6 research outputs found
Left Circumflex Coronary Artery as the Culprit Vessel in ST-Segment-Elevation Myocardial Infarction
No full textThe prevalence of the left circumflex coronary artery (LCx) as the culprit vessel in ST-segment-elevation myocardial infarction (STEMI) is reportedly lowest among that of the 3 main epicardial arteries, and has not been described for non-STEMI (NSTEMI) and stable angina pectoris. We sought to define the distribution of culprit arteries in these clinical presentations and suggest mechanisms for the differences.We reviewed 189 coronary angiograms of patients with STEMI, 203 with NSTEMI, and 548 with stable angina (n=940), and compared distributions of stenotic and culprit coronary arteries (lesions prompting intervention).Obstructive coronary lesions (≥50% narrowing) were more prevalent in the left anterior descending coronary artery (LAD) (36%–38%) and similar in the LCx and right coronary artery (RCA) (27%–29%), regardless of clinical presentation (P &lt;0.01). In NSTEMI and stable angina, culprit vessels and total obstructive disease had the same distribution. In STEMI, however, a culprit LCx was significantly less prevalent (17%) than was total obstructive disease (27%; P &lt;0.01), or a culprit LAD (47%) or RCA (34%) (both P &lt;0.001). In our computed tomographic angiographic model of coronary longitudinal strain (percentage of shortening), LCx strain was only 1.5% ± 2.4%, versus 9.5% ± 2.9% for LAD strain and 10.1% ± 3.9% for RCA strain.In STEMI, LCx plaques seem less prone to rupturing. Culprit and total disease distributions are similar in NSTEMI and angina, suggesting a different ischemic pathophysiology in these presentations. Lower LCx longitudinal strain might contribute to reduced plaque rupture in STEMI.</jats:p
Left Ventricular “Longitudinal Rotation” and Conduction Abnormalities—A New Outlook on Dyssynchrony
No full textBackground: The complete left bundle branch block (CLBBB) results in ventricular dyssynchrony and a reduction in systolic and diastolic efficiency. We noticed a distinct clockwise rotation of the left ventricle (LV) in patients with CLBBB (“longitudinal rotation”). Aim: The aim of this study was to quantify the “longitudinal rotation” of the LV in patients with CLBBB in comparison to patients with normal conduction or complete right bundle branch block (CRBBB). Methods: Sixty consecutive patients with normal QRS, CRBBB, or CLBBB were included. Stored raw data DICOM 2D apical-4 chambers view images cine clips were analyzed using EchoPac plugin version 203 (GE Vingmed Ultrasound AS, Horten, Norway). In EchoPac–Q-Analysis, 2D strain application was selected. Instead of apical view algorithms, the SAX-MV (short axis—mitral valve level) algorithm was selected for analysis. A closed loop endocardial contour was drawn to initiate the analysis. The “posterior” segment (representing the mitral valve) was excluded before finalizing the analysis. Longitudinal rotation direction, peak angle, and time-to-peak rotation were recorded. Results: All patients with CLBBB (n = 21) had clockwise longitudinal rotation with mean four chamber peak rotation angle of −3.9 ± 2.4°. This rotation is significantly larger than in patients with normal QRS (−1.4 ± 3°, p = 0.005) and CRBBB (0.1 ± 2.2°, p = 0.00001). Clockwise rotation was found to be correlated to QRS duration in patients with the non-RBBB pattern. The angle of rotation was not associated with a lower ejection fraction or the presence of regional wall abnormalities. Conclusions: Significant clockwise longitudinal rotation was found in CLBBB patients compared to normal QRS or CRBBB patients using speckle-tracking echocardiography
Author Correction: Open-access quantitative MRI data of the spinal cord and reproducibility across participants, sites and manufacturers (Scientific Data, (2021), 8, 1, (219), 10.1038/s41597-021-00941-8)
No full textIn the original version of this Data Descriptor, the Figure 4 legend was a duplicate of the Figure 3 legend. The Figure 4 legend has now been corrected to read as follows in both the PDF and HTML versions of the Data Descriptor
Author Correction: Open-access quantitative MRI data of the spinal cord and reproducibility across participants, sites and manufacturers
No full textSotagliflozin in patients with diabetes and recent worsening heart failure
No full textBACKGROUND Sodium-glucose cotransporter 2 (SGLT2) inhibitors reduce the risk of hospitalization for heart failure or death from cardiovascular causes among patients with stable heart failure. However, the safety and efficacy of SGLT2 inhibitors when initiated soon after an episode of decompensated heart failure are unknown. METHODS We performed a multicenter, double-blind trial in which patients with type 2 diabetes mellitus who were recently hospitalized for worsening heart failure were randomly assigned to receive sotagliflozin or placebo. The primary end point was the total number of deaths from cardiovascular causes and hospitalizations and urgent visits for heart failure (first and subsequent events). The trial ended early because of loss of funding from the sponsor. RESULTS A total of 1222 patients underwent randomization (608 to the sotagliflozin group and 614 to the placebo group) and were followed for a median of 9.0 months; the first dose of sotagliflozin or placebo was administered before discharge in 48.8% and a median of 2 days after discharge in 51.2%. Among these patients, 600 primary end-point events occurred (245 in the sotagliflozin group and 355 in the placebo group). The rate (the number of events per 100 patient-years) of primary end-point events was lower in the sotagliflozin group than in the placebo group (51.0 vs. 76.3; hazard ratio, 0.67; 95% confidence interval [CI], 0.52 to 0.85; P<0.001). The rate of death from cardiovascular causes was 10.6 in the sotagliflozin group and 12.5 in the placebo group (hazard ratio, 0.84; 95% CI, 0.58 to 1.22); the rate of death from any cause was 13.5 in the sotagliflozin group and 16.3 in the placebo group (hazard ratio, 0.82; 95% CI, 0.59 to 1.14). Diarrhea was more common with sotagliflozin than with placebo (6.1% vs. 3.4%), as was severe hypoglycemia (1.5% vs. 0.3%). The percentage of patients with hypotension was similar in the sotagliflozin group and the placebo group (6.0% and 4.6%, respectively), as was the percentage with acute kidney injury (4.1% and 4.4%, respectively). The benefits of sotagliflozin were consistent in the prespecified subgroups of patients stratified according to the timing of the first dose. CONCLUSIONS In patients with diabetes and recent worsening heart failure, sotagliflozin therapy, initiated before or shortly after discharge, resulted in a significantly lower total number of deaths from cardiovascular causes and hospitalizations and urgent visits for heart failure than placebo. (Funded by Sanofi and Lexicon Pharmaceuticals; SOLOIST-WHF ClinicalTrials.gov number, NCT03521934.)
