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Background: Long non-coding RNAs (lncRNAs) are pivotal players in cellular processes, and their unique cell-type specific expression patterns render them attractive biomarkers and therapeutic targets. Yet, the functional roles of most lncRNAs remain enigmatic. To address the need to identify new druggable lncRNAs, we developed a comprehensive approach integrating transcription factor binding data with other genetic features to generate a machine learning model, which we have called INFLAMeR (Identifying Novel Functional LncRNAs with Advanced Machine Learning Resources). Methods: INFLAMeR was trained on high-throughput CRISPR interference (CRISPRi) screens across seven cell lines, and the algorithm was based on 71 genetic features. To validate the predictions, we selected candidate lncRNAs in the human K562 leukemia cell line and determined the impact of their knockdown (KD) on cell proliferation and chemotherapeutic drug response. We further performed transcriptomic analysis for candidate genes. Based on these findings, we assessed the lncRNA small nucleolar RNA host gene 6 (SNHG6) for its role in myeloid differentiation. Finally, we established a mouse K562 leukemia xenograft model to determine whether SNHG6 KD attenuates tumor growth in vivo. Results: The INFLAMeR model successfully reconstituted CRISPRi screening data and predicted functional lncRNAs that were previously overlooked. Intensive cell-based and transcriptomic validation of nearly fifty genes in K562 revealed cell type-specific functionality for 85% of the predicted lncRNAs. In this respect, our cell-based and transcriptomic analyses predicted a role for SNHG6 in hematopoiesis and leukemia. Consistent with its predicted role in hematopoietic differentiation, SNHG6 transcription is regulated by hematopoiesis-associated transcription factors. SNHG6 KD reduced the proliferation of leukemia cells and sensitized them to differentiation. Treatment of K562 leukemic cells with hemin and PMA, respectively, demonstrated that SNHG6 inhibits red blood cell differentiation but strongly promotes megakaryocyte differentiation. Using a xenograft mouse model, we demonstrate that SNHG6 KD attenuated tumor growth in vivo. Conclusions: Our approach not only improved the identification and characterization of functional lncRNAs through genomic approaches in a cell type-specific manner, but also identified new lncRNAs with roles in hematopoiesis and leukemia. Such approaches can be readily applied to identify novel targets for precision medicine. [ABSTRACT FROM AUTHOR]

Background: The treatment of myopericarditis is different than that of acute myocardial infarction (AMI). However, since their clinical presentation is frequently similar it may be difficult to distinguish between these entities despite a disparate underlying pathogenesis. Myopericarditis is primarily an inflammatory disease associated with high C-reactive protein (CRP) and relatively low elevated troponin concentrations, while AMI is characterized by the opposite. We hypothesized that evaluation of the CRP/troponin ratio on presentation to the emergency department could improve the differentiation between these two related clinical entities whose therapy is different. Such differentiation should facilitate triage to appropriate and expeditious therapy. Methods: We evaluated the CRP/troponin ratio on presentation among patients consecutively included in a large single center registry that included 1898 consecutive patients comprising 1025 ST-elevation myocardial infarction (STEMI) patients, 518 Non-STEMI (NSTEMI) patients, and 355 patients diagnosed on discharge as myopericarditis. CRP and troponin were sampled on admission in all patients and their ratio was assessed against discharge diagnosis. ROC analysis of the CRP/troponin ratios evaluated the diagnostic accuracy of myopericarditis against all AMI, STEMI, and NSTEMI patients. Results: Median admission CRP/troponin ratios were 84, 65, and 436 mg×ml/liter×ng in STEMI, NSTEMI and myopericarditis groups, respectively (p<0.001) demonstrating good differentiating capability. The Receiver-operator-curve of admission CRP/troponin ratio for diagnosis of myopericarditis against all AMI, STEMI, and NSTEMI patients yielded an area-under-the curve of 0.74, 0.73, and 0.765, respectively. CRP/troponin ratio>500 resulted in specificity exceeding 85%, and for a ratio>1000, specificity>92%. Conclusion: The CRP/troponin ratio can serve as an effective tool to differentiate between myopericarditis and AMI. In the appropriate clinical context, the CRP/troponin ratio may preclude further evaluation. [ABSTRACT FROM AUTHOR]

