Search

On the basis of glacier and lake-level records, this paper attempts, for the first time, a comparison between high-resolution palaeohydrological and palaeoglaciological data in west-central Europe over the past 3500 years. A data set of tree-ring width, radiocarbon and archaeological data, in addition to historical sources, were used to reconstruct fluctuations of the Great Aletsch, the Gorner and the Lower Grindelwald glaciers in the Swiss Alps. The three ice-streams experienced nearly synchronous advances at c. 1000–600 BC and AD 500–600, 800–900; 1100–1200 and 1300–1860. These glacier fluctuations show strong correspondence with lake-level variations reconstructed in eastern France (Jura mountains and Pre-Alps) and on the Swiss Plateau. This supports the hypothesis of elimatically driven fluctuations. Historical date available for the period since AD 1550 reveal, in detail, various meteorological conditions behind the succesive glacier advances. Howere, in agreement with the general trend shown by the historical data, the synchroneity between glacier advances and periods of higher lake level suggests the impact of general winter cooling and an increase in summer moistur as responsible for reinforced feeding of both glaciers and lakes in west-central Europe ;over the past 3500 years. Finally, comparison between the Great Aletsech glacier and the residual 14C records supports the hypothesis that variations in solar activity were a major forcing factor of climatic oscillations in west-central Europe during the last Holocence. [ABSTRACT FROM AUTHOR]

Background: Concerns exist that long-term cardiac alterations occur after SARS-CoV-2 infection, particularly in patients who were hospitalized in the acute phase or who remain symptomatic. This study investigates potential long-term functional and morphological alterations after SARS-CoV-2 infection., Methods: The authors of this study investigated patients after SARS-CoV-2 infection by using a mobile 1.5-T clinical magnetic resonance scanner for cardiac alterations. Cardiac function and dimensions were assessed using a highly efficient cardiac magnetic resonance (CMR) protocol, which included cine sequences, global longitudinal and circumferential strain assessed by fast-Strain-ENCoded imaging (fSENC), and T1 and T2 mapping. We assessed symptoms through a questionnaire. Patients were compared with a control group matched for age, gender, body mass index, and body surface area., Results: Median follow-up time was 395 (192-408) days. The final population included 183 participants (age 48.4±14.3 years, 48.1% male). During the acute phase of SARS-CoV-2 infection, 27 patients were hospital-admitted. 42 patients reported persistent symptoms (shortness of breath, chest pain, palpitations, or leg edema), and 63 reported impaired exercise tolerance. Left ventricular functional and morphological parameters were within the normal range. T1- and T2-relaxation times were also within the normal range, indicating that the presence of myocardial edema or fibrosis were unlikely. Persistently symptomatic patients showed a slightly reduced indexed LV-SV. Functional parameters remained normal in patients who were hospitalized for SARS-CoV-2, persistently symptomatic, or with ongoing impaired exercise tolerance., Conclusion: Irrespective of ongoing symptoms or severity of prior illness, patients who have recovered from SARS-CoV-2 infection, demonstrate normal functional and morphological cardiac parameters. Long-term cardiac changes due to SARS-CoV-2 infection appear to be rare., Competing Interests: Declaration of Interests The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: James G. Whayne reports a relationship with Myocardial Solutions Inc., Morrisville, NC, United States that includes: employment. Christian Stehning reports a relationship with Philips Clinical Science, Hamburg, Germany that includes: employment. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Background and Purpose: Patients with coronary artery bypass grafts (CABG) face an elevated risk of major adverse cardiac events (MACE). High-dose dobutamine stress cardiovascular magnetic resonance imaging (DCMR) is a well-established technique to detect hemodynamically significant coronary artery disease (CAD). However, there is a lack of data regarding the safety of DCMR in patients with CABG. This study aims to evaluate the safety of DCMR in patients with CABG., Methods: We retrospectively studied patients after CABG who subsequently underwent DCMR between November 2008 and July 2018. Side effects, defined as adverse events and minor symptoms, during DCMR were analyzed and compared to 200 individuals matched for age, sex and BMI without prior CABG undergoing DCMR., Results: 336 patients (70±9 years, 85% men) were identified. Adverse events occurred in 35 CABG patients (10%) and 18 controls (9%, p=0.595). A drop of systolic blood pressure (SBP) >40mmHg (12 patients), non-sustained ventricular tachycardia (6 patients), increase in SBP >200mmHg (5 patients), monomorphic premature ventricular contractions (PVC) (2 patients), bigeminy (2 patients), left bundle-branch block (2 patients), as well as tachycardiac paroxysmal atrial fibrillation, bradycardia, supraventricular tachycardia, couplets/triplets, and sinus arrhythmia in one patient each occurred in the study group. In addition, one patient was hospitalized due to tachycardiac paroxysmal atrial fibrillation and transient ischemic attack. 29 (8.7%) examinations in the study group were aborted because of either chest pain, dyspnea, nausea, dizziness, a drop of SBP, arrhythmias, tachycardiac paroxysmal atrial fibrillation, monomorphic PVCs, or non-sustained ventricular tachycardia. The rate of aborted examination was comparable to the control group (15 (7.5%), p=0.631). Univariable logistic regression analysis revealed that female sex (OR 2.21, 95% CI 1.2 - 4.3, p=0.017) and inducible ischemia (OR 3.50, 95% CI 2.0 - 6.0, p<0.001) were associated with an increased risk of side effects during DCMR., Conclusion: Dobutamine stress CMR did not show a relevant increase of adverse events in patients with prior CABG compared to patients without prior CABG. Female sex and dobutamine-induced myocardial ischemia are associated with side effects during DCMR., Competing Interests: Competing interests The authors declare that they have no competing interests. Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Inc.)

