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Segmental dysfunction

Grazyna Nowak, Diana Takacsova Bakajsova, Judit Megyesi
Previously, we documented that activation of protein kinase C-ε (PKC-ε) mediates mitochondrial dysfunction in cultured renal proximal tubule cells (RPTC). This study tested whether deletion of the PKC-ε decreases dysfunction of renal cortical mitochondria and improves kidney function after renal ischemia. PKC-ε levels in mitochondria of ischemic kidneys increased 24h after ischemia. Complex I- and complex II-coupled state 3 respirations were reduced 44% and 27%, respectively, in wild-type (WT) but unchanged and increased in PKC-ε-deficient (KO) mice after ischemia...
October 19, 2016: American Journal of Physiology. Renal Physiology
Suma Babu, Erik P Pioro, Jianbo Li, Yuebing Li
INTRODUCTION: We compared the yield of limb and thoracic paraspinal muscles for revealing lower motor neuron (LMN) dysfunction on electromyography (EMG) in amyotrophic lateral sclerosis (ALS). METHODS: A retrospective review of 354 patients with clinically definite or probable ALS was performed. Seventeen limb muscles and thoracic paraspinal muscles were evaluated for the presence of both active and chronic denervation. RESULTS: Distal limb muscles showed the highest electrodiagnostic sensitivities of LMN dysfunction in ALS regardless of onset region and diagnostic certainty at the time of diagnosis...
October 19, 2016: Muscle & Nerve
Waldemar Elikowski, Małgorzata Małek-Elikowska, Bartosz Kudliński, Paweł Skrzywanek, Sławomir Smól, Stanisław Rzymski
In typical takotsubo cardiomyopathy (TC) apical transient left ventricular dysfunction with concomitant ECG changes mimicking acute anterior myocardial infarction can be observed. Reverse TC (RTC) characterized by contractile disturbances in all basal and often simultaneous mid-ventricular segments is definitely less frequent. ECG pattern of RTC is less known. The authors present ECG findings in 5 cases of RTC in course of intracranial hemorrhage (ICH); 3 patients were diagnosed with subarachnoid hemorrhage (SAH) and the other two with intracerebral hemorrhage or subdural posttraumatic hematoma...
September 29, 2016: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Enrico Agabiti Rosei
Current Hypertension Guidelines emphasize the importance of assessing the presence of preclinical organ damage. In fact, an extensive evaluation of organ damage may increase the number of patients classified at high CV risk and therefore strongly influence the clinical management of patients. Hypertensive heart disease remains to date the form of organ damage for which there is the greatest amount of evidence of a strong independent prognostic significance. In the presence of a chronic pressure overload, a parallel addition of sarcomers takes place with an increase in myocyte width, which in turn increases left ventricular wall thickness; myocyte hypertrophy is also associated with apoptosis, collagen deposition and ventricular fibrosis with an impairment of coronary hemodynamics as well, thus profoundly influencing functional properties of the left (and right) ventricle...
September 2016: Journal of Hypertension
Ben Clark, Sarah Withers, Anthony Heagerty
OBJECTIVE: Resistance arteries significantly contribute to peripheral vascular resistance, and also determine insulin-sensitivity by controlling blood flow to skeletal muscle. Increased microvascular tone therefore facilitates the development of hypertension and insulin-resistance. Surrounding most blood vessels, perivascular adipose tissue (PVAT) exerts a vasorelaxant 'anti-contractile' effect. Few studies on skeletal muscle resistance arteries have investigated this vasorelaxant effect and the role of insulin...
September 2016: Journal of Hypertension
Yusuke Kobayashi, Hideo Kobayashi, Hiroaki Ishiguro, Keisuke Yatsu, Tetsuya Fujikawa, Satoshi Umemura
OBJECTIVE: Though both carotid bulb and aortic arch are known to play important roles in regulation of blood pressure through modulation in baroreflex function, few studies have investigated the association of carotid bulb atherosclerosis and large arterial stiffness and orthostatic blood pressure change. DESIGN AND METHOD: Patients with metabolic disorder such as hypertension, dyslipidemia and diabetes mellitus underwent measurement of segment-specific carotid intima-media thickness (IMT) (as an index of atherosclerosis of carotid bulb), cardio-ankle vascular index (CAVI) (as an index for large arterial stiffness), heart rate variability (HRV) (as an index of baroreflex function) and sit-to-stand orthostatic blood pressure change (as a simple method for detecting orthostatic hypotension)...
September 2016: Journal of Hypertension
Hae-Young Lee, Chan-Soon Park, Sang-Hoon Na, Kyung-Jin Kim, Chan Joo Lee, Sungha Park
A 47-year-old woman was admitted via emergency department due to dyspnea NYHA Fc II-III aggravated for 2 months after upper respiratory infection. Her height and body weight were 161 cm / 67 kg. Initial vital signs were 110/70 mmHg - 112 BPM - 24/min - 36.5°C. Chest PA showed cardiomegaly and pulmonary congestion (Figure 1). B-natriuretic peptide level was markedly increased (2002 pg/mL, normal range ≤ 100 pg/mL). The echocardiographic examination showed severely dilated LV cavity (61/72 mm) and severe LV systolic dysfunction (EF 28%) with normal left ventricular wall thickness (9/11 mm) (Figure 2)...
