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Arrhythmogenic right ventricular cardiomyopathy (ARVC) is one of the major causes of sudden death. Myocardial atrophy with subsequent fibro-fatty replacement predominantly affects right ventricular myocardium and results in global and regional dysfunction as well as areas of slow conduction and dispersion of refractoriness, which are prerequisites for reentrant ventricular tachyarrhythmias. ARVC is commonly presented in patients <65 years old. However, few cases of elderly people suffering from this cardiomyopathy have been reported in the literature. We present a case of an 82-year-old woman with sustained ventricular tachycardia due to first diagnosed ARVC.

The application of nuclear magnetic resonance (NMR) to systems of limited quantity has stimulated the use of micro-coils (diameter <1mm). One method recently proposed for the union of micro-coils with Magic Angle sample Spinning (MAS), involves the integration of a tuned micro-coil circuit within standard MAS rotors inductively coupled to the MAS probe coil, termed "magic-angle coil spinning" (MACS). The spinning of conductive materials results in the creation of circulating Foucault (eddy) currents, which generate heat. We report the first data acquired with a 4mm MACS system and spinning up to 10kHz. The need to spin faster necessitates improved methods to control heating. We propose an approximate solution to calculate the power losses (heat) from the eddy currents for a solenoidal coil, in order to provide insight into the functional dependencies of Foucault currents. Experimental tests of the dependencies reveal conditions which result in reduced sample heating and negligible temperature distributions over the sample volume.

We describe the case of a 58-year-old man who developed acute severe anemia and thrombocytopenia after the administration of tirofiban following coronary artery angioplasty. The intravenous administration of IgG immunoglobulin completely resolved both the anemia and the thrombocytopenia. Although thrombocytopenia has been reported as a sequela to the use of tirofiban, there has been no prior report of a link between tirofiban use and anemia. Our successful resolution of both the anemia and the thrombocytopenia with immunoglobulin supports the theory that these severe sequelae of tirofiban are of autoimmune origin.

The Permanent Scatterers Interferometric SAR technique (PSInSAR) is a method that accurately estimates the near vertical terrain deformation rates, of the order of ∼1 mm year(-1), overcoming the physical and technical restrictions of classic InSAR. In this paper the method is strengthened by creating a robust processing chain, incorporating PSInSAR analysis together with algorithmic adaptations for Permanent Scatterer Candidates (PSCs) and Permanent Scatterers (PSs) selection. The processing chain, called PerSePHONE, was applied and validated in the geophysically active area of the Gulf of Corinth. The analysis indicated a clear subsidence trend in the north-eastern part of the gulf, with the maximum deformation of ∼2.5 mm year(-1) occurring in the region north of the Gulf of Alkyonides. The validity of the results was assessed against geophysical/geological and geodetic studies conducted in the area, which include continuous seismic profiling data and GPS height measurements. All these observations converge to the same deformation pattern as the one derived by the PSInSAR technique.

Background: This study was designed to investigate the association of the 894G>T polymorphism in the eNOS gene with risk of acute myocardial infarction (AMI), extent of coronary artery disease (CAD) on coronary angiography, and in-hospital mortality after AMI., Methods: We studied 1602 consecutive patients who were enrolled in the GEMIG study. The control group was comprised by 727 individuals, who were randomly selected from the general adult population., Results: The prevalence of the Asp298 variant of eNOS was not found to be significantly and independently associated with risk of AMI (RR = 1.08, 95%CI = 0.77-1.51, P = 0.663), extent of CAD on angiography (OR = 1.18, 95%CI = 0.63-2.23, P = 0.605) and in-hospital mortality (RR = 1.08, 95%CI = 0.29-4.04, P = 0.908)., Conclusion: In contrast to previous reports, homozygosity for the Asp298 variant of the 894G>T polymorphism in the eNOS gene was not found to be associated with risk of AMI, extent of CAD and in-hospital mortality after AMI.

The role of heart rate reduction in the management of myocardial ischemia and chronic stable angina is pivotal. However, broad use and appropriate dosing of commonly used rate-slowing drugs is limited by their poor tolerability. Ivabradine is a selective inhibitor of the If currents of the sinoatrial node cells. If currents activity determines the slope of the depolarization curve towards the threshold level controlling heart rate in patients with sinus rhythm. Ivabradine, a compound of the benzocyclobutane (S 16257), exhibits a unique specificity for the If current and has a more favorable profile of adverse reactions compared to other If inhibitors. Accordingly, ivabradine has been used in the treatment of stable angina, where it presented anti-anginal and anti-ischemic effects equivalent to the effects of atenolol and amlodipine. Clinical studies proved the efficacy of ivabradine in patients with stable angina, while clinical data are awaited to verify its probable value in the treatment of atrial tachyarrhythmias and tachycardia due to ventricular dysfunction. Thus, the clinical value of ivabradine, which has completed clinical development for stable angina, is expected to exceed its role in the treatment of myocardial ischemia. In this context, ivabradine, promising efficacious and safe pharmacological management of heart rate, is a huge step in cardiovascular therapeutics.

