502 research outputs found
The role of cardiovascular imaging for myocardial injury in hospitalized COVID-19 patients
No full textThis is a pre-copyedited, author-produced version of an article accepted for publication in European Heart Journal - Cardiovascular Imaging, following peer review. The version of record: Bernard Cosyns, Stijn Lochy, Maria Luiza Luchian, Alessia Gimelli, Gianluca Pontone, Sabine D Allard, Johan de Mey, Peter Rosseel, Marc Dweck, Steffen E Petersen, Thor Edvardsen, on behalf of the European Association of Cardiovascular Imaging (EACVI), The role of cardiovascular imaging for myocardial injury in hospitalized COVID-19 patients, European Heart Journal - Cardiovascular Imaging, Volume 21, Issue 7, July 2020, Pages 709–714, https://doi.org/10.1093/ehjci/jeaa136
is available online at: https://doi.org/10.1093/ehjci/jeaa13
Foraminiferal stratigraphy and paleoenvironments of a high latitude marginal marine basin – A Late Cretaceous record from IODP Site U1512 (Great Australian Bight)
No full textThe 690 m core recovered at IODP Site U1512 offers unparalleled insights into climate during the peak and demise of the Cretaceous hothouse from the southern high latitudes. A new high-resolution micropaleontological record (notably deep water agglutinated foraminifera, DWAF) combined with additional geochemical data was produced from this locality, with the goal of recognizing benthic foraminiferal biozones, their relationship to the Tethyan realm and associated paleoenvironmental changes. We document a diverse benthic foraminiferal assemblage consisting of 162 taxa (110 agglutinated and 52 calcareous). The most common elements of the DWAF assemblage are tubular (i.e., Kalamopsis grzybowskii, Bathysiphon spp.) and planispiral forms (i.e., Ammodiscus spp., Haplophragmoides spp., Buzasina sp., Labrospira spp.). The Turonian strata yield abundant Bulbobaculites problematicus and Spiroplectammina navarroana. The presence of Uvigerinammina jankoi provides a tie point to the Tethyan DWAF biozonation of Geroch and Nowak (1984). The calcareous foraminiferal assemblage is composed of cosmopolitan deep-water forms including Lenticulina, Dentalina, Gavelinella/Anomalinoides, Praebulimina and Pseudobolivina. Organic geochemical data (notably steranes/hopanes ratios), foraminiferal assemblages, together with an increasing abundance of radiolaria reveal a complex and constantly changing marginal marine paleoenvironment. The prevailing regime (oxic or dysoxic, marine, or terrestrially influenced) was strongly influenced by paleobathymetry, unstable oceanic circulation and terrestrial runoff. These factors caused the paleoenvironment to change five times over 10 million years, each lasting <2 Ma. A major increase in the abundance of radiolaria (>50%) after the mid-Turonian followed a peak in the abundance of tubular epifaunal foraminifera during the lower to mid-Turonian. This is possibly related to an increase in bathymetry, that could correspond to a preceding sea level lowstand, and associated changes in ocean chemistry, such as changes in organic flux or salinity. Foraminiferal and geochemical evidence from Site U1512 allow for far-reaching interpretations of the paleoenvironments of the Great Australian Bight during the Late Cretaceous
COVID-19 pandemic and cardiac imaging: EACVI recommendations on precautions, indications, prioritization, and protection for patients and healthcare personnel
No full textThis is a pre-copyedited, author-produced version of an article accepted for publication in Cardiovascular Research following peer review. The version of record Helge Skulstad, Bernard Cosyns, Bogdan A Popescu, Maurizio Galderisi, Giovanni Di Salvo, Erwan Donal, Steffen Petersen, Alessia Gimelli, Kristina H Haugaa, Denisa Muraru, Ana G Almeida, Jeanette Schulz-Menger, Marc R Dweck, Gianluca Pontone, Leyla Elif Sade, Bernhard Gerber, Pal Maurovich-Horvat, Tara Bharucha, Matteo Cameli, Julien Magne, Mark Westwood, Gerald Maurer, Thor Edvardsen, COVID-19 pandemic and cardiac imaging: EACVI recommendations on precautions, indications, prioritization, and protection for patients and healthcare personnel, European Heart Journal - Cardiovascular Imaging, , jeaa072, https://doi.org/10.1093/ehjci/jeaa072 is available online at: https://doi.org/10.1093/ehjci/jeaa072
EACVI communication paper: First international young dedicated multimodal cardiovascular imaging simulation education event organized by the ESC
No full textImaging in ESC clinical guidelines: Chronic coronary syndromes
