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The Determinants of Cardiac Output  

NSDL National Science Digital Library

Part of the Gross Physiology of the Cardiovascular System site, this 22-minute video presentation explains fundamental but often misunderstood concepts about the determinants of cardiac output, using Dr. Anderson's hydraulic model of the cardiovascular system. It is a useful summary and overview of the concepts presented in greater detail in the online text. A transcript of the video presentation is available.

Anderson, Robert M.


Predictors of low cardiac output syndrome after coronary artery bypass  

Microsoft Academic Search

The purpose of this study was to identify patients at risk for the development of low cardiac output syndrome after coronary artery bypass. Low cardiac output syndrome was defined as the need for postoperative intraaortic balloon pump or inotropic support for longer than 30 minutes in the intensive care unit to maintain the systolic blood pressure greater than 90 mm

Vivek Rao; Joan Ivanov; Richard D. Weisel; John S. Ikonomidis; George T. Christakis; Tirone E. David



Mathematics and the Heart: Understanding Cardiac Output  

ERIC Educational Resources Information Center

This paper illustrates a biological application of the concepts of relative change and area under a curve, from mathematics. We study two biological measures "relative change in cardiac output" and "cardiac output", which are predictors of heart blockages and other related ailments. Cardiac output refers to the quantity of…

Champanerkar, Jyoti



Methods and apparatus for determining cardiac output  

NASA Technical Reports Server (NTRS)

The present invention provides methods and apparatus for determining a dynamical property of the systemic or pulmonary arterial tree using long time scale information, i.e., information obtained from measurements over time scales greater than a single cardiac cycle. In one aspect, the invention provides a method and apparatus for monitoring cardiac output (CO) from a single blood pressure signal measurement obtained at any site in the systemic or pulmonary arterial tree or from any related measurement including, for example, fingertip photoplethysmography.According to the method the time constant of the arterial tree, defined to be the product of the total peripheral resistance (TPR) and the nearly constant arterial compliance, is determined by analyzing the long time scale variations (greater than a single cardiac cycle) in any of these blood pressure signals. Then, according to Ohm's law, a value proportional to CO may be determined from the ratio of the blood pressure signal to the estimated time constant. The proportional CO values derived from this method may be calibrated to absolute CO, if desired, with a single, absolute measure of CO (e.g., thermodilution). The present invention may be applied to invasive radial arterial blood pressure or pulmonary arterial blood pressure signals which are routinely measured in intensive care units and surgical suites or to noninvasively measured peripheral arterial blood pressure signals or related noninvasively measured signals in order to facilitate the clinical monitoring of CO as well as TPR.

Cohen, Richard J. (Inventor); Mukkamala, Ramakrishna (Inventor); Sherman, Derin A. (Inventor)



Bioimpedance and bioreactance methods for monitoring cardiac output.  


Noninvasive continuous cardiac output monitoring may have wide clinical applications in anaesthesiology, emergency care and cardiology. It can improve outcomes, establish diagnosis, guide therapy and help risk stratification. The present article describes the theory behind the two noninvasive continuous monitoring methods for cardiac output assessment such as bioimpedance and bioreactance. The review discusses the advantages and disadvantages of these methods and highlights the recent method comparison studies. The use of bioimpedance and bioreactance to estimate cardiac output under haemodynamic challenges is also discussed. In particular, the article focuses on performance of the two methods in the assessment of fluid responsiveness using passive leg raising test and cardiac output response to exercise stress testing. PMID:25480768

Jakovljevic, Djordje G; Trenell, Michael I; MacGowan, Guy A



Evaluation of heavy water for indicator dilution cardiac output measurement  

SciTech Connect

We evaluated deuterium oxide (D2O) as a tracer for cardiac output measurements. Cardiac output measurements made by thermodilution were compared with those made by indicator dilution with D2O and indocyanine green as tracers. Five triplicate measurements for each method were made at intervals of 30 minutes in each of 9 anesthetized, mechanically ventilated goats. Cardiac output ranged between 0.68 and 3.79 L/min. The 45 data points yielded a correlation coefficient of 0.948 for the comparison of D2O indicator dilution cardiac output measurements with thermodilution measurements and a linear regression slope of 1.046. D2O indicator dilution measurements were biased by -0.11 +/- 0.22 L/min compared with thermodilution measurements and had a standard deviation of +/- 0.12 L/min for triplicate measurements. Hematocrits ranging between 20 and 50 vol% had no effect on optical density for D2O. D2O is more stable than indocyanine green and approximately one-tenth the price (40 cents per injection compared with $4). The basic instrumentation cost of approximately $9,000 is an additional initial expense, but provides the ability to perform pulmonary extravascular water measurements with a double-indicator dilution technique. D2O has potential as a tracer for the clinical determination of indicator dilution cardiac output measurements and pulmonary extravascular water measurements.

Schreiner, M.S.; Leksell, L.G.; Neufeld, G.R. (Univ. of Pennsylvania School of Medicine, Philadelphia (USA))



Evaluation of noninvasive cardiac output methods during exercise  

NASA Technical Reports Server (NTRS)

Noninvasive techniques to estimate cardiac output (Qc) will be used during future space flight. This retrospective literature survey compared the Qc techniques of carbon dioxide rebreathing (CO2-R), CO2 single breath (CO2-S), Doppler (DOP), impedance (IM), and inert gas (IG: acetylene or nitrous oxide) to direct (DIR) assessments measured at rest and during exercise.

Moore, Alan D.; Barrows, Linda H.; Rashid, Michael; Siconolfi, Steven F.



Red cell volume and cardiac output in anaemic preterm infants  

Microsoft Academic Search

To test the hypothesis that haemoglobin concentration is a poor predictor of benefit from transfusion in preterm infants, and that red cell volume is the most important indicator of anaemia, 24 preterm infants receiving red cell transfusions had red cell volume, haemoglobin concentration, and cardiac output measured before and after transfusion. Red cell volume was measured either using dilution of

I Hudson; A Cooke; B Holland; A Houston; J G Jones; T Turner; C A Wardrop



Measurement of cardiac output from dynamic pulmonary circulation time CT  

SciTech Connect

Purpose: To introduce a method of estimating cardiac output from the dynamic pulmonary circulation time CT that is primarily used to determine the optimal time window of CT pulmonary angiography (CTPA). Methods: Dynamic pulmonary circulation time CT series, acquired for eight patients, were retrospectively analyzed. The dynamic CT series was acquired, prior to the main CTPA, in cine mode (1 frame/s) for a single slice at the level of the main pulmonary artery covering the cross sections of ascending aorta (AA) and descending aorta (DA) during the infusion of iodinated contrast. The time series of contrast changes obtained for DA, which is the downstream of AA, was assumed to be related to the time series for AA by the convolution with a delay function. The delay time constant in the delay function, representing the average time interval between the cross sections of AA and DA, was determined by least square error fitting between the convoluted AA time series and the DA time series. The cardiac output was then calculated by dividing the volume of the aortic arch between the cross sections of AA and DA (estimated from the single slice CT image) by the average time interval, and multiplying the result by a correction factor. Results: The mean cardiac output value for the six patients was 5.11 (l/min) (with a standard deviation of 1.57 l/min), which is in good agreement with the literature value; the data for the other two patients were too noisy for processing. Conclusions: The dynamic single-slice pulmonary circulation time CT series also can be used to estimate cardiac output.

Yee, Seonghwan, E-mail: [Department of Radiation Oncology, Beaumont Health System, Royal Oak, Michigan 48073 (United States)] [Department of Radiation Oncology, Beaumont Health System, Royal Oak, Michigan 48073 (United States); Scalzetti, Ernest M. [Department of Radiology, SUNY Upstate Medical University, Syracuse, New York 13210 (United States)] [Department of Radiology, SUNY Upstate Medical University, Syracuse, New York 13210 (United States)



Transthoracic electrical bioimpedance versus thermodilution technique for cardiac output measurement during mechanical ventilation  

Microsoft Academic Search

To study the possible influence of mechanical ventilation on the accurracy of thoracic electrical bioimpedance (TEI) in the measurement of cardiac output, we determined cardiac output concurrently by TEI using Kubicek's equation and by thermodilution in 8 acutely ill patients who were mechanically ventilated (assist\\/control mode) but who had no underlying respiratory failure. Cardiac outputs were lower with TEI than

J. C. Preiser; A. Daper; J.-N. Parquier; B. Contempré; J.-L. Vincent



Regional blood flow distribution in dog during induced hypotension and low cardiac output. Spontaneous breathing versus artificial ventilation.  