Integration of quantum emitters in photonic structures is an important step in the broader quest to generate and manipulate on-demand single photons via compact solid-state devices. Unfortunately, implementations relying on material platforms that also serve as the emitter host often suffer from a tradeoff between the desired emitter properties and the photonic system practicality and performance. Here, we demonstrate "pick and place" integration of a Si3N4 microdisk optical resonator with a bright emitter host in the form of ∼20-nm-thick hexagonal boron nitride (hBN). The film folds around the microdisk maximizing contact to ultimately form a hybrid hBN/Si3N4 structure. The local strain that develops in the hBN film at the resonator circumference deterministically activates a low density of defect emitters within the whispering gallery mode volume of the microdisk. These conditions allow us to demonstrate cavity-mediated out-coupling of emission from defect states in hBN through the microdisk cavity modes. Our results pave the route toward the development of chip-scale quantum photonic circuits with independent emitter/resonator optimization for active and passive functionalities. [ABSTRACT FROM AUTHOR]

The low level of methionine, an essential sulfur-containing amino acid, limits the nutritional quality of seeds. Two main factors can control the level of protein-bound methionine: the level of free methionine that limits protein accumulation and the methionine residues inside the storage proteins. To reveal the main limiting factor, we generated transgenic Arabidopsis thaliana seed-specific plants expressing the methionine-rich sunflower seed storage (SSA) protein (A1/A2). The contents of protein-bound methionine in the water-soluble protein fraction that includes the SSA in A1/A2 were 5.3- and 10.5-fold, respectively, compared to control, an empty vector (EV). This suggests that free methionine can support this accumulation. To elucidate if the level of free methionine could be increased further in the protein-bound methionine, these lines were crossed with previously characterized plants having higher levels of free methionine in seeds (called SSE). The progenies of the crosses (A1S, A2S) exhibited the highest level of protein-bound methionine, but this level did not differ significantly from A2, suggesting that all the methionine residues of A2 were filled with methionine. It also suggests that the content of methionine residues in the storage proteins is the main limiting factor. The results also proposed that the storage proteins can change their content in response to high levels of free methionine or SSA. This was assumed since the water-soluble protein fraction was highest in A1S/A2S as well as in SSE compared to EV and A1/A2. By using these seeds, we also aimed at gaining more knowledge about the link between high free methionine and the levels of metabolites that usually accumulate during abiotic stresses. This putative connection was derived from a previous analysis of SSE. The results of metabolic profiling showed that the levels of 29 and 20 out of the 56 metabolites were significantly higher in SSE and A1, respectively, that had higher level of free methionine, compared A1S/A2S, which had lower free methionine levels. This suggests a strong link between high free methionine and the accumulation of stress-associated metabolites. [ABSTRACT FROM AUTHOR]

Abstract: Aims: Readmissions for heart failure (HF) are a major burden. We aimed to assess whether the extent of improvement in pulmonary fluid content (ΔPC) during HF hospitalization evaluated by lung impedance (LI), or indirectly by other clinical and laboratory parameters, predicts readmissions. Methods and results: The present study is based on pre‐defined secondary analysis of the IMPEDANCE‐HF extended trial comprising 266 HF patients at New York Heart Association Class II–IV and left ventricular ejection fraction ≤ 35% randomized to LI‐guided or conventional therapy during long‐term follow‐up. Lung impedance‐guided patients were followed for 58 ± 36 months and the control patients for 46 ± 34 months (P < 0.01) accounting for 253 and 478 HF hospitalizations, respectively (P < 0.01). Lung impedance, N‐terminal pro‐brain natriuretic peptide, weight, radiological score, New York Heart Association class, lung rales, leg oedema, or jugular venous pressure were measured at admission and discharge on each hospitalization in both groups with the difference defined as ΔPC. Average LI‐assessed ΔPC was 12.1% vs. 9.2%, and time to HF readmission was 659 vs. 306 days in the LI‐guided and control groups, respectively (P < 0.01). Lung impedance‐based ΔPC predicted 30 and 90 day HF readmission better than ΔPC assessed by the other variables (P < 0.01). The readmission rate for HF was lower if ΔPC > median compared with ΔPC ≤ median for all parameters evaluated in both study groups with the most pronounced difference predicted by LI (P < 0.01). Net reclassification improvement analysis showed that adding LI to the traditional clinical and laboratory parameters improved the predictive power significantly. Conclusions: The extent of ΔPC improvement, primarily the LI based, during HF‐hospitalization, and study group allocation strongly predicted readmission and event‐free survival time. [ABSTRACT FROM AUTHOR]