High-resolution nuclear magnetic resonance spectra from samples located in inhomogeneous static and radio frequency magnetic fields can be obtained by applying a train of z-rotation radio frequency pulses to repeatedly refocus the inhomogeneous broadening during signal detection. z-rotation pulses based on an adiabatic double passage are effective over wide bandwidths using a limited amount of radio frequency power at the expense of being time consuming and, consequently, sensitive to motion of the spin bearing molecules. The signal damping resulting from molecular self-diffusion during the pulse was studied experimentally and using Brownian dynamics simulations. The results show that the analytical expression for diffusion damping during a double spin echo is a reasonable approximation for the signal decay during an adiabatic z-rotation pulse. Methods to alleviate the effects of diffusion are discussed.

High-resolution NMR spectra of materials subject to anisotropic broadening are usually obtained by rotating the sample about the magic angle, which is 54.7 degrees to the static magnetic field. In projected magic angle spinning (p-MAS), the sample is spun about two angles, neither of which is the magic angle. This provides a method of obtaining isotropic spectra while spinning at shallow angles. The p-MAS experiment may be used in situations where spinning the sample at the magic angle is not possible due to geometric or other constraints, allowing the choice of spinning angle to be determined by factors such as the shape of the sample, rather than by the spin physics. The application of this technique to bovine tissue samples is demonstrated as a proof of principle for future biological or medical applications., (2005 Wiley-Liss, Inc)

Resolved NMR spectra from samples in inhomogeneous B0 and B1 fields can be obtained with the so-called "ex situ" methodology, employing a train of composite or adiabatic z-rotation RF pulses to periodically refocus the inhomogeneous broadening during the detection of the time-domain signal. Earlier schemes relied on a linear correlation between the inhomogeneous B0 and B1 fields. Here the pulse length, bandwidth, and amplitude of the adiabatic pulses of the hyperbolic secant type are adjusted to improve the refocusing for a setup with non-linear correlation. The field correlation is measured using a two-dimensional nutation experiment augmented with a third dimension with varying RF carrier frequency accounting for off-resonance effects. The pulse optimization is performed with a computer algorithm using the experimentally determined field correlation and a standard adiabatic z-rotation pulse as a starting point for the iterative optimization procedure. The shape of the z-rotation RF pulse is manipulated to provide refocusing for the conditions given by the sample-, magnet-, and RF-coil geometry.

Magnetic resonance imaging (MRI) encounters fundamental limits in circumstances in which the static magnetic field is not sufficiently strong to truncate unwanted, so-called concomitant components of the gradient field. This limitation affects the attainable optimal image fidelity and resolution most prominently in low-field imaging. In this article, we introduce the use of pulsed magnetic-field averaging toward relaxing these constraints. It is found that the image of an object can be retrieved by pulsed low fields in the presence of the full spatial variation of the imaging encoding gradient field even in the absence of the typical uniform high-field time-independent contribution. In addition, error-compensation schemes can be introduced through the application of symmetrized pulse sequences. Such schemes substantially mitigate artifacts related to evolution in strong magnetic-field gradients, magnetic fields that vary in direction and orientation, and imperfections of the applied field pulses.

Magic-angle sample spinning is one of the cornerstones in high-resolution NMR of solid and semisolid materials. The technique enhances spectral resolution by averaging away rank 2 anisotropic spin interactions, thereby producing isotropic-like spectra with resolved chemical shifts and scalar couplings. In principle, it should be possible to induce similar effects in a static sample if the direction of the magnetic field is varied (e.g., magic-angle rotation of the B0 field). Here we will review some recent experimental results that show progress toward this goal. Also, we will explore some alternative approaches that may enable the recovery of spectral resolution in cases where the field is rotating off the magic angle. Such a possibility could help mitigate the technical problems that render difficult the practical implementation of this method at moderately strong magnetic fields.

A way to use adiabatic radiofrequency pulses and modulated magnetic-field gradient pulses, together constituting a "shim pulse," for NMR spectroscopy and imaging is demonstrated. These pulses capitalize on phase shifts derived from probe gradient coils to compensate for nonlinear intrinsic main magnetic field homogeneity for spectroscopy, as well as for deviations from linear gradients for imaging. This approach opens up the possibility of exploiting cheaper, less-than-perfect magnets and gradient coils for NMR applications.

Mechanical rotation of a sample at 54.7 degrees with respect to the static magnetic field, so-called magic-angle spinning (MAS), is currently a routine procedure in nuclear magnetic resonance (NMR). The technique enhances the spectral resolution by averaging away anisotropic spin interactions thereby producing isotropic-like spectra with resolved chemical shifts and scalar couplings. It should be possible to induce similar effects in a static sample if the direction of the magnetic field is varied, e.g., magic-angle rotation of the B0 field (B0-MAS). Here, this principle is experimentally demonstrated in a static sample of solid hyperpolarized xenon at approximately 3.4 mT. By extension to moderately high fields, it is possible to foresee interesting applications in situations where physical manipulation of the sample is inconvenient or impossible. Such situations are expected to arise in many cases from materials to biomedicine and are particularly relevant to the novel approach of ex situ NMR spectroscopy and imaging.