PubMed Central

Respiratory muscle blood flow and organ blood flow was studied in two groups of dogs with radioactively labeled microspheres to assess the influence of the working respiratory muscles on the regional distribution of blood flow when arterial pressure and cardiac output were lowered by pericardial tamponade. In one group (n = 6), the dogs were paralyzed and mechanically ventilated (Mv), while in the other (n = 6), they were left to breathe spontaneously (Sb). Cardiac output fell to 30% of control values during tamponade in both groups and was maintained constant. None of the dogs was hypoxic. Ventilation in the Sb group peaked after 50 min of hypotension, but remained unchanged in the Mv group. Duplicate measurements of blood flow were made during a control period and after 50 min of tamponade (corresponding to the peak ventilation in Sb). Blood flow to the respiratory muscles increased significantly (P less than 0.001) during tamponade in Sb (diaphragmatic flow increased to 361% of control values), while it decreased in Mv. Although the arterial blood pressure and cardiac output were comparable in the two groups, blood flow distribution during tamponade was different. In Sb, the respiratory muscles received 21% of the cardiac output, compared with only 3% in the Mv group. Thus, by muscle paralysis and Mv, a large fraction of the cardiac output used by the working respiratory muscles can be made available for perfusion of other organs during low cardiac output state: blood flows to the liver, brain, and quadriceps muscles were significantly higher during tamponade in the Mv group compared with the Sb group. Similarly, blood lactate at all times after the induction of low cardiac output and hypotension was significantly lower in the Mv animals (P less than 0.005). PMID:6886012

Viires, N; Sillye, G; Aubier, M; Rassidakis, A; Roussos, C



Non-invasive determination of cardiac output by Doppler echocardiography and electrical bioimpedance  

Microsoft Academic Search

Cardiac output measured by thermodilution in 25 patients within 24 hours of acute myocardial infarction was compared with cardiac output measured by Doppler echocardiography (24 patients) and electrical bioimpedance (25 patients). The mean (range) cardiac outputs measured by Doppler (4.03 (2.2-6.0) 1\\/min) and electrical bioimpedance (3.79 (1.1-6.2) 1\\/min) were similar to the mean thermodilution value (3.95 (2.1-6.2) 1\\/min). Both non-invasive

D B Northridge; I N Findlay; J Wilson; E Henderson; H J Dargie



Maximal Cardiac Output Determines 6 Minutes Walking Distance in Pulmonary Hypertension  

PubMed Central

Purpose The 6 minutes walk test (6MWT) is often shown to be the best predictor of mortality in pulmonary hypertension (PH) probably because it challenges the failing heart to deliver adequate cardiac output. We hypothesised that the 6MWT elicits maximal cardiac output as measured during a maximal cardiopulmonary exercise testing (CPET). Methods 18 patients with chronic thromboembolic pulmonary hypertension (n?=?12) or pulmonary arterial hypertension (n?=?6) and 10 healthy subjects performed a 6MWT and CPET with measurements of cardiac output (non invasive rebreathing device) before and directly after exercise. Heart rate was measured during 6MWT with a cardiofrequence meter. Results Cardiac output and heart rate measured at the end of the 6MWT were linearly related to 6MW distance (mean±SD: 490±87 m). Patients with a high NT-pro-BNP achieve a maximum cardiac output during the 6MWT, while in normal subjects and in patients with a low-normal NT-proBNP, cardiac output at the end of a 6MWT was lower than achieved at maximum exercise during a CPET. In both cases, heart rate is the major determinant of exercise-induced increase in cardiac output. However, stroke volume increased during CPET in healthy subjects, not in PH patients. Conclusion Maximal cardiac output is elicited by 6MWT in PH patients with failing right ventricle. Cardiac output increase is dependent on chronotropic response in patients with PH. PMID:24647561

Deboeck, Gaël; Taboada, Dolores; Hagan, Guy; Treacy, Carmen; Page, Kathy; Sheares, Karen; Naeije, Robert; Pepke-Zaba, Joanna



Cardiac Output Assessed by Invasive and Minimally Invasive Techniques  

PubMed Central

Cardiac output (CO) measurement has long been considered essential to the assessment and guidance of therapeutic decisions in critically ill patients and for patients undergoing certain high-risk surgeries. Despite controversies, complications and inherent errors in measurement, pulmonary artery catheter (PAC) continuous and intermittent bolus techniques of CO measurement continue to be the gold standard. Newer techniques provide less invasive alternatives; however, currently available monitors are unable to provide central circulation pressures or true mixed venous saturations. Esophageal Doppler and pulse contour monitors can predict fluid responsiveness and have been shown to decrease postoperative morbidity. Many minimally invasive techniques continue to suffer from decreased accuracy and reliability under periods of hemodynamic instability, and so few have reached the level of interchangeability with the PAC. PMID:21776254

Lee, Allison J.; Cohn, Jennifer Hochman; Ranasinghe, J. Sudharma



Chronic measurement of cardiac output in conscious mice.  


We describe the feasibility of chronic measurement of cardiac output (CO) in conscious mice. With the use of gas anesthesia, mice >30 g body wt were instrumented either with transit-time flow probes or electromagnetic probes placed on the ascending aorta. Ascending aortic flow values were recorded 6-16 days after surgery when probes had fully grown in. In the first set of experiments, while mice were under ketamine-xylazine anesthesia, estimates of stroke volume (SV) obtained by the transit-time technique were compared with those simultaneously obtained by echocardiography. Transit-time values of SV were similar to those obtained by echocardiography. The average difference +/- SD between the methods was 2 +/- 7 microl. In the second set of studies, transit-time values of CO were compared with those obtained by the electromagnetic flow probes. In conscious resting conditions, estimates +/- SD) of cardiac index (CI) obtained by the transit-time and electromagnetic flow probes were 484 +/- 119 and 531 +/- 103 ml x min(-1) x kg body wt(-1), respectively. Transit-time flow probes were also implanted in mice with a myocardial infarction (MI) induced by ligation of a coronary artery 3 wk before probe implantation. In these MI mice (n = 7), average (+/- SD) resting and stimulated (by volume loading) values of CO were significantly lower than in noninfarcted mice (n = 15) (resting CO 16 +/- 3 vs. 20 +/- 4 ml/min; stimulated CO 20 +/- 5 vs. 26 +/- 6 ml/min). Finally, using transfer function analysis, we found that, in resting conditions for both intact and MI mice, spontaneous variations in CO (> 0.1 Hz) were mainly due to those occurring in SV rather than in heart rate. These data indicate that CO can be measured chronically and reliably in conscious mice, also in conditions of heart failure, and that variations in preload are an important determinant of CO in this species. PMID:11832416

Janssen, B; Debets, J; Leenders, P; Smits, J



High flow variant postural orthostatic tachycardia syndrome amplifies the cardiac output response to exercise in adolescents  

PubMed Central

Abstract Postural orthostatic tachycardia syndrome (POTS) is characterized by chronic fatigue and dizziness and affected individuals by definition have orthostatic intolerance and tachycardia. There is considerable overlap of symptoms in patients with POTS and chronic fatigue syndrome (CFS), prompting speculation that POTS is akin to a deconditioned state. We previously showed that adolescents with postural orthostatic tachycardia syndrome (POTS) have excessive heart rate (HR) during, and slower HR recovery after, exercise – hallmarks of deconditioning. We also noted exaggerated cardiac output during exercise which led us to hypothesize that tachycardia could be a manifestation of a high output state rather than a consequence of deconditioning. We audited records of adolescents presenting with long?standing history of any mix of fatigue, dizziness, nausea, who underwent both head?up tilt table test and maximal exercise testing with measurement of cardiac output at rest plus 2–3 levels of exercise, and determined the cardiac output () versus oxygen uptake () relationship. Subjects with chronic fatigue were diagnosed with POTS if their HR rose ?40 beat·min?1 with head?up tilt. Among 107 POTS patients the distribution of slopes for the , relationship was skewed toward higher slopes but showed two peaks with a split at ~7.0 L·min?1 per L·min?1, designated as normal (5.08 ± 1.17, N = 66) and hyperkinetic (8.99 ± 1.31, N = 41) subgroups. In contrast, cardiac output rose appropriately with in 141 patients with chronic fatigue but without POTS, exhibiting a normal distribution and an average slope of 6.10 ± 2.09 L·min?1 per L·min?1. Mean arterial blood pressure and pulse pressure from rest to exercise rose similarly in both groups. We conclude that 40% of POTS adolescents demonstrate a hyperkinetic circulation during exercise. We attribute this to failure of normal regional vasoconstriction during exercise, such that patients must increase flow through an inappropriately vasodilated systemic circulation to maintain perfusion pressure. PMID:25168872

Pianosi, Paolo T.; Goodloe, Adele H.; Soma, David; Parker, Ken O.; Brands, Chad K.; Fischer, Philip R.