September 2016: Journal of Hypertension
Junichiro Hashimoto
The central aorta constitutes the main trunk of the systemic arterial tree. It dilates passively with cardiac ejection during systole and then constricts with its recoil function during diastole, thereby regulating blood pressure and blood flow. The central pulsatile hemodynamics affects local hemodynamics within as well as downstream of the aorta (e.g., end organs).The aorta progressively stiffens and dilates with advancing age, and such age-dependent change is accelerated by hypertension. According to the law of Laplace, wall stress depends on the diameter and pressure of the blood vessel...
September 2016: Journal of Hypertension
Chong-Jin Kim
With several lines of evidence, angiotensin-converting enzyme (ACE) inhibitors are recommended in patients with left ventricular systolic dysfunction or heart failure after myocardial infarction, and angiotensin receptor blockers (ARBs) are indicated in patients who are intolerant of ACE inhibitors. Up to 20% of patients cannot tolerate ACE inhibitors due to adverse reactions such as cough or angioedema, ARBs could be an alternative to ACE inhibitors. However, there is lack of data whether ARBs are comparable to ACE inhibitors in patients with myocardial infarction...
September 2016: Journal of Hypertension
Akane Yamabe, Atsushi Irisawa, Ikuo Wada, Goro Shibukawa, Mariko Fujisawa, Ai Sato, Ryo Igarashi, Takumi Maki, Koki Hoshi
Background and study aims: Biliary stent dysfunction is mainly caused by biliary sludge that forms as a result of bacterial adherence and subsequent biofilm formation on the inner surface of the stent. Silver ions arewell known to have excellent antimicrobial activity against a wide range of microorganisms. In this study, we designed and constructed silver-coated plastic stent (PS) and investigated whether the silver coating prevented bacterial adherence and biofilm formation through the use of electron microscopy...
October 2016: Endoscopy International Open
Tomoko Negishi, Kazuaki Negishi, Paaladinesh Thavendiranathan, Goo-Yeong Cho, Bogdan A Popescu, Dragos Vinereanu, Koji Kurosawa, Martin Penicka, Thomas H Marwick
OBJECTIVES: This study sought to show the degree to which experience and training affect the precision and validity of global longitudinal strain (GLS) measurement and to evaluate the variability of strain measurement after feedback. BACKGROUND: The application of GLS for the detection of subclinical dysfunction has been recommended in an expert consensus document and is being used with increasing frequency. The role of experience in the precision and validity of GLS measurement is unknown, as is the efficacy of training...
October 6, 2016: JACC. Cardiovascular Imaging
Wonho Kim, Ramon Quesada, Melanie B Schernthaner, Raul E Herrera, Juan-Carlos Zevallos, Victor N Becerra, Juan M Acuña, Barry T Katzen
OBJECTIVE: We investigated whether successful revascularization of total occlusion of a large lower-extremity artery is associated with improvement of left ventricular (LV) diastolic function. BACKGROUND: Total occlusion of a large lower-extremity artery might affect the systemic vascular resistance and increase the afterload, because the left ventricle must work harder to eject blood into a smaller vascular bed. Chronic elevation of afterload is a cause of LV diastolic dysfunction...
October 15, 2016: Journal of Invasive Cardiology
Vikrant Mahajani, Vidya Suratkal
Takotsubo Cardiomyopathy (TC) is also known as Stress Induced Cardiomyopathy or Broken Heart Syndrome. Typically there is transient systolic dysfunction of the apical or the mid segments of the left ventricle that occurs in the presence of acute emotional stress. Some atypical variants have been described. Hyperadrenergic state associated with emotional stress is cited as the probable etiology. It mimics Acute Myocardial Infarction with concomitant rise in cardiac biomarkers, ECG, 2D-Echocardiography abnormalities comprising of left ventricular dysfunction with regional wall motion abnormality, no significant Coronary Artery Disease on angiography...
June 2016: Journal of the Association of Physicians of India
I E Chazova, T V Martynyuk
Chronic thromboembolic pulmonary hypertension (CTEPH) is precapillary pulmonary hypertension, in which chronic obstruction of large and middle branches of pulmonary arteries (PAs) and secondary changes in the lung microcirculatory bed result in a progressive increase in pulmonary vascular resistance and PA pressure with the development of severe right cardiac dysfunction and heart failure. CTEPH is a unique form of pulmonary hypertension since it is potentially curable by surgical treatment. The diagnostic criteria for CTEPH are a mean PA pressure of ≥25 mm Hg, as evidenced by right heart catheterization; a PA wedge pressure of ≤15 mm Hg; a pulmonary vascular resistance of >2 Wood units; the presence of chronic/organized thrombi/emboli in the elastic PAs (pulmonary trunk, lobular, segmental, subsegmental PAs); effective anticoagulant therapy at therapeutic dosages over at least 3 months...