A pulse sequence consisting of an excitation pulse and two adiabatic full-passage pulses with scaled relative peak amplitudes is combined with phase encoding to recover chemical shift information within 3D images in a 1D inhomogeneous static magnetic field with a matched rf field gradient. The results are discussed in the context of ex situ magnetic resonance and imaging. The future directions of our research in implementing the ex situ technique in a real one-sided system are also discussed.

The use of inhomogeneous but spatially correlated static and radiofrequency (RF) magnetic fields offers a potential methodology for performing magnetic resonance spectroscopy of samples placed outside the bore of the magnet. However, its practical implementation still presents challenging problems, among them the control of nuclear spins over broad frequency offset intervals. The present study introduces an efficient method of encoding the phase of the magnetization when the variation of the static field along the sample is much larger than the RF amplitude. The procedure is based on the use of consecutively applied full-passage adiabatic pulses. The induced phase modulation is broadband and selective because it does not depend on the offset relative to the central frequency and the limits can be sharply defined. Finally, the encoded phase depends almost linearly on the local RF amplitude. All these features enable the recovery of an inhomogeneity-free spectrum with amplitudes close to the theoretically attainable maximum.

In this paper we demonstrate experimentally that the continuously phase-modulated homonuclear decoupling sequence DUMBO-1 is suitable for high-resolution proton NMR spectroscopy of rigid solids. Over a wide range of experimental conditions, we show on the model sample L-alanine as well as on small peptides that proton linewidths of less than 0.5 ppm can be obtained under DUMBO-1 decoupling. In particular the DUMBO-1 sequence yields well resolved proton spectra both at slow and fast MAS. The DUMBO-1 decoupling scheme can in principle be inserted in any multi-nuclear or multi-dimensional solid-state NMR experiment which requires a high-resolution 1H dimension. An example is provided with the 13C-1H MAS-J-HMQC experiment.

The experimental lineshapes of the carboxyl and methyl carbon resonances of fully 13C enriched L-Alanine are studied in detail at different MAS frequencies and decoupling field strengths. Complex lineshapes at intermediate spinning speeds were explained by the joint effect of off rotational resonance and coherent CSA-dipolar cross-correlation. Whereas off rotational-resonance effects lead to complex lineshapes due to a splitting of some energy levels, coherent CSA-dipolar cross-correlation introduces either a differential intensity and/or a differential broadening of the lines of the J-multiplet. The conditions which lead to such effects are explained and experimentally verified. Additional simulations show that these effects can be expected over a wide range of static magnetic fields and are not restricted to L-Alanine.

We show how high-resolution NMR spectra can be obtained for solids for which the spectra are normally broadened due to structural disorder. The method relies on correlations in the chemical shifts between pairs of coupled spins. It is found experimentally that there are strong correlations in the chemical shifts between neighboring spins in both phosphorus-31 and carbon-13 spectra. These correlations can be exploited not only to provide resolution in two-dimensional spectra, but also to yield "chains" of correlated chemical shifts, constituting a valuable new source of structural information for disordered materials.

In a recent publication we presented a method to obtain highly resolved NMR spectra in the presence of an inhomogeneous B(0) field with the help of a matched RF gradient. If RF gradient pulses are combined with "ideal" 90 degrees pulses to form inhomogeneous z rotation pulses, the line broadening caused by the B(0) gradient can be refocused, while the full chemical shift information is maintained. This approach is of potential use for NMR spectroscopy in an inhomogeneous magnetic field produced by an "ex-situ" surface spectrometer. In this contribution, we extend this method toward two-dimensional spectroscopy with high resolution in one or both dimensions. Line narrowing in the indirect dimension can be achieved by two types of nutation echoes, thus leading to depth-sensitive NMR spectra with full chemical shift information. If the nutation echo in the indirect dimension is combined with a stroboscopic acquisition using inhomogeneous z-rotation pulses, highly resolved two-dimensional correlation spectra can be obtained in matched field gradients. Finally, we demonstrate that an INEPT coherence transfer from proton to carbon spins is possible in inhomogeneous B(0) fields. Thus, it is possible to obtain one-dimensional (13)C NMR spectra with increased sensitivity and two-dimensional HETCOR spectra in the presence of B(0) gradients of 0.4 mT/cm. These schemes may be of some value for ex-situ NMR analysis of materials and biological systems.

In this article a method is suggested for restricting a sample (spatial localization) by preparing the magnetization with a phase-modulated radiofrequency pulse which inverts magnetization only over a very narrow range of radiofrequency field strengths. This is the most efficient method, in terms of sensitivity, of restricting the sample to improve rf homogeneity. The method is demonstrated by using it to improve the resolution obtained in a homonuclear dipolar decoupling experiment.