Primary Extracorporeal Membrane Oxygenation Versus Primary Ventricular Assist Device Implantation in Low Cardiac Output Syndrome Following Cardiac Operation  

Microsoft Academic Search

Mechanical support is often the only therapeutic option in low cardiac output (LCO) following cardiac operation using extracorporeal circulation (ECC). However, the question whether primary ventricular assist device (VAD) or primary extracorporeal membrane oxy- genation (ECMO) followed by secondary VAD implanta- tion is superior remains unclear.We analyzed the outcome of 183 patients with LCO following ECC. Primary VAD implantation (VAD)

Stefan Klotz; Andreas Rukosujew; Henryk Welp; Christof Schmid; Tonny D. T. Tjan; Hans H. Scheld



Effect of heat stress on cardiac output and systemic vascular conductance during simulated hemorrhage to presyncope in young men  

PubMed Central

During moderate actual or simulated hemorrhage, as cardiac output decreases, reductions in systemic vascular conductance (SVC) maintain mean arterial pressure (MAP). Heat stress, however, compromises the control of MAP during simulated hemorrhage, and it remains unknown whether this response is due to a persistently high SVC and/or a low cardiac output. This study tested the hypothesis that an inadequate decrease in SVC is the primary contributing mechanism by which heat stress compromises blood pressure control during simulated hemorrhage. Simulated hemorrhage was imposed via lower body negative pressure (LBNP) to presyncope in 11 passively heat-stressed subjects (increase core temperature: 1.2 ± 0.2°C; means ± SD). Cardiac output was measured via thermodilution, and SVC was calculated while subjects were normothermic, heat stressed, and throughout subsequent LBNP. MAP was not changed by heat stress but was reduced to 45 ± 12 mmHg at the termination of LBNP. Heat stress increased cardiac output from 7.1 ± 1.1 to 11.7 ± 2.2 l/min (P < 0.001) and increased SVC from 0.094 ± 0.018 to 0.163 ± 0.032 l·min?1·mmHg?1 (P < 0.001). Although cardiac output at the onset of syncopal symptoms was 37 ± 16% lower relative to pre-LBNP, presyncope cardiac output (7.3 ± 2.0 l/min) was not different than normothermic values (P = 0.46). SVC did not change throughout LBNP (P > 0.05) and at presyncope was 0.168 ± 0.044 l·min?1·mmHg?1. These data indicate that in humans a cardiac output adequate to maintain MAP while normothermic is no longer adequate during a heat-stressed-simulated hemorrhage. The absence of a decrease in SVC at a time of profound reductions in MAP suggests that inadequate control of vascular conductance is a primary mechanism compromising blood pressure control during these conditions. PMID:22367508

Ganio, Matthew S.; Overgaard, Morten; Seifert, Thomas; Secher, Niels H.; Johansson, Pär I.; Meyer, Martin A. S.



The cardiac output from blood pressure algorithms trial*  

PubMed Central

Objective The value of different algorithms that estimate cardiac output (CO) by analysis of a peripheral arterial blood pressure (ABP) waveform has not been definitively identified. In this investigation, we developed a testing data set containing a large number of radial ABP waveform segments and contemporaneous reference CO by thermodilution measurements, collected in an intensive care unit (ICU) patient population during routine clinical operations. We employed this data set to evaluate a set of investigational algorithms, and to establish a public resource for the meaningful comparison of alternative CO-from-ABP algorithms. Design A retrospective comparative analysis of eight investigational CO-from-ABP algorithms using the Multiparameter Intelligent Monitoring in Intensive Care II database. Setting Mixed medical/surgical ICU of a university hospital. Patients A total of 120 cases. Interventions None. Measurements CO estimated by eight investigational CO-from-ABP algorithms, and COTD as a reference. Main Results All investigational methods were significantly better than mean arterial pressure (MAP) at estimating direction changes in COTD. Only the formula proposed by Liljestrand and Zander in 1928 was a significantly better quantitative estimator of COTD compared with MAP (95% limits-of-agreement with COTD: –1.76/+1.41 L/min versus –2.20/+1.82 L/min, respectively; p < 0.001, per the Kolmogorov-Smirnov test). The Liljestrand method was even more accurate when applied to the cleanest ABP waveforms. Other investigational algorithms were not significantly superior to MAP as quantitative estimators of CO. Conclusions Based on ABP data recorded during routine intensive care unit (ICU) operations, the Liljestrand and Zander method is a better estimator of COTD than MAP alone. Our attempts to fully replicate commercially-available methods were unsuccessful, and these methods could not be evaluated. However, the data set is publicly and freely available, and developers and vendors of CO-from-ABP algorithms are invited to test their methods using these data. PMID:19112280

Sun, James X.; Reisner, Andrew T.; Saeed, Mohammed; Heldt, Thomas; Mark, Roger G.



Measurement of cardiac output by use of noninvasively measured transient hemodilution curves with photoacoustic technology  

PubMed Central

We present the theoretical basis and experimental verification for cardiac output measurements using noninvasively measured hemodilution curves afforded with an indicator dilution technique and the emerging photoacoustic technology. A photoacoustic system noninvasively tracks a transient hemodilution effect induced by a bolus of isotonic saline as an indicator. As a result, a photoacoustic indicator dilution curve is obtained, which allows to estimate cardiac output from the developed algorithm. The experiments with a porcine blood circulatory phantom system demonstrated the feasibility of this technology towards the development of a noninvasive cardiac output measurement system for patient monitoring. PMID:24877007

Kang, Dongyel; Huang, Qiaojian; Li, Youzhi



Measurement of cardiac output by use of noninvasively measured transient hemodilution curves with photoacoustic technology.  


We present the theoretical basis and experimental verification for cardiac output measurements using noninvasively measured hemodilution curves afforded with an indicator dilution technique and the emerging photoacoustic technology. A photoacoustic system noninvasively tracks a transient hemodilution effect induced by a bolus of isotonic saline as an indicator. As a result, a photoacoustic indicator dilution curve is obtained, which allows to estimate cardiac output from the developed algorithm. The experiments with a porcine blood circulatory phantom system demonstrated the feasibility of this technology towards the development of a noninvasive cardiac output measurement system for patient monitoring. PMID:24877007

Kang, Dongyel; Huang, Qiaojian; Li, Youzhi



Lithium Dilution Cardiac Output Measurements Using a Peripheral Injection Site: Comparison with Central Injection Technique and Thermodilution  

Microsoft Academic Search

Objective. The lithium dilution technique for the measurement of cardiac output by the central injection of lithium chloride was introduced by Linton et al. in 1993. In the present report, we compare lithium dilution cardiac output measurement (LD) by the peripheral injection of lithium chloride (pLD) and by central venous injection (cLD), cardiac output determined by electromagnetic flowmetry (EM), and

Tadayoshi Kurita; Koji Morita; Shigeru Kato; Hiroyuki Kawasaki; Mutsuhito Kikura; Tomiei Kazama; Kazuyuki Ikeda



[Echocardiography in emergency admissions. Recognition of cardiac low-output failure].  