Background: Left ventricular (LV) thrombus formation is a common but potentially serious complication, typically occurring after myocardial infarction. Due to perceived high thromboembolic risk and lack of safety data, stress cardiac magnetic resonance (CMR) imaging especially with dobutamine is usually avoided despite its high diagnostic yield. This study aimed to investigate the characteristics, safety and outcome of patients with LV thrombus undergoing dobutamine or vasodilator stress CMR., Methods: Patients undergoing stress CMR with concomitant LV thrombus were retrospectively included. Risk factors, comorbidities, and previous embolic events were recorded. Periprocedural safety was assessed for up to 48 h following the examination. Major adverse cardiac events (MACE) 12 months before the diagnosis were compared to 12 months after the exam and between patients and a matched control group. Additionally, patients were followed up for all-cause mortality., Results: 95 patients (78 male, 65 ± 10.7 years) were included. Among them, 43 patients underwent dobutamine (36 high-dose, 7 low-dose) and 52 vasodilator stress CMR. Periprocedural safety was excellent with no adverse events. During a period of 24 months, 27 MACE (14.7%) occurred in patients and controls with no statistical difference between groups. During a median follow-up of 33.7 months (IQR 37.6 months), 6 deaths (6.3%) occurred. Type of stress agent, thrombus mobility, or protrusion were not correlated to embolic events or death., Conclusion: The addition of a stress test to a CMR exam is safe and does increase the generally high cardioembolic event rate in LV thrombus patients. Therefore, it is useful to support reperfusion decision-making., (© 2023. The Author(s).)

There is ample evidence showing that childhood maltreatment increases two to three fold the risk of victimization in adulthood. Various risk factors, including posttraumatic stress disorder (PTSD) symptoms, dissociation, self-blame, and alcohol abuse are related to revictimization. Although previous research examined associations between risk factors for revictimization, the evidence is limited and the proposed models mostly include a handful of risk factors. Therefore, it is critical to investigate a more comprehensive model explaining the link between childhood maltreatment and adulthood (re)victimization. Accordingly, this study tested a data-driven theoretical path model consisting of 33 variables (and their associations) that could potentially enhance understanding of factors explaining revictimization. Cross-sectional data derived from a multi-wave study were used for this investigation. Participants (N = 2156, age mean  = 19.94, SD = 2.89) were first-year female psychology students in the Netherlands and New Zealand, who responded to a battery of questionnaires and performed two computer tasks. The path model created by structural equation modelling using modification indices showed that peritraumatic dissociation, PTSD symptoms, trauma load, loneliness, and drug use were important mediators. Attachment styles, maladaptive schemas, meaning in life, and sex motives connected childhood maltreatment to adulthood victimization via other factors (i.e., PTSD symptoms, risky sex behavior, loneliness, emotion dysregulation, and sex motives). The model indicated that childhood maltreatment was associated with cognitive patterns (e.g., anxious attachment style), which in turn were associated with emotional factors (e.g., emotion dysregulation), and then with behavioral factors (e.g., risky sex behavior) resulting in revictimization. The findings of the study should be interpreted in the light of the limitations. In particular, the cross-sectional design of the study hinders us from ascertaining that the mediators preceded the outcome variable., Competing Interests: Declaration of competing interest The authors have no financial disclosures nor conflicts of interest to declare., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction: Advanced chronic kidney disease (CKD) is an independent risk factor for coronary artery disease (CAD). Due to its unique uremia-derived pathophysiology of atherosclerosis and the limitations of using potentially harmful contrast agents, the best non-invasive approach to assess CAD in these patients remains unclear. We sought to investigate the accuracy, safety, and prognosis of patients with severe CKD undergoing dobutamine stress cardiac magnetic resonance imaging (CMR)., Materials and Methods: In this retrospective, single-center study, patients on dialysis or with a glomerular filtration rate of <15 ml/min/1.73 m 2 who underwent dobutamine stress CMR were included. A rest and stress wall motion analysis was performed using dobutamine/atropine as stressor. The target heart rate was 85% of the maximum heart rate. Periprocedural adverse events and 1-year follow-up data were obtained., Results: A total of 176 patients (127 men, 49 women) with a mean age of 60.9 ± 14.7 years were included, of which 156 patients were on permanent dialysis. Short-term symptoms such as angina or shortness of breath during stress CMR were frequent (22.1%), but major complications were rare (one patient with myocardial infarction, 0.6%). The 1-year event rate was high (16.4%) with a significant independent correlation to reduced ejection fraction at rest ( p  = 0.037) and failure to achieve the target heart rate ( p  = 0.029). The overall accuracy for predicting significant CAD was good (sensitivity of 71.4%, specificity of 98.4%) and excellent if the target heart rate was achieved (83.3%, 97.9%). A negative stress CMR was highly predictive for the absence of major adverse cardiac event or any coronary revascularization during the 1-year follow-up (negative predictive value of 95.0%)., Discussion: Dobutamine stress CMR is a safe and accurate diagnostic imaging technique in patients at advanced stages of chronic kidney disease. A reduced ejection fraction and the inability to reach the target heart rate are independent predictors of a poor outcome., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer OB declared a past co-authorship with the authors AO, NF, and FA to the handling editor., (© 2023 Weberling, Seitz, Salatzki, Ochs, Haney, Siry, Heins, Steen, Frey and André.)