No full textThe European Society of Cardiology (ESC) has recently published new guidelines on the diagnosis and management of chronic coronary syndromes (CCS). The 2019 guideline identified six common clinical scenarios of CCS defined by the different evolutionary phases of coronary artery disease (CAD), excluding the situations in which an acute coronary event, often with coronary thrombus formation, dominates the clinical presentation. This review aims at providing a summary of novel or revised concepts in the guidelines together with the recent data underlying the major changes on the use of cardiac imaging in patients with suspected or known CCS. Based on data from contemporary cohorts of patients referred for diagnostic testing, the pre-test probabilities of CAD based on age, sex and symptoms have been adjusted substantially downward as compared with 2013 ESC guidelines. Further, the impact of various risk factors and modifiers on the pre-test probability was highlighted and a new concept of 'Clinical likelihood of CAD' was introduced. Recommendations regarding diagnostic tests to establish or rule-out obstructive CAD have been updated with recent data on their diagnostic performance in different patient groups and impact on patient outcome. As the initial strategy to diagnose CAD in symptomatic patients, non-invasive functional imaging for myocardial ischaemia, coronary computed tomography angiography or invasive coronary angiography combined with functional evaluation may be used, unless obstructive CAD can be excluded by clinical assessment alone. When available, imaging tests instead of the exercise electrocardiogram are recommended when following the non-invasive diagnostic strategy
Autoimmunity and viral immunity in Addison’s disease
No full textAutoimmune Addison’s disease (AAD) is caused by an immunological destruction of the steroid producing cells of the adrenal cortex. Both genetic and environmental factors are involved in disease development, and while multiple studies have highlighted several genes linked to the disease, far less is known about possible environmental factors and the role played by the adrenal tissue itself. By studying the well-established human adrenocortical carcinoma cell line NCI- H295R as a model of the adrenal cortex, adrenal cells were shown to respond to environmental factors in the form of virus induced type I and III interferons (IFNs) by potentiating chemokine production and by upregulation of MHC class I and the tissue specific enzyme 21-hydroxylase (21OH). This can be important traits in the T cell- mediated adrenal tissue destruction, recruiting potentially 21OH-specific autoreactive T cells to the tissue. In addition, the same IFNs were shown to have a direct cytotoxic effect on the adrenocortical cells. From a large clinical material we have found that AAD patients have elevated levels of the chemokines CXCL10 and CXCL9 in their sera, while producing significantly lower levels of the same chemokines after stimulation of PBMC with type I and II IFNs and the TLR3 ligand poly (I:C). This is also the case when investigating the relative mRNA expression of selected IFN stimulated genes (ISGs) after IFN or poly (I:C) stimulation. Cytomegalovirus (CMV) has been implicated in autoimmune disease development, including AAD. Nevertheless, we found that AAD patients in general have normal humoral and cellular immunity towards CMV, with no differences in CD8+ T cell specific responses. However, the AAD patients were found to have significantly lower levels of total circulating CD8+ T cells. While CMV infections do not appear to be linked to AAD disease development in general, individual patients showed signs supporting CMV as a possible perpetrator. One patient had serological signs suggesting a reactivating CMV infection, while having extremely low levels of CMV specific CD8+ T cells. The same patient was also part of the chemokine study, where she had low chemokine production after IFN stimuli in addition to an upregulation of three ISGs in her peripheral blood. Intriguingly, the daughter of this patient also had AAD and, despite of being anti-CMV IgG positive, had virtually no CMV specific CD8+ T cells. These findings suggest that an inheritable immunological phenotype may increase individuals’ susceptibility to develop AAD, but also impair their ability to control viral infections. Taken together, the work included in this thesis provides important insight into AAD development. We have shown using adrenocortical cells that the adrenal cortex could play a part in its own destruction in response to interferons induced by viruses. Furthermore, while having a normal cellular and humoral immunity towards the common virus CMV, the innate immune system of AAD patients does not appear to function optimally. Thus for individual patients, CMV infection could be a precipitating event in disease development
The Effects of High- Versus Moderate-Intensity Exercise on Fatigue in Sarcoidosis