Detection of acute cardiac dysfunction and differential diagnosis of low cardiac output syndrome is challenging for emergency physicians. For the critical ill patient it is essential to rapidly identify the underlying disease to initiate the correct therapy and optimize patient outcome. Echocardiography is the diagnostic tool of choice for the evaluation of low cardiac output states. In the setting of the emergency department the use of focused echocardiography instead of detailed echocardiographic studies of cardiologists is appropriate and should be provided for emergency care. The differentiation in preserved versus reduced left ventricular ejection fraction as a first assessment is helpful, particularly for physicians not well trained in echocardiography. The structured and focused approach to evaluate or exclude differential diagnoses of cardiac dysfunction is the key for optimal management of acute and critically ill patients with low cardiac output. PMID:23052991

Schmidt, J; Maier, A; Christ, M



Comparison of bioimpedance versus thermodilution cardiac output during cardiac surgery: Evaluation of a second-generation bioimpedance device  

Microsoft Academic Search

Objective: To compare a second-generation thoracic electrical bioimpedance (TEB) hemodynamic monitoring system with the clinically used pulmonary artery catheter thermodilution (TD-PAC) system. Design: Blinded, simultaneous measurements at specified key time points during surgery. Setting: University teaching hospital cardiac surgical operating rooms. Participants: Forty-seven patients undergoing primary elective coronary artery bypass surgery. Interventions: Timed cardiac output measurements by thermodilution and continuous

Bruce D. Spiess; Muhammad A. Patel; Louise O. Soltow; Ian H. Wright



Effects of aging on cardiac output, regional blood flow, and body composition in Fischer-344 rats.  


The purpose of this study was to determine the effects of maturation and aging on cardiac output, the distribution of cardiac output, tissue blood flow (determined by using the radioactive-microsphere technique), and body composition in conscious juvenile (2-mo-old), adult (6-mo-old), and aged (24-mo-old) male Fischer-344 rats. Cardiac output was lower in juvenile rats (51 +/- 4 ml/min) than in adult (106 +/- 5 ml/min) or aged (119 +/- 10 ml/min) rats, but cardiac index was not different among groups. The proportion of cardiac output going to most tissues did not change with increasing age. However, the fraction of cardiac output to brain and spinal cord tissue and to skeletal muscle was greater in juvenile rats than that in the two adult groups. In addition, aged rats had a greater percent cardiac output to adipose tissue and a lower percent cardiac output to cutaneous and reproductive tissues than that in juvenile and adult rats. Differences in age also had little effect on mass-specific perfusion rates in most tissues. However, juvenile rats had lower flows to the pancreas, gastrointestinal tract, thyroid and parathyroid glands, and kidneys than did adult rats, and aged rats had lower flows to the white portion of rectus femoris muscle, spleen, thyroid and parathyroid glands, and prostate gland than did adult rats. Body mass of juvenile rats was composed of a lower percent adipose mass and a greater fraction of brain and spinal cord, heart, kidney, liver, and skeletal muscle than that of the adult and aged animals. Relative to the young adult rats, the body mass of aged animals had a greater percent adipose tissue mass and a lower percent skeletal muscle and skin mass. These data demonstrate that maturation and aging have a significant effect on the distribution of cardiac output but relatively little influence on mass-specific tissue perfusion rates in conscious rats. The old-age-related alterations in cardiac output distribution to adipose and cutaneous tissues appear to be associated with the increases in percent body fat and the decreases in the fraction of skin mass, respectively, whereas the decrease in the portion of cardiac output directed to reproductive tissue of aged rats appears to be related to a decrease in mass-specific blood flow to the prostate gland. PMID:9804586

Delp, M D; Evans, M V; Duan, C



Cardiac Remodeling in Fish: Strategies to Maintain Heart Function during Temperature Change  

Microsoft Academic Search

Rainbow trout remain active in waters that seasonally change between 4°C and 20°C. To explore how these fish are able to maintain cardiac function over this temperature range we characterized changes in cardiac morphology, contractile function, and the expression of contractile proteins in trout following acclimation to 4°C (cold), 12°C (control), and 17°C (warm). The relative ventricular mass (RVM) of

Jordan M. Klaiman; Andrew J. Fenna; Holly A. Shiels; Joseph Macri; Todd E. Gillis



Continuous cardiac output measurement - Aspects of Doppler frequency analysis  

NASA Technical Reports Server (NTRS)

From the suprasternal notch blood flow velocity in the aorta can be measured non-invasively by a Doppler probe. Integration over systole after frequency analysis gives a measure of stroke volume if a separate diameter observation is incorporated. Frequency analysis by a zero crossing counter or by a set of parallel phaselock loops was less effective than a set of bandpass filters. Observations on dogs, baboons and humans before and after exercise or surgery suggest the indications to be useful. Application to judging heart failure by the effect of introducing a volume load is indicated. Changes in output also are measured in freely moving subjects.

Mackay, R. S.; Hechtman, H. B.



Effect of Hemorrhage on Cardiac Output, PVP, Alodosterone and Diuresis during Immersion in Men  

NASA Technical Reports Server (NTRS)

The purpose of this study was to test the hypothesis that a reduction in blood volume would attenuate or eliminate immersion-induced increases in cardiac output (Q (sup dot) sub co)) and urine excretion, and to investigate accompanying vasoactive and fluid-electrolyte hormonal responses.

Simanonok, K.; Greenleaf, John E.; Bernauer, E. M.; Wade, C. E.; Keil, L. C.



Real-time cardiac output estimation of the circulatory system under left ventricular assistance  

Microsoft Academic Search

A method for indirect and real-time estimation of the cardiac output of the circulatory system supported by the left ventricular assist device (LVAD) is proposed. This method has low invasiveness and is useful for clinical applications of the LVAD since it needs only two measurements: the rate of blood outflow from the LVAD and the aortic pressure. The method is

Makoto Yoshizawa; Hiroshi Takeda; Makoto Miura; Tomoyuki Yambe; Yoshiaki Katahira; Shin-ichi Nitta



Bioimpedance versus thermodilution cardiac output measurement: The bomed NCCOM3 after coronary bypass surgery  

Microsoft Academic Search

Values obtained for cardiac output (CO) were compared using thermodilution (TD) with those obtained using bioimpedance (Bi) as measured using the Bomed NCCOM3 (Revision 6) in 28 consecutive patients in the first 24h after coronary artery bypass surgery (CABS). In 46 paired measurements made in the first 12 h after CABS Bi values for CO were significantly lower than TD

A. N. Thomas; J. Ryan; B. R. H. Doran; B. J. Pollard



Changes in cardiac output during swimming and aquatic hypoxia in the air-breathing Pacific tarpon  

E-print Network

is that air-breathing in fishes evolved to allow survival in hypoxic water (Gunther, 1871; Barrell, 1916Changes in cardiac output during swimming and aquatic hypoxia in the air-breathing Pacific tarpon T online 1 August 2007 Abstract Pacific tarpon (Megalops cyprinoides) use a modified gas bladder as an air

Farrell, Anthony P.


Cardiac output and stroke volume estimation using a hybrid of three Windkessel models  

Microsoft Academic Search

Cardiac output (CO) and stroke volume (SV) are the key hemodynamic parameters to be monitored and assessed in ambulatory and critically ill patients. The purpose of this study was to introduce and validate a new algorithm to continuously estimate, within a proportionality constant, CO and SV by means of mathematical analysis of peripheral arterial blood pressure (ABP) waveforms. The algorithm

Tatsuya Arai; Kichang Lee; Richard J. Cohen



Regulation of cardiac output and gut blood flow in the sea raven, Hemitripterus americanus  

Microsoft Academic Search

Coeliac artery blood flow (Fca) before and after feeding was recorded in the sea raven. To obtain basic information about the scope of cardiovascular adjustment in the sea raven, a separate series of experiments was performed, in which ventral (Pva), and dorsal (Pda) aortic blood pressure, heart rate (HR) and cardiac output (jaz) were monitored during rest and encouraged exercise.