Aims We report the maternal and foetal outcomes at birth and after 6 months in a cohort of pregnant women with hypertrophic cardiomyopathy (HCM). Although most women with HCM tolerate pregnancy well, there is an increased risk of obstetric and cardiovascular complications. Methods and results All pregnant women with HCM entered into the prospective worldwide Registry of Pregnancy and Cardiac disease (ROPAC) were included in this analysis. The primary endpoint was a major adverse cardiovascular event (MACE), which included death, heart failure (HF), thrombo-embolic event, and arrhythmia. Baseline and outcome data were analysed and compared for patients with MACE vs. without MACE and for patients with obstructive HCM vs. nonobstructive HCM. Sixty pregnant women (mean age 30.4 ± 6.0 years) with HCM (41.7% obstructive) were included. No maternal mortality occurred in this cohort. In 14 (23%) patients at least one MACE occurred: 9 (15.0%) HF and 7 (12%) an arrhythmia (6 ventricular and 1 atrial fibrillation). MACE occurred most commonly during the 3rd trimester and postpartum period. In total, 3 (5.0%) women experienced foetal loss. Women with MACE had a higher rate of emergency Caesarean delivery for cardiac reasons (21.4% vs. 0%, P = 0.01). No significant differences in pregnancy outcome were found between women with obstructive and non-obstructive HCM. NYHA functional class of ≥II and signs of HF before pregnancy, were associated with MACE. Conclusion Although most women with HCM tolerated pregnancy well, cardiovascular complications were not uncommon and predicted by pre-pregnancy status facilitating pre-pregnancy counselling and targeted antenatal care. [ABSTRACT FROM AUTHOR]

Aims Left ventricular (LV) two-dimensional longitudinal strain (2DLS) analysis by echocardiography has been suggested as a useful tool for the detection of acute coronary syndromes (ACS). Our aim was to determine whether 2DLS analysis could assist in triage of patients with chest pain (CP) in the emergency department (ED). Methods and results We prospectively enrolled patients presenting to the ED with CP and suspected ACS but without a diagnostic ECG or elevated troponin. An echocardiogram was performed within 24 h of CP. For each patient, a histogram of LV myocardial peak systolic strain (PSS) was generated and the value identifying the 20% worst strain values (PSS20%) was determined. A predefined value of greater than 217% was considered abnormal. 2DLS analysis was available for 605 patients (mean age 58+9 years, 70% males), of which 74 (12.2%) had ACS. During a 6-month follow-up, MACE occurred in 4 (5.8%) patients with and in 3 (0.6%) without ACS. An abnormal PSS20% was present in 60/74 patients with ACS (sensitivity 81%, negative predictive value 91%), but also in 391/531 patients without ACS (specificity 26%, positive predictive value 13%). Similar results were found for global longitudinal strain (GLS). Receiver-operating characteristic curves showed an area under curve of 0.59 for PSS20% and 0.6 for GLS (P = 0.3). Independent predictors of abnormal 2DLS were male gender, body mass index, heart rate, and mean tissue Doppler e', but not ACS. Conclusion In this large multicentre prospective study, 2DLS was not a useful tool to rule out ACS in the ED. Clinical trial registration http://clinicaltrials.gov. Unique identifier NCT01163019. [ABSTRACT FROM AUTHOR]

The formation of half-light half-matter quasiparticles under strong coupling results in properties unique from those of the constituent components. Fingerprints of both light and matter are imprinted on the new quasiparticles, called polaritons. In the context of two-dimensional (2D) materials, this opens up the possibility of exploiting the intriguing spin-valley physics of a bare semiconductor combined with the light mass of the photonic component for possible quantum technologies. Specifically, the valley degree of freedom, which remained largely unexplored until the advent of these materials, is highly attractive in this context as it provides an optically accessible route for the control and manipulation of electron spin. Here, we report the observation of room-temperature strongly coupled light-matter quasiparticles that are valley polarized because of the coupling of photons with specific helicity to excitons that occupy quantum mechanically distinct valleys in momentum space. The realization of valley polaritons in 2D semiconductor microcavities presents the first step towards engineering valley-polaritonic devices. [ABSTRACT FROM AUTHOR]