Physiological behavior of greenhouse-grown chrysanthemum (Chrysanthemum morifolium ´’Shrek’ ´ and ´Bomber Green´) in response to the plant growth retardant B-9 and the cytokinin BAP
No full textilustraciones, diagramas, fotografías, tablasEl crisantemo (Chrysanthemum morifolium Ram) representa la tercera flor de corte de
importancia económica en el mercado internacional. En el presente estudio, se caracterizó
la respuesta de plantas de crisantemo ‘Shrek’ y ‘Bomber Green’ y la vida de florero de
tallos cortados, a la aplicación del retardante de crecimiento B-9 (daminozida) y la
citoquinina (6-benciladenina, BAP). En un primer ensayo se evaluó la aplicación de B-9,
con un testigo absoluto sin adición de B-9 y un testigo comercial (TC), usando 6
concentraciones diferentes aplicadas a los 28, 36, 44 y 52 días después del trasplante
(DDT). En un segundo ensayo, se evaluó la aplicación de la citoquinina (CK) BAP (0, 33,3,
66,6 y 100 mg kg-1
) suministrada a los 28, 36, 44 y 52 DDT. La respuesta a estos
tratamientos fue evaluada con una cuantificación de la masa seca acumulada en órganos
(raíz, tallo, hojas y flores) y cálculos de algunos parámetros de crecimiento. Se determinó
el índice de clorofilas con medidor portátil SPAD-502 en hojas del estrato bajo, medio y
superior. Se caracterizó también la duración en días de la vida en florero, inicio de
amarillamiento y grado de amarillamiento de las hojas. La aplicación de B-9 generó una
reducción en la altura de la planta. El cultivar ‘Shrek’ tuvo diferencias estadísticas (P<0,05)
en la acumulación y en parámetros de crecimiento relacionados con el área foliar. La
acumulación de masa seca fue mayor en tallos de los dos cultivares. Con aplicación de
CK, el índice de clorofila incrementó en los estratos medio y superior, mientras que, en las
hojas del estrato inferior disminuyó y se presentó amarillamiento del follaje. La mayor vida
en florero se obtuvo en tallos de ‘Bomber Green’. Los factores que promueven el
amarillamiento del follaje podrían estar relacionados con el material vegetal y la interacción
con las condiciones ambientales a las cuales se expongan las plantas durante el crecimiento y desarrollo (Texto tomado de la fuente).The chrysanthemum (Chrysanthemum morifolium Ram) represents the third cut flower of
economic importance in the international market. The present study characterized the
responses of chrysanthemum plants ‘Shrek’ and ‘Bomber Green’ to the application of the
growth retardant B-9 (active ingredient daminozide), and the addition of the citokinin 6-
benzyladenine (6-BAP) on the chlorophyll content and vase life of cut flower stems. The
first trial evaluated the application of seven concentrations of B-9 applied at 28, 36, 44 and
52 days after transplant (DAT). A second trial evaluated the application of three
concentrations of 6-BAP supplied at 28, 36, 44 and 52 DAT. Dry mass accumulation in the
various plant organs (roots, stems, leaves and flowers) were evaluated along with
calculation of some growth parameters. The chlorophyll index was determined with a
SPAD-502 portable meter in leaves of the lower, middle, and upper third of plants. Finally,
the duration in days of vase life and the onset and degree of leaf yellowing were
characterized in the two cultivars. The application of B-9 caused a reduction in plant height
and the cultivar ‘Shrek’ had statistical differences (P<0.05) in biomass accumulation and
growth parameters related to leaf area. Dry mass gain was greater in stems of the two
cultivars. With CK application the chlorophyll index increased in the middle and upper
leaves, while in the leaves of the lower third had lower values and yellowing symptoms.
The longest vase life was observed in flower stems of ‘Bomber Green’. The factors that
promote the yellowing of the foliage could be related to plant genetics and its interaction
with environmental conditions during the crop growing cycle.MaestríaMagíster en Ciencias AgrariasFisiología de Cultivo