Michael Axelsson; William R. Driedzic; Anthony P. Farrell; Stefan Nilsson



Electrical velocimetry for measuring cardiac output in children with congenital heart disease  

Microsoft Academic Search

Background. The purpose of this study was to evaluate the agreement of cardiac output measurements obtained by electrical velocimetry (COEV) and those that derived from the direct Fick-oxygen principle (COF) in infants and children with congenital heart defects. Methods. Simultaneous measurements of COEV and COF were compared in 32 paediatric patients, aged 11 days to 17.8 yr, undergoing diagnostic right

K. Norozi; C. Beck; W. A. Osthaus; I. Wille; A. Wessel; H. Bertram




Microsoft Academic Search

Summary Cardiac output (Q. ) and blood flow distribution were measured in adult largescale suckers at rest and while swimming. Cardiac output was directly measured using an ultrasonic flowprobe in f ish during the summer (16?C), fall (10?C) and winter (5?C). Largescale suckers were adept at holding station against a current without swimming and, when engaged in this behavior, they



Embryonic and adult-derived resident cardiac macrophages are maintained through distinct mechanisms at steady state and during inflammation.  


Cardiac macrophages are crucial for tissue repair after cardiac injury but are not well characterized. Here we identify four populations of cardiac macrophages. At steady state, resident macrophages were primarily maintained through local proliferation. However, after macrophage depletion or during cardiac inflammation, Ly6c(hi) monocytes contributed to all four macrophage populations, whereas resident macrophages also expanded numerically through proliferation. Genetic fate mapping revealed that yolk-sac and fetal monocyte progenitors gave rise to the majority of cardiac macrophages, and the heart was among a minority of organs in which substantial numbers of yolk-sac macrophages persisted in adulthood. CCR2 expression and dependence distinguished cardiac macrophages of adult monocyte versus embryonic origin. Transcriptional and functional data revealed that monocyte-derived macrophages coordinate cardiac inflammation, while playing redundant but lesser roles in antigen sampling and efferocytosis. These data highlight the presence of multiple cardiac macrophage subsets, with different functions, origins, and strategies to regulate compartment size. PMID:24439267

Epelman, Slava; Lavine, Kory J; Beaudin, Anna E; Sojka, Dorothy K; Carrero, Javier A; Calderon, Boris; Brija, Thaddeus; Gautier, Emmanuel L; Ivanov, Stoyan; Satpathy, Ansuman T; Schilling, Joel D; Schwendener, Reto; Sergin, Ismail; Razani, Babak; Forsberg, E Camilla; Yokoyama, Wayne M; Unanue, Emil R; Colonna, Marco; Randolph, Gwendalyn J; Mann, Douglas L



Cardiac Remodeling in Fish: Strategies to Maintain Heart Function during Temperature Change  

PubMed Central

Rainbow trout remain active in waters that seasonally change between 4°C and 20°C. To explore how these fish are able to maintain cardiac function over this temperature range we characterized changes in cardiac morphology, contractile function, and the expression of contractile proteins in trout following acclimation to 4°C (cold), 12°C (control), and 17°C (warm). The relative ventricular mass (RVM) of the cold acclimated male fish was significantly greater than that of males in the control group. In addition, the compact myocardium of the cold acclimated male hearts was thinner compared to controls while the amount of spongy myocardium was found to have increased. Cold acclimation also caused an increase in connective tissue content, as well as muscle bundle area in the spongy myocardium of the male fish. Conversely, warm acclimation of male fish caused an increase in the thickness of the compact myocardium and a decrease in the amount of spongy myocardium. There was also a decrease in connective tissue content in both myocardial layers. In contrast, there was no change in the RVM or connective tissue content in the hearts of female trout with warm or cold acclimation. Cold acclimation also caused a 50% increase in the maximal rate of cardiac AM Mg2+-ATPase but did not influence the Ca2+ sensitivity of this enzyme. To identify a mechanism for this change we utilized two-dimensional difference gel electrophoresis to characterize changes in the cardiac contractile proteins. Cold acclimation caused subtle changes in the phosphorylation state of the slow skeletal isoform of troponin T found in the heart, as well as of myosin binding protein C. These results demonstrate that acclimation of trout to warm and cold temperatures has opposing effects on cardiac morphology and tissue composition and that this results in distinct warm and cold cardiac phenotypes. PMID:21915331

Klaiman, Jordan M.; Fenna, Andrew J.; Shiels, Holly A.; Macri, Joseph; Gillis, Todd E.



Cardiac remodeling in fish: strategies to maintain heart function during temperature Change.  


Rainbow trout remain active in waters that seasonally change between 4°C and 20°C. To explore how these fish are able to maintain cardiac function over this temperature range we characterized changes in cardiac morphology, contractile function, and the expression of contractile proteins in trout following acclimation to 4°C (cold), 12°C (control), and 17°C (warm). The relative ventricular mass (RVM) of the cold acclimated male fish was significantly greater than that of males in the control group. In addition, the compact myocardium of the cold acclimated male hearts was thinner compared to controls while the amount of spongy myocardium was found to have increased. Cold acclimation also caused an increase in connective tissue content, as well as muscle bundle area in the spongy myocardium of the male fish. Conversely, warm acclimation of male fish caused an increase in the thickness of the compact myocardium and a decrease in the amount of spongy myocardium. There was also a decrease in connective tissue content in both myocardial layers. In contrast, there was no change in the RVM or connective tissue content in the hearts of female trout with warm or cold acclimation. Cold acclimation also caused a 50% increase in the maximal rate of cardiac AM Mg(2+)-ATPase but did not influence the Ca(2+) sensitivity of this enzyme. To identify a mechanism for this change we utilized two-dimensional difference gel electrophoresis to characterize changes in the cardiac contractile proteins. Cold acclimation caused subtle changes in the phosphorylation state of the slow skeletal isoform of troponin T found in the heart, as well as of myosin binding protein C. These results demonstrate that acclimation of trout to warm and cold temperatures has opposing effects on cardiac morphology and tissue composition and that this results in distinct warm and cold cardiac phenotypes. PMID:21915331

Klaiman, Jordan M; Fenna, Andrew J; Shiels, Holly A; Macri, Joseph; Gillis, Todd E



Changes in cardiac output during swimming and aquatic hypoxia in the air-breathing Pacific tarpon.  


Pacific tarpon (Megalops cyprinoides) use a modified gas bladder as an air-breathing organ (ABO). We examined changes in cardiac output (V(b)) associated with increases in air-breathing that accompany exercise and aquatic hypoxia. Juvenile (0.49 kg) and adult (1.21 kg) tarpon were allowed to recover in a swim flume at 27 degrees C after being instrumented with a Doppler flow probe around the ventral aorta to monitor V(b) and with a fibre-optic oxygen sensor in the ABO to monitor air-breathing frequency. Under normoxic conditions and in both juveniles and adults, routine air-breathing frequency was 0.03 breaths min(-1) and V(b) was about 15 mL min(-1) kg(-1). Normoxic exercise (swimming at about 1.1 body lengths s(-1)) increased air-breathing frequency by 8-fold in both groups (reaching 0.23 breaths min(-1)) and increased V(b) by 3-fold for juveniles and 2-fold for adults. Hypoxic exposure (2 kPa O2) at rest increased air-breathing frequency 19-fold (to around 0.53 breaths min(-1)) in both groups, and while V(b) again increased 3-fold in resting juvenile fish, V(b) was unchanged in resting adult fish. Exercise in hypoxia increased air-breathing frequency 35-fold (to 0.95 breaths min(-1)) in comparison with resting normoxic fish. While juvenile fish increased V(b) nearly 2-fold with exercise in hypoxia, adult fish maintained the same V(b) irrespective of exercise state and became agitated in comparison. These results imply that air-breathing during exercise and hypoxia can benefit oxygen delivery, but to differing degrees in juvenile and adult tarpon. We discuss this difference in the context of myocardial oxygen supply. PMID:17869150

Clark, T D; Seymour, R S; Christian, K; Wells, R M G; Baldwin, J; Farrell, A P



Peripartum cardiomyopathy: postpartum decompensation and use of non-invasive cardiac output monitoring.  