Objectives: We present our experience with a novel method for real time co-registration of intravascular ultrasound (IVUS) and coronary angiography. Background: A major limitation of the current practice of concomitant use of coronary angiography and IVUS is that the locations of the acquired IVUS images are not correlated with their exact locations on the vessel roadmap obtained by coronary angiography. Methods: Phantoms simulating the coronary tree were used to test the accuracy and potential of co-registration. Subsequently we examined patients who underwent IVUS during cardiac catheterization. Analysis and feasibility were performed in 42 arteries of 36 patients. Results: The statistical validation in phantoms resulted in a co-registration accuracy of 1.12 mm. The length measurement on an angiogram resulted in an accuracy of 0.38 mm. Co-registration in patients was successful in all cases and four categories were assisted by 1(bad) to 5 (good) grading. Accuracy (the co-registration precision in pointing at the exact corresponding location): 4.8±0.41; Ease of use and workflow: 4.74±0.44; Stent landing zone detection and evaluation: 4.58±0.5; Stent landing zone length and diameter measurement: 4.94±0.23. The co-registration error was estimated as no more than 1 mm. Conclusion: In this pilot study, we found that the novel IVUS and coronary angiography co-registration method is accurate, easy to use, fast and user-friendly. This method precludes the need to use motorized automated pull back device. [ABSTRACT FROM AUTHOR]

The instantaneous lung impedance (ILI) is one of the methods to assess pulmonary congestion or edema (PCE) in chronic heart failure (CHF) patients. Due to usually existing PCE in CHF patients when evaluated, baseline lung impedance (BLI) is unknown. Therefore, the relation of ILI to BLI is unknown. Our aim was to evaluate methods to calculate and appraise BLI or its derivative as reflecting the clinical status of CHF patients. ILI and New York Heart Association (NYHA) class were assessed in 222 patients (67 ± 11 years, LVEF <35 %) during 32 months of frequent outpatient clinic visits. ILI, measured in 120 asymptomatic patients at NYHA class I, with no congestion on the chest X-ray and a low-normal 6-min walk, was defined as BLI. Using measured BLI and ILI values in these patients, formulas for BLI calculation were derived based on logistic regression analysis or on the disparity between BLI and ILI values at different NYHA stages. Both models were equally reliable with <3 % difference between measured and calculated BLI (p = NS). ΔLIR = (ILI/BLI - 1) × 100 % reflected the degree of PCE, or deviation from baseline, correlated with NYHA class (r = -0.9, p < 0.001) and could serve for monitoring. Of study patients, 123 were re-hospitalized for PCE during follow up. Their ΔLIR decreased gradually from -21.7 ± 8.2 % 4 weeks pre-admission to -37.8 ± 9.3 % on admission (p < 0.001). Patients improved during hospital stay (NYHA 3.7 ± 0.5 to 2.9 ± 0.8, p < 0.0001) with ΔLIR increasing to -29.1 ± 12.0 % (p < 0.001). ΔLIR based on calculated BLI correlated with the clinical status of CHF patients and allowed the prediction of hospitalizations for PCE. [ABSTRACT FROM AUTHOR]

Background: Monitoring of lung fluid content (LFC) in order to predict acute heart failure (AHF) during acute myocardial infarction (AMI) is an unmet challenge. Aim: To evaluate in AMI patients the ability of proposed radiological score (RS), which is the sum of selected radiological signs of congestion, to reflect correctly LFC, as assessed with repeat physical examinations and lung impedance (LI) measurements. Methods: Chest X-rays were taken at baseline, when rales were detected, whenever indicated, and at conclusion of monitoring. RS grading for LFC assessment was: RS == 0--1 for normal X-ray, RS == 2--4 for interstitial congestion, and RS values of 5--6, 7--8 and 9--10 signified mild, moderate and severe alveolar edema, respectively. Results: 624 AMI patients without AHF at baseline were monitored (94 ±± 42 h). 476 patients (76%) with baseline RS of 0.3 ±± 0.5 did not develop AHF. Overt AHF developed in 148 patients (24%) during monitoring; baseline RS (0.6 ±± 0.8) reached 5.4 ±± 0.7, 7.0 ±± 0.8, and 9.8 ±± 0.5 at the stages of mild, moderate, and severe alveolar edema, respectively. AHF resolved with treatment. RS decreased to 1.5 ±± 1.3 ( P < 0.01) and correlated with physical examination (r == 0.6, P < 0.01) and LI (r == −−0.9, P < 0.01). Conclusion: RS correlated well with findings on physical examination during AHF and closely correlated with LI. [ABSTRACT FROM AUTHOR]