No full textBackground: Fatigue is a common symptom in patients with sarcoidosis. Despite lacking evidence on whether high-intensity interval training (HIIT) will aggravate fatigue, moderate-intensity exercise is often recommended. This study aimed to investigate whether a single session of HIIT would affect fatigue differently from a single session of moderate-intensity continuous training (MICT). Methods: Forty-one patients with pulmonary sarcoidosis were recruited to a cross-over study. All patients completed one treadmill session of HIIT (85% of peak heart rate (HRpeak)) and one of MICT (70% of HRpeak). Fatigue was assessed with the Visual Analogue Scale 0-100 mm, before (T0), after (T1), and 24 hours after (T2) each exercise session. Paired sample t-test was used to compare changes in fatigue from T0 to T1 and from T0 to T2 between HIIT and MICT. Results: No statistically significant difference in fatigue levels was found between HIIT and MICT, either at T1 (3.6 (13.5) and 1.4 (13.5)) or at T2 (8.2 (17.0) and 2.1 (17.1)). Conclusions: A single session of HIIT did not affect fatigue differently than a single session of MICT. These preliminary findings support the need for further research on the long-term effect of HIIT on fatigue in patients with sarcoidosis.</p
Level 1 of Entrustable Professional Activities in adult echocardiography: A position statement from the EACVI regarding the training and competence requirements for selecting and interpreting echocardiographic examinations
No full textThe goal of Level 1 training in echocardiography is to enable the trainee to select echocardiography appropriately for the evaluation of a specific clinical question, and then to interpret the report. It is not the goal of Level 1 training to teach how to perform the examination itself - that is the goal of higher levels of training. However, understanding the principles, indications, and findings of this crucial technique is valuable to many medical professionals including outside cardiology. This should be seen as part of a general understanding of cardiac imaging modalities. The purpose of this position statement is to define the scope and outline the general requirements for Level 1 training and competence in echocardiography. Moreover, the document aims to make a clear distinction between Level 1 competence in echocardiography and focus cardiac ultrasound (FoCUS)
End criteria for reaching maximal oxygen uptake must be strict and adjusted to sex and age: a cross-sectional study
No full text© 2014 Edvardsen et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Objective: To describe different end criteria for reaching maximal oxygen uptake (VO2max) during a continuous graded exercise test on the treadmill, and to explore the manner by which different end criteria have an impact on the magnitude of the VO2max result. Methods: A sample of 861 individuals (390 women) aged 20–85 years performed an exercise test on a treadmill until exhaustion. Gas exchange, heart rate, blood lactate concentration and Borg Scale6–20 rating were measured, and the impact of different end criteria on VO2max was studied;VO2 leveling off, maximal heart rate (HRmax), different levels of respiratory exchange ratio (RER), and postexercise blood lactate concentration. Results: Eight hundred and four healthy participants (93%) fulfilled the exercise test until voluntary exhaustion. There were no sex-related differences in HRmax, RER, or Borg Scale rating, whereas blood lactate concentration was 18% lower in women (P<0.001). Forty-two percent of the participants achieved a plateau in VO2; these individuals had 5% higher ventilation (P = 0.033), 4% higher RER (P<0.001), and 5% higher blood lactate concentration (P = 0.047) compared with participants who did not reach a VO2 plateau. When using RER ≥1.15 or blood lactate concentration ≥8.0 mmol•L–1, VO2max was 4% (P = 0.012) and 10% greater (P<0.001), respectively. A blood lactate concentration ≥8.0 mmol•L–1 excluded 63% of the participants in the 50–85-year-old cohort. Conclusions: A range of typical end criteria are presented in a random sample of subjects aged 20–85 years. The choice of end criteria will have an impact on the number of the participants as well as the VO2max outcome. Suggestions for new recommendations are given.Seksjon for idrettsmedisinske fag / Department of Sports Medicin
Overvåking av Ruakerkilen. Fase I – Grunnlagsundersøkelse 2009-2010. Vannkvalitet og undervannsbiotoper
No full textUndersøkelser av undervannsbiotoper (fastsittende alger, undervannsenger og bløtbunnsfauna) og vannmasser (næringssalter, klorofyll-a, oksygen) i Ruakerkilen, Grimstad kommune, ble gjennomført i 2009-2010 som første fase av en langvarig overvåking. Formålet med undersøkelsen har vært å dokumentere dagens status og danne grunnlag for de videre undersøkelsene. Resultatene viser at Ruakerkilen er preget av næringsrike forhold i vannmassene og stor nedbrytning i bunnområdene som resulterer i anoksiske sedimenter uten dyreliv i de dypeste områdene. Algevegetasjonen i strandsonen er artsfattig, antagelig grunnet små arealer med egnet substrat, i tillegg til noe næringsanrikning og lav saltholdighet. Bløtbunnsfaunaen er typisk for brakkvannsområder med varierende saltholdighet. En stor undervannseng med skruehavgras (Ruppia cirrhosa) vokser midtre deler av Ruakerkilen. Resultatene viser også at vannmassene ikke er stagnerende, men at det stadig tilføres nytt vann utenifra.Fylkesmannen i Aust-Agde
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