The utility of a non-invasive cardiac output monitor (NICOM™) in guiding the peripartum management and identification of postpartum complications in a patient with severe peripartum cardiomyopathy is reported. A 31-year-old nulliparous woman at 35 weeks of gestation presented with a three-week history of worsening dyspnea and progressive functional deterioration. A transthoracic echocardiogram showed severe left ventricular systolic dysfunction with an ejection fraction <20%. Cardiac status was monitored using NICOM™ during labor and delivery. The baseline values were: cardiac output 5.3 L/min, total peripheral resistance 1549 dynes.sec/cm(5), stroke volume 42.1 mL and stroke volume variation 18%. She received early epidural analgesia during labor, titrated slowly with a loading dose of 0.0625% bupivacaine 10 mL and fentanyl 25 ?g, followed by patient-controlled epidural analgesia (0.0625% bupivacaine with fentanyl 2 ?g/mL, infusion at 10 mL/h, bolus dose 5 mL and lockout interval 10 min). After epidural drug administration, total peripheral resistance decreased, cardiac output increased, and satisfactory analgesia was obtained. She had an uneventful vaginal delivery with a forceps-assisted second stage after prophylactic administration of furosemide 20 mg. NICOM™ was discontinued after delivery. Fifteen hours post-delivery, the patient developed cardiogenic shock, which resolved after aggressive therapy with inotropes and furosemide. NICOM™ can be used to guide treatment during labor and delivery in patients with critical peripartum cardiomyopathy. We suggest that use of NICOM™ be extended into the postpartum period to detect signs of cardiac decompensation in such patients. PMID:24360329

Lorello, G; Cubillos, J; McDonald, M; Balki, M



Reliability of peak and maximal cardiac output assessed using thoracic bioimpedance in children  

Microsoft Academic Search

The purpose of this study was to evaluate the reliability of a thoracic electrical bioimpedance based device (PhysioFlow) for the determination of cardiac output and stroke volume during exercise at peak oxygen uptake (peak \\u000a in children. The reliability of peak \\u000a is also reported. Eleven boys and nine girls aged 10–11 years completed a cycle ergometer test to voluntary exhaustion on three

Joanne Welsman; Katie Bywater; Colin Farr; Deborah Welford; Neil Armstrong



Continuous intraoperative noninvasive cardiac output monitoring using a new thoracic bioimpedance device  

Microsoft Academic Search

Objectives: To compare a new noninvasive bioimpedance device with the standard thermodilution method during the intraoperative period in high-risk patients undergoing oncological surgery.Design: Prospectively collected data with retrospective analysis.Setting: The study was undertaken at a university hospital, single institution.Participants: Twenty-three selected adults undergoing extensive, ablative oncological surgery.Interventions: Simultaneous measurements of cardiac output by a new bioimpedance method and the standard

Duraiyah Thangathurai; Christopher Charbonnet; Peter Roessler; Charles C. J. Wo; Maged Mikhail; Roland Yoshida; William C. Shoemaker



Cardiac output measurement: Lack of agreement between thermodilution and thoracic electric bioimpedance in two clinical settings  

Microsoft Academic Search

Study objective: To determine the agreement between thermodilution (TD) and thoracic electric bioimpedance (TEB) techniques in cardiac output (CO) measurements in hyperdynamic kidney recipients and normodynamic patients subjected to radical cystectomy. The main objective was to determine the reliability of TEB in CO measurement.Design: Open two-group study.Setting: Unïversity hospital.Patients: 19 kidney recipients and 5 radical cystectomy patients.Interventions: Radial artery cannula

Mohamed M. Atallah; Atef D. Demain



Pressure Pulse Contour-derived Stroke Volume and Cardiac Output in the Morbidly Obese Patient  

Microsoft Academic Search

Background  The pressure pulse contour method for measuring stroke volume (SV) and cardiac output (CO) has come of age. Various methods\\u000a have been proposed, but at this time no single technique has shown clear superiority over the others. This commentary and\\u000a review discusses the various methods, and particularly the pressure recording analytical method (PRAM). Dissection of the\\u000a method shows that vascular

Donald P. Bernstein



Changes in cardiac output during swimming and aquatic hypoxia in the air-breathing Pacific tarpon  

Microsoft Academic Search

Pacific tarpon (Megalops cyprinoides) use a modified gas bladder as an air-breathing organ (ABO). We examined changes in cardiac output (V?b) associated with increases in air-breathing that accompany exercise and aquatic hypoxia. Juvenile (0.49 kg) and adult (1.21 kg) tarpon were allowed to recover in a swim flume at 27 °C after being instrumented with a Doppler flow probe around the ventral aorta

T. D. Clark; R. S. Seymour; K. Christian; R. M. G. Wells; J. Baldwin; A. P. Farrell



Cardiac output distribution in miniature swine during locomotory exercise to VO\\/sub 3max  

Microsoft Academic Search

Distribution of cardiac output (CO) was studied in miniature swine (22 +\\/- 1 kg) during level treadmill exercise up to the speed (17.7 km\\/hr) that elicited maximal oxygen consumption (VO\\/sub 2max\\/) (60 +\\/- 4 m1\\/min\\/kg). COs and tissue blood flows (BFs) were measured with the radiolabelled microsphere technique. CO increased from a preexercise value of 2.1 +\\/- 0.5 1\\/min up

R. B. Armstrong; M. D. Delp; M. H. Laughlin



Cardiac output variations in supine resting subjects during head-out cold water immersion  

NASA Astrophysics Data System (ADS)

Five men, aged 31.2 years (SD 2.3), under semi-nude conditions and resting in a dorsal reclining position, were exposed to thermoneutral air for 30 min, followed immediately by a cold water (15°C) immersion for 60 min. Cardiac output was measured using a dualbeam Doppler flow meter. During immersion in cold water, cardiac frequency ( f c) showed an initial bradycardia. The lowest values were reached at about 10 min after immersion, 58.3 (SD 2.5) to 48.3 (SD 7.8) beats min-1 ( P < 0.05). By the 20th min of exposure, f c had gradually risen to 70.0 beats min-1 (SD 6.6, P < 0.05). This change could be due to the inhibition of the initial vagal reflex by increased catecholamine concentration. Stroke volume ( V s) was significantly increased ( P < 0.05) during the whole cold immersion period. Cardiac output, increased from 3.57 (SD 0.50) to 6.26 (SD 1.33)1 min-1 ( P < 0.05) and its change with time was a function of both V s and f c. On the other hand, systolic flow acceleration was unchanged during the period of immersion. The changes in the respiratory variables (ventilation, oxygen uptake, carbon dioxide output and respiratory exchange ratio) during immersion showed an initial hyperventilation followed, as immersion proceeded, by a slower metabolic increase due to shivering.

Vogelaere, P.; Deklunder, G.; Lecroart, J.



Noninvasive Determination of Cardiac Output by the Inert-Gas-Rebreathing Method – Comparison with Cardiovascular Magnetic Resonance Imaging  

Microsoft Academic Search

Background: An easy, noninvasive and accurate technique for measuring cardiac output (CO) would be desirable for the diagnosis and therapy of cardiac diseases. Innocor, a novel inert-gas-rebreathing (IGR) system, has shown promising results in smaller studies. An extensive evaluation in a larger, less homogeneous patient collective is lacking. Methods: We prospectively assessed the accuracy and reproducibility of CO measurements obtained

Joachim Saur; Stephan Fluechter; Frederik Trinkmann; Theano Papavassiliu; Stefan Schoenberg; Joerg Weissmann; Dariusch Haghi; Martin Borggrefe; Jens J. Kaden



Comparison and reliability of two non-invasive acetylene uptake techniques for the measurement of cardiac output  

Microsoft Academic Search

Comparison and reliability of two non-invasive acetylene uptake techniques for the measurement of cardiac output. Thirteen trained male cyclists performed CO2 rebreathing (CO2RB) at intensities from rest to 200 W, and open-circuit acetylene uptake (OpCirc) and single-breath acetylene uptake (SB) at intensities from rest to 300 W, with all procedures using 50 W increments. Oxygen consumption \\u000a cardiac output \\u000a and heart rate (HR), were

D. W. Dibski; D. J. Smith; R. Jensen; S. R. Norris; G. T. Ford



Automated non-invasive measurement of cardiac output: comparison of electrical bioimpedance and carbon dioxide rebreathing techniques  