2016: Terapevticheskiĭ Arkhiv
J Tobias Kühl, Thomas S Kristensen, Anna F Thomsen, Louise Hindsø, Kristoffer L Hansen, Olav W Nielsen, Henning Kelbæk, Klaus F Kofoed
BACKGROUND: Signs of pulmonary congestion obtained from cardiac computed tomography angiographic (coronary CTA) images have not previously been related to clinical congestion or outcome and the clinical value is, therefore, unknown. Our objective was to test the hypothesis that signs of pulmonary congestion predict clinical heart failure and adverse outcome in patients with myocardial infarction. METHODS: Coronary CTA was performed before invasive treatment in 400 prospectively included patients with non ST segment elevation myocardial infarction in an observational study...
September 15, 2016: Journal of Cardiovascular Computed Tomography
Ryan B Griggs, Leonid M Yermakov, Keiichiro Susuki
Communication in the central nervous system (CNS) occurs through initiation and propagation of action potentials at excitable domains along axons. Action potentials generated at the axon initial segment (AIS) are regenerated at nodes of Ranvier through the process of saltatory conduction. Proper formation and maintenance of the molecular structure at the AIS and nodes are required for sustaining conduction fidelity. In myelinated CNS axons, paranodal junctions between the axolemma and myelinating oligodendrocytes delineate nodes of Ranvier and regulate the distribution and localization of specialized functional elements, such as voltage-gated sodium channels and mitochondria...
October 4, 2016: Neuroscience Research
Daniele Bosone, Roberto Fogari, Matteo Cotta Ramusino, Natascia Ghiotto, Elena Guaschino, Annalisa Zoppi, Angela D'Angelo, Alfredo Costa
The aim of the study was to evaluate the usefulness of Holter monitoring for the detection of silent myocardial ischemia (SMI) in elderly type 2 diabetic patients with hypertension and the possible relationship between SMI and cardiovascular autonomic neuropathy (CAN). Two hundred and forty-three asymptomatic outpatients, aged 65-75 years, with type 2 diabetes and essential hypertension underwent 24-h ECG monitoring and 5 tests for the evaluation of both parasympathetic (heart rate variability, response to breath deeping, and Valsalva manoeuvre) and sympathetic (cold pressor test and orthostatic hypotension test) autonomic function...
October 6, 2016: Heart and Vessels
Takumi Higuma, Tsunenari Soeda, Masahiro Yamada, Takashi Yokota, Hiroaki Yokoyama, Kei Izumiyama, Fumie Nishizaki, Yoshiyasu Minami, Lei Xing, Erika Yamamoto, Hang Lee, Ken Okumura, Ik-Kyung Jang
OBJECTIVES: The aim of this study was to evaluate if residual thrombus burden after aspiration thrombectomy affects the outcomes of primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction (STEMI). BACKGROUND: Recent studies failed to show clinical benefit of aspiration thrombectomy in STEMI patients. This might be due to insufficient removal of thrombus at the culprit lesion. METHODS: A total of 109 STEMI patients who underwent aspiration thrombectomy followed by stenting within 24 h from symptom onset were included...
October 10, 2016: JACC. Cardiovascular Interventions
Shunsuke Aoi, Naoki Misumida, Blase Carabello, Maurice Rachko
BACKGROUND: Takotsubo cardiomyopathy (TCM) is an intriguing phenomenon characterized by transient and reversible left ventricular (LV) dysfunction despite angiographically unobstructed coronary arteries. The detailed pathophysiology of stunned, viable myocardium in TCM remains to be determined. Post-extrasystolic potentiation (PESP), the phenomenon of enhanced LV contractility following extrasystole, has been used to assess myocardial viability. METHODS: Utilizing a local database, we identified 74 cases that met the modified Mayo Clinic criteria for TCM between October 2004 and March 2016...
September 17, 2016: International Journal of Cardiology
Yashwant Agrawal, Sourabh Aggarwal, Jagadeesh K Kalavakunta, Vishal Gupta
Brugada syndrome (BS), a life-threatening channelopathy associated with reduced inward sodium current due to dysfunctional sodium channels, is characterized by ST-segment elevation with downsloping "coved type" (type 1) or "saddle back" (type 2) pattern in V1-V3 precordial chest leads (1, 2). Brugada phenocopy, a term describing conditions inducing Brugada-like pattern of electrocardiogram (EKG) manifestations in patients without true BS, is an emerging condition (3). We describe a case series of Brugada phenocopy with hyponatremia...
October 2016: Journal of the Saudi Heart Association
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