinonaphthalene-8-sulphonic acid

    Energy Technology Data Exchange (ETDEWEB)

    Hirose, Mika; Sugiyama, Shigeru, E-mail: sugiyama@chem.eng.osaka-u.ac.jp [Lipid Active Structure Project, 1-1 Machikaneyama-cho, Toyonaka 560-0043 (Japan); Osaka University, 1-1 Machikaneyama-cho, Toyonaka 560-0043 (Japan); Ishida, Hanako; Niiyama, Mayumi [Lipid Active Structure Project, 1-1 Machikaneyama-cho, Toyonaka 560-0043 (Japan); Osaka University, 2-1 Yamadaoka, Suita 565-0871 (Japan); Matsuoka, Daisuke; Hara, Toshiaki [Lipid Active Structure Project, 1-1 Machikaneyama-cho, Toyonaka 560-0043 (Japan); Osaka University, 1-1 Machikaneyama-cho, Toyonaka 560-0043 (Japan); Mizohata, Eiichi [Osaka University, 2-1 Yamadaoka, Suita 565-0871 (Japan); Murakami, Satoshi [Tokyo Institute of Technology, Nagatsuta, Midori-ku, Yokohama, Kanagaw 226-8501 (Japan); Inoue, Tsuyoshi [Osaka University, 2-1 Yamadaoka, Suita 565-0871 (Japan); Matsuoka, Shigeru; Murata, Michio [Lipid Active Structure Project, 1-1 Machikaneyama-cho, Toyonaka 560-0043 (Japan); Osaka University, 1-1 Machikaneyama-cho, Toyonaka 560-0043 (Japan)

    2013-11-01

    The crystal structure of human-heart-type fatty-acid-binding protein in complex with anilinonaphthalene-8-sulfonate was solved at 2.15 Å resolution revealing the detailed binding mechanism of the fluorescent probe 1-anilinonaphthalene-8-sulfonate. Heart-type fatty-acid-binding protein (FABP3), which is a cytosolic protein abundantly found in cardiomyocytes, plays a role in trafficking fatty acids throughout cellular compartments by reversibly binding intracellular fatty acids with relatively high affinity. The fluorescent probe 1-anilinonaphthalene-8-sulfonate (ANS) is extensively utilized for examining the interaction of ligands with fatty-acid-binding proteins. The X-ray structure of FABP3 was determined in the presence of ANS and revealed the detailed ANS-binding mechanism. Furthermore, four water molecules were clearly identified in the binding cavity. Through these water molecules, the bound ANS molecule forms indirect hydrogen-bond interactions with FABP3. The adipocyte-type fatty-acid-binding protein (FABP4) exhibits 67% sequence identity with FABP3 and its crystal structure is almost the same as that of FABP3. However, FABP4 can bind with a higher affinity to ANS than FABP3. To understand the difference in their ligand specificities, a structural comparison was performed between FABP3–ANS and FABP4–ANS complexes. The result revealed that the orientation of ANS binding to FABP3 is completely opposite to that of ANS binding to FABP4, and the substitution of valine in FABP4 to leucine in FABP3 may result in greater steric hindrance between the side-chain of Leu115 and the aniline ring of ANS.

  7. Cardiac rehabilitation patient's perspectives on the recovery following heart valve surgery: a narrative analysis

    DEFF Research Database (Denmark)

    Hansen, Tina Birgitte; Zwisler, Ann Dorthe Olsen; Kikkenborg Berg, Selina

    2016-01-01

    , the participants expected to return to normality. The analysis identified four courses of recovery, with three non-linear complex pathways deviating from the classic restitution narrative: the frustrated struggle to resume normality, the challenged expectation of normality - being in a limbo and becoming a heart......AIMS: To explore the structure and content of narratives about the recovery process am