Microsoft Academic Search

Two commercial automated, non-invasive systems for estimation of cardiac output were evaluated. Values of cardiac output obtained by electrical bioimpedance cardiography (BoMed NCCOM3 machine) were compared with values derived from an indirect Fick technique that uses carbon dioxide rebreathing (Gould 9000 IV system) during 103 simultaneous measurements made at rest in 19 randomly selected subjects and on exercise in 11

S A Smith; A E Russell; M J West; J Chalmers



99mTc-Labelled serum albumin in cardiac output and blood volume studies  

PubMed Central

The use of human serum albumin labelled with iodine-131 (RIHSA) as the radioactive indicator in the measurement of cardiac output by the external counting technique is not ideal since the emission characteristics, physical half-life, and physiological fate restrict the amount that can be administered. A more suitable material, especially because of the short physical half-life of the isotope involved, is albumin labelled with technetium-99m. This communication describes a simple three-stage process for the preparation of such a complex which was then tested in subjects with no impairment of cardiac performance for its suitability in assays of cardiac output by the external counting method. Values were within the same range as those obtained with RIHSA in comparable subjects. Blood volumes estimated with 99mTc-albumin were within the limits of physiological variation of values derived with RIHSA in the same subjects. Serial blood samplings and urine collection during a period of 24 hours after administration showed that the preparation was lost continuously from the circulation at a more rapid rate than RIHSA. The greatest loss was in the first few hours when most of the urinary excretion of the isotope occurred. Comparison of the present data with published results using an alternative preparation suggests that our product may be more stable. PMID:4935673

Williams, M. Jean; Deegan, T.



Physiologic and Clinical Principles behind Noninvasive Resuscitation Techniques and Cardiac Output Monitoring  

PubMed Central

Clinical assessment and vital signs are poor predictors of the overall hemodynamic state. Optimal measurement of the response to fluid resuscitation and hemodynamics has previously required invasive measurement with radial and pulmonary artery catheterization. Newer noninvasive resuscitation technology offers the hope of more accurately and safely monitoring a broader range of critically ill patients while using fewer resources. Fluid responsiveness, the cardiac response to volume loading, represents a dynamic method of improving upon the assessment of preload when compared to static measures like central venous pressure. Multiple new hemodynamic monitors now exist that can noninvasively report cardiac output and oxygen delivery in a continuous manner. Proper assessment of the potential future role of these techniques in resuscitation requires understanding the underlying physiologic and clinical principles, reviewing the most recent literature examining their clinical validity, and evaluating their respective advantages and limitations. PMID:21860802

Napoli, Anthony M.



Effect of hemorrhage on cardiac output, vasopressin, aldosterone, and diuresis during immersion in men  

NASA Technical Reports Server (NTRS)

The purpose of this research was to test the hypotesis that a reduction in blood volume would attenuate or eliminate immersion-induced increases in cardiac output (Q(sub co)) and urine excretion, and to investigate accompanying vasoactive and fluid-electrolyte hormonal responses. Eight men (19-23 yr) were supine during a 2-hr control period in air, and then sat for 5-hr test periods in air at 20 C (dry control, DC); water at 34.5 C (wet control, WC); and water (34.5 C) after hemorrhage (WH) of 14.8 plus or minus 0.3 percent of their blood volume. Blood volume was -11.6 plus or minus 0.6 percent at immersion (time 0). Mean (bar-X hrs 1-5) Q(sub co) was unchanged in WC (5.3 plus or minus 0.01 l/min) and in WH (4.5 plus or minus 0.1 l/min), but decreased (P less than 0.05) in DC to 3.6 plus or minus 0.1 l/min. Mean urine excretion rates were 1.0 plus or minus 0.2 ml/min for DC and 1.1 plus or minus 0.2 ml/min for WH; both were lower (P less than 0.05) than that for WC of 2.0 plus or minus 0.4 ml/min. Plasma (Na+) and (Osm) were unchanged in all experiments. Mean plasma vasopressin (PVP) (bar-X hrs 1-5) was 1.1 plus or minus 0.1 pg/ml in WC, and higher (P less than 0.05) in DC (2.1 plus or minus 0.2 pg/ml)and WH (2.1 plus or minus 0.1 pg/ml); it was unchanged during air and water test periods. Thus, hemorrhage attenuated the immersion-induced increase in Q(sub co), eliminated the WC diuresis, maintained plasma renin activity and PVP at DC levels and did not change immersion-induced aldosterone suppression; the osmotic diuresis during control immersion is apparently not due to either aldosterone suppression or vasopressin suppression.

Greenleaf, J. E.; Simanonok, K.; Bernauer, E. M.; Wade, C. E.; Keil, L. C.



Quantification of Cardiac Sac Network Effects on a Movement-Related Parameter of Pyloric Network Output in the Lobster  

E-print Network

Output in the Lobster JEFF B. THUMA AND SCOTT L. HOOPER Neuroscience Program, Department of Biological on a movement-related parameter of pyloric network output in the lobster. J Neurophysiol 89: 745­753, 2003; 10 of cardiac sac activity on the OSF of all pyloric neurons in the lobster, Panulirus interruptus

Hooper, Scott


Negative pressure breathing increases cardiac output and nitrogen elimination in seated subjects.  


During denitrogenation for rescue, crew members of an internally pressurized disabled submarine (DISSUB) must sit upright, which may hamper venous return, cardiac output and peripheral circulation. Since negative pressure breathing (NPB) might counteract this problem, denitrogenation was measured in sitting subjects performing NPB. Seven male subjects completed 125-minute nitrogen (N2) washouts breathing either 100% oxygen (O2) or a normoxic gas (21% O2 in argon) in control conditions and intermittent (I: inspirations only) or continuous (C) NPB at -10 or -15 cmH2O. N2 elimination was measured using a closed rebreathing system. INPB (intermittent) (-15cmH2O) and CNPB (continous breathing) (-10 and -15cmH2O) increased cardiac output (CO) 9% during both O2 and normoxic breathing. Systolic and diastolic blood pressures were unaffected by the CO increase, suggesting a peripheral vasodilatation and enhanced tissue perfusion leading to increased N2 elimination. With the CO boost, N2 washout increased 6% breathing O2 at -15 cmH2O CNPB and INPB, while during normoxic breathing there were 6% and 12% increases due to CNBP, -10 and -15 respectively and 6% with -15cmH2O INPB; breathing 100% O2 yielding 5% to 15% less N2 washout than normoxic breathing. Negative pressure breathing during denitrogenation may facilitate decompression in divers and in crew members being rescued from a DISSUB. PMID:24224284

Lundgren, Claes E G; Eckhardt, Lukas G; Senf, Curtis J; Bowdwin, Melina R; Pendergast, David R



The use of electrical cardiometry for continuous cardiac output monitoring in preterm neonates: a validation study.  


Background?Electrical cardiometry (EC) is a continuous noninvasive method for measuring cardiac output (CO), but there are limited data on premature infants. We evaluated the utility of EC monitoring by comparing the results obtained using EC to measurements of CO and systemic blood flow using echocardiography (ECHO). Methods?In this prospective observational study, 40 preterm neonates underwent 108-paired EC and ECHO measurements. Results?There were correlations between EC-CO and left ventricular output (LVO, p?output (RVO, p?

Song, R; Rich, W; Kim, J H; Finer, N N; Katheria, A C



Noninvasive aortic bloodflow by Pulsed Doppler Echocardiography (PDE) compared to cardiac output by the direct Fick procedure  

NASA Technical Reports Server (NTRS)

Left ventricular stroke volume was estimated from the systolic velocity integral in the ascending aorta by pulsed Doppler Echocardiography (PDE) and the cross sectional area of the aorta estimated by M mode echocardiography on 15 patients with coronary disease undergoing right catheterization for diagnostic purposes. Cardiac output was calculated from stroke volume and heart volume using the PDE method as well as the Fick procedure for comparison. The mean value for the cardiac output via the PDE method (4.42 L/min) was only 6% lower than for the cardiac output obtained from the Fick procedure (4.69 L/min) and the correlation between the two methods was excellent (r=0.967, p less than .01). The good agreement between the two methods demonstrates that the PDE technique offers a reliable noninvasive alternative for estimating cardiac output, requiring no active cooperation by the subject. It was concluded that the Doppler method is superior to the Fick method in that it provides beat by beat information on cardiac performance.