Background: By and large, prior registries and randomized trials have not distinguished between acute heart failure (AHF) associated with acute coronary syndrome (ACS) versus other causes. Aims: To examine whether the treatments and outcomes of ACS-associated AHF are different from non-ACS-associated AHF. Methods: We examined in a prospective, nationwide hospital-based survey the adjusted outcomes of AHF patients with and without ACS as its principal cause. Results: Of the 4102 patients in our national heart failure survey, 2336 (56.9%) had AHF, of whom 923 (39.5%) had ACS-associated AHF. These patients were more likely to receive intravenous inotropes and vasodilators and to undergo coronary angiography and revascularization, but less likely to receive intravenous diuretics. The unadjusted in-hospital, 30-day, one-year, and four-year mortality rates for AHF patients with or without ACS were 6.5% versus 5.0% ( P == 0.13), 10.3% versus 7.5% ( P == 0.02), 26.6% versus 31.0% ( P == 0.02), and 55.3% versus 63.3% ( P == 0.0001), respectively. In the multivariate analysis, the adjusted mortality risk for patients with ACS at the respective time points were 1.46 (0.99--2.10), 1.67 (1.22--2.30), 1.02 (0.86--1.20), and 0.93 (0.82--1.04). Conclusions: Patients with ACS-associated AHF seem to have a unique clinical course and perhaps should be distinguished from other AHF patients in future trials and registries. [ABSTRACT FROM AUTHOR]

Background: Current guidelines regarding the use of intravenous morphine (IM) in the management of patients with acute decompensated heart failure (ADHF) are discordant; whereas the American guidelines reserve IM for terminal patients, the European guidelines recommend its use in the early stage of treatment. Our aim was to determine the impact of IM on outcomes of ADHF patients. Methods: Stepwise logistic regression and propensity score analysis of ADHF patients with and without use of IM was performed in a national heart failure survey. Results: Of the 4102 enrolled patients, we identified 2336 ADHF patients, of whom 218 (9.3%) received IM. IM patients were more likely to have acute coronary syndromes, acute rather than exacerbation of chronic heart failure, and diabetes mellitus and dyslipidemia. They had higher heart rate, were less likely to receive diuretics and more likely to receive aspirin and statins. Unadjusted in-hospital mortality rates were 11.5% versus 5.0% for patients who did or did not receive IM, and the adjusted odds ratio (OR) for in-hospital death was: 2.0 (1.1--3.5, P == 0.02). Using propensity analysis, we identified 218 matched pairs of patients who did or did not receive IM. In multivariable analysis accounting for the propensity score (c-statistic 0.82), IM was not associated with increased in-hospital death (OR: 1.2 (0.6--2.4), P == 0.55). Conclusion: IM was used sparingly in our ADHF cohort, and was independently associated with increased in-hospital death in multivariable analysis, but not in propensity score analysis. Thus, IM may be used in ADHF, but with caution. Further randomized trials are warranted. [ABSTRACT FROM AUTHOR]

Aims: The present study was designed to identify and compare predictors of short- and long-term mortality in elderly and young patients hospitalized with acute heart failure (HF). [ABSTRACT FROM PUBLISHER]

Aims: Atrial fibrillation (AF) and heart failure (HF) commonly coexist, and each adversely affects the other. The aim of the study was to prospectively evaluate the impact of AF and its subtypes on management, and early and long-term outcome of hospitalized HF patients. [ABSTRACT FROM PUBLISHER]

The article focuses on the study of the association of admission glucose levels and mortality among hospitalized nondiabetic patients with heart failure. The authors studied the data of 4,102 patients where it centers on the 1,122 nondiabetic patients who were admitted because of acute or chronic HF. The result of the study showed that in-hospital and 60-day mortality are associated with admission blood glucose levels but not the 6-month or 1-year mortality in nondiabetic patients with HF.