Rapamycin Attenuated Cardiac Hypertrophy Induced by Isoproterenol and Maintained Energy Homeostasis via Inhibiting NF-?B Activation  

PubMed Central

Rapamycin, also known as sirolimus, is an immunosuppressant drug used to prevent rejection organ (especially kidney) transplantation. However, little is known about the role of Rapa in cardiac hypertrophy induced by isoproterenol and its underlying mechanism. In this study, Rapa was administrated intraperitoneally for one week after the rat model of cardiac hypertrophy induced by isoproterenol established. Rapa was demonstrated to attenuate isoproterenol-induced cardiac hypertrophy, maintain the structure integrity and functional performance of mitochondria, and upregulate genes related to fatty acid metabolism in hypertrophied hearts. To further study the implication of NF-?B in the protective role of Rapa, cardiomyocytes were pretreated with TNF-? or transfected with siRNA against NF-?B/p65 subunit. It was revealed that the upregulation of extracellular circulating proinflammatory cytokines induced by isoproterenol was able to be reversed by Rapa, which was dependent on NF-?B pathway. Furthermore, the regression of cardiac hypertrophy and maintaining energy homeostasis by Rapa in cardiomyocytes may be attributed to the inactivation of NF-?B. Our results shed new light on mechanisms underlying the protective role of Rapa against cardiac hypertrophy induced by isoproterenol, suggesting that blocking proinflammatory response by Rapa might contribute to the maintenance of energy homeostasis during the progression of cardiac hypertrophy. PMID:25045214

Chen, Xi; Zeng, Siyu; Zou, Jian; Chen, Yanfang; Yue, Zhongbao; Gao, Ying; Zhang, Luankun; Cao, Weiwei; Liu, Peiqing



Reference values for total blood volume and cardiac output in humans  

SciTech Connect

Much research has been devoted to measurement of total blood volume (TBV) and cardiac output (CO) in humans but not enough effort has been devoted to collection and reduction of results for the purpose of deriving typical or {open_quotes}reference{close_quotes} values. Identification of normal values for TBV and CO is needed not only for clinical evaluations but also for the development of biokinetic models for ultra-short-lived radionuclides used in nuclear medicine (Leggett and Williams 1989). The purpose of this report is to offer reference values for TBV and CO, along with estimates of the associated uncertainties that arise from intra- and inter-subject variation, errors in measurement techniques, and other sources. Reference values are derived for basal supine CO and TBV in reference adult humans, and differences associated with age, sex, body size, body position, exercise, and other circumstances are discussed.

Williams, L.R. [Indiana Univ., South Bend, IN (United States). Division of Liberal Arts and Sciences] [Indiana Univ., South Bend, IN (United States). Division of Liberal Arts and Sciences



Rowing increases stroke volume and cardiac output to a greater extent than cycling.  


Exercise stimulates increases in heart rate (HR), stroke volume (SV) and cardiac output (CO). These adaptive mechanisms are strongly dependent on the type of exercise. Both rowing and cycling are widely used for physical training worldwide; however, evidence regarding the differences in major hemodynamic parameters during rowing and cycling remains insufficient. Ten healthy male volunteers were randomly assigned to perform either a rowing or cycling exercise. After 20 min rest, the group who had rowed first performed the cycling exercise and vice versa. Exercise was performed at a power-to-weight ratio of 2 W/kg for 2 min. HR, SV, CO and blood pressure (BP) were measured noninvasively using pulse-wave analysis at baseline and immediately after each exercise. HR, SV and CO were significantly higher after exercise than at rest. Whereas HR was comparable between rowing and cycling, SV and CO were significantly higher after rowing than after cycling. BP was comparable among all three measurements. Rowing increased SV and CO to a greater extent than cycling, whereas HR and BP were not influenced by the type of exercise. Our data suggest that rowing leads to more extensive stimulation of cardiac contractility and/or decreases in peripheral vascular resistance compared with cycling. PMID:25317691

Horn, P; Ostadal, P; Ostadal, B



Increased systemic cardiac output improves arterial oxygen saturation in bidirectional cavopulmonary shunt.  


The low arterial oxygen saturation (SaO2) after bidirectional cavopulmonary shunt (BCPS) predicts poor prognosis. The venous oxygen saturation of inferior vena cava (SivcO2), as well as the pulmonary blood flow/systemic blood flow ratio (Q p/Q s) affects the SaO2. The purpose of this study is to determine whether SivcO2 or Q p/Q s should be increased to achieve better outcomes after BCPS. Forty-eight patients undergoing BCPS were included. Data of patients' age and body weight, SivcO2, Q p/Q s, pulmonary artery (PA) pressure and resistance, PA area index, morphology of ventricle, atrioventricular valve regurgitation, and history of PA plasty were collected. Stepwise multiple logistic regression analyses were used to investigate which of the factors most affected the SaO2 after BCPS. There was a significant correlation between SivcO2 and SaO2 (r = 0.771, P < 0.00001). There was no strong correlation between Q p/Q s and SaO2 (r = 0.358, P < 0.05). Stepwise multiple logistic regression analyses revealed that both SivcO2 (r = 0.49, 95 % confidence interval (CI) 0.37-0.62, P < 0.0001) and Q p/Q s (r = 11.1, 95 % CI 3.3-18.9, P = 0.007) most affected SaO2 after BCPS. Since the SivcO2 has a stronger correlation than Q p/Q s with SaO2, despite the fact that both raising Q p/Q s and raising cardiac output can increase SaO2, raising cardiac output should be considered prior to Q p/Q s to raise the SaO2 after BCPS. PMID:24213974

Oka, Norihiko; Miyaji, Kagami; Kitamura, Tadashi; Itatani, Keiichi; Yoshii, Takeshi; Inoue, Nobuyuki; Fukunishi, Takuma; Shibata, Ko; Torii, Shinzo



In vivo validation of cardiac output assessment in non-standard 3D echocardiographic images  

NASA Astrophysics Data System (ADS)

Automatic segmentation of the endocardial surface in three-dimensional (3D) echocardiographic images is an important tool to assess left ventricular (LV) geometry and cardiac output (CO). The presence of speckle noise as well as the nonisotropic characteristics of the myocardium impose strong demands on the segmentation algorithm. In the analysis of normal heart geometries of standardized (apical) views, it is advantageous to incorporate a priori knowledge about the shape and appearance of the heart. In contrast, when analyzing abnormal heart geometries, for example in children with congenital malformations, this a priori knowledge about the shape and anatomy of the LV might induce erroneous segmentation results. This study describes a fully automated segmentation method for the analysis of non-standard echocardiographic images, without making strong assumptions on the shape and appearance of the heart. The method was validated in vivo in a piglet model. Real-time 3D echocardiographic image sequences of five piglets were acquired in radiofrequency (rf) format. These ECG-gated full volume images were acquired intra-operatively in a non-standard view. Cardiac blood flow was measured simultaneously by an ultrasound transit time flow probe positioned around the common pulmonary artery. Three-dimensional adaptive filtering using the characteristics of speckle was performed on the demodulated rf data to reduce the influence of speckle noise and to optimize the distinction between blood and myocardium. A gradient-based 3D deformable simplex mesh was then used to segment the endocardial surface. A gradient and a speed force were included as external forces of the model. To balance data fitting and mesh regularity, one fixed set of weighting parameters of internal, gradient and speed forces was used for all data sets. End-diastolic and end-systolic volumes were computed from the segmented endocardial surface. The cardiac output derived from this automatic segmentation was validated quantitatively by comparing it with the CO values measured from the volume flow in the pulmonary artery. Relative bias varied between 0 and -17%, where the nominal accuracy of the flow meter is in the order of 10%. Assuming the CO measurements from the flow probe as a gold standard, excellent correlation (r = 0.99) was observed with the CO estimates obtained from image segmentation.

Nillesen, M. M.; Lopata, R. G. P.; de Boode, W. P.; Gerrits, I. H.; Huisman, H. J.; Thijssen, J. M.; Kapusta, L.; de Korte, C. L.



Noninvasive cardiac output measurement by inert gas rebreathing in suspected pulmonary hypertension.  


The objective of this study was to evaluate inert gas rebreathing (IGR