Background: Cigarette smoking is a known risk factor for sudden cardiac death (SCD). However, the effect of continued cigarette smoking and smoking cessation on SCD risk in patients with established coronary artery disease (CAD) is subject to controversy. We, therefore, evaluated the effect of cigarette smoking on SCD risk in a large cohort of patients with established CAD. Methods: The study population was composed of 3122 patients with a previous myocardial infarction or stable angina who participated in the Bezafibrate Infarction Prevention Trial. Patients were prospectively followed up for a mean of 8.2 years. The primary end point was the incidence of SCD according to smoking status. Results: Among the 370 patients who were current smokers, 30 (8.1%) experienced SCD; 83 (4.6%) of the 1821 patients who had quit smoking and 43 (4.6%) of the 931 patients who had never smoked experienced SCD (P = .01). In multivariate analyses, current smoking was associated with a significant increase in the risk of SCD (hazard ratio, 2.47; 95% confidence interval, 1.46-4.19). Patients who had stopped smoking had no significant increase in the risk of SCD compared with patients who had never smoked (hazard ratio, 1.06; 95% confidence interval, 0.70-1.62). Conclusions: Current cigarette smoking is a powerful independent predictor of SCD risk in patients with CAD. Patients who quit smoking experienced a significant reduction in SCD risk. Thus, efforts to reduce mortality from SCD in patients with CAD should include vigorous smoking cessation strategies. [ABSTRACT FROM AUTHOR]

The predictive value of plasma atrial natriuretic peptide (ANP) on the cardioversion outcome was evaluated in 46 hospitalized patients with recent-onset atrial fibrillation (AF). Cardioversion was successful in 42 (91%) patients, 7 (15%) of them regained sinus rhythm spontaneously. After 12 months, 14 (33%) cardioverted patients were in chronic AF. There were no differences in plasma ANP levels between groups where cardioversion failed, those who cardioverted but later developed chronic AF or those who remained in sinus rhythm. However, among patients who were on antiarrhythmic therapy, ANP levels obtained after cardioversion were lower in those who later remained in sinus rhythm. We conclude that lower ANP after cardioversion may be associated with increased chances of long-term preservation of sinus rhythm.Copyright © 2001 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

It is difficult to assess acute therapeutic intervention therapy, particularly in patients with unstable angina. Our aim was to evaluate the feasibility of a pain-scoring method and to compare the response to sublingual administration of an isosorbide dinitrate (ISDN) tablet, ISDN spray or nitroglycerin (NTG) spray. Pain scoring was assessed by the subjective grading of the patients’ pain severity from 1 to 10. We studied 205 patients (mean age 66 ± 13 years). Pain attenuation, defined as at least 50% reduction in pain intensity, occurred in the ISDN tablet, ISDN spray and NTG spray groups after 360 ± 290, 318 ± 289 and 233 ± 271 s, respectively (p = 0.0005). In conclusion, pain scoring is a feasible and useful clinical method to assess antianginal therapy in unstable angina patients. Sublingual nitrate sprays, particularly NTG, seem to alleviate anginal pain faster than ISDN tablets in this patient population. [ABSTRACT FROM AUTHOR]

The present non-intervention screening study was undertaken to explore the relationships between pre-existing low total cholesterol and all-cause mortality. Eleven thousand, five hundred and sixty-three patients with coronary heart disease who attended a screening visit but were not included in the Bezafibrate Infarction Prevention study were followed-up for a mean of 3·3 years after determination of baseline total cholesterol. Five hundred and ninety-five (5%) of this largely unselected population who had total cholesterol levels ≤ 160 mg. dl−1 formed the study population. The remaining 10 968 patients acted as controls. The relative risk of all-cause mortality among patients with low cholesterol compared to others was 1·49 (95% CI: 1·16–1·91). The relative risk of non-cardiac death was 2·27 times higher in the low cholesterol group than in the controls (95· CI: 1·49–3·45), whereas the risk of cardiac death was the same in both groups (relative risk 1·09; 95% CI: 0·76–1·56). The most frequent cause of non-cardiac death associated with low total cholesterol was cancer. These results in patients with coronary heart disease add weight to previous studies associating low total cholesterol with an increased risk of non-cardiac death. However, a longer follow-up of this cohort of patients is necessary in order to clarify this association. [ABSTRACT FROM PUBLISHER]

Oxidized ouabain, a product of the oxidative cleavage of the rhamnose ring in ouabain has been found to have a higher inotropic toxic ratio in cultured cardiac myocytes. The purpose of our study was to evaluate the efficacy and toxicity of oxidized ouabain in comparison with ouabain in intact animals. Drugs were infused to healthy cats; the positive inotropic effect, and the time-course of development of arrhythmia were followed and recorded until death. Oxidized ouabain was associated with a higher increase in arterial blood pressure, a mean increase of 41±19% as compared with 21±8% in the ouabain group (p<0.10). There were no significant differences in maximal increases of dP/dt or dP/dt/P (65±29%, 28±10% for oxidized ouabain and 49±16%, 27±11% for ouabain, respectively). The mean doses causing persistent arrhythmia (toxic dose) were 93±23 μg/kg of oxidized ouabain vs 39±14 μg/kg of ouabain. Lethal arrhythmias were produced by 215±46 μg/kg of oxidized ouabain and 62±16 μg/kg of ouabain. The radio of toxic to lethal doses was 0.62±0.11 for ouabain vs 0.45±0.09 for oxidized ouabain (p<0.05), but the inotropic to toxic dose ratios were not different. We conclude that oxidized ouabain acts similarly to the known cardiac glycosides in doses which produce inotropic effects in cats, has a lower potency as compared to ouabain, and appears to have a more benign course of intoxication. [ABSTRACT FROM AUTHOR]

Isosorbide-5-mononitrate was administered in a continuous intravenous infusion, according to the haemodynamic response, to 19 patients with left heart failure of ischaemic aetiology; 12 with acute heart failure complicating an acute myocardial infarction and 7 with chronic ischaemic failure. In both groups, the following statistically significant haemodynamic changes were observed: a decrease in PCWP from 25·4 ±4 to 17·2 ± 4·6 mmHg; an increase in SWI from 19 ± 10 t0 23·6 ± 13·1 gm m−2; a slight increase in cardiac index with no change in arterial pressure and only minimal decrease in vascular resistance. There were two major differences in the haemodynamic response between the patients with acute heart failure and those with chronic disease: (a) the duration of the effect of isosorbide-5-mononitrate on the PCWP was longer in the first group (mean, 8 hours, compared to 1·5 hours in the chronic group), and (b) the effect on afterload was more pronounced in the group with chronic ischaemic failure than in the first group. Thus, isosorbide-5-mononitrate administered by intravenous infusion under careful monitoring appears to have a beneficial role in the treatment of acute as well as chronic ischaemic heart failure. [ABSTRACT FROM PUBLISHER]

An abstract of the article "Using Surface Thoracic Bioimpedance for monitoring patients with risk development of Acute Heart Failure. New experience," by M. Shochat and colleagues is presented.

The article presents a study which examined the use of surface lung impedance monitoring in predicting hospitalization for patients with chronic heart failure (CHF) and who suffered episodes of acute pulmonary edema (APE).

The article provides information on the mechanism of sudden death in the Wolff-Parkinson-White (WPW) syndrome. Sudden death is a rare complication of the WPW syndrome. This complication may occur without any apparent environmental triggers in young, previously asymptomatic persons. It is generally believed that the common mechanism of sudden death in WPW patients, especially in the young, is ventricular fibrillation precipitated by atrial fibrillation capable to conduct rapidly over the accessory pathway.

Background. In advanced heart failure, the compensatory responses to reduced cardiac output, in spite of fluid retention, lead to maladaptive consequences. [ABSTRACT FROM PUBLISHER]

An abstract of the study "The Benefit of Early Use of Lipid-lowering Drugs at Discharge in Patients with Acute Coronary Syndromes and Heart Failure," by S. Gottlieb and J. Leor, is presented.

An abstract of the study "Internal thoracic impedance monitoring: a new prospect in acute heart failure," by M. Shochat and colleagues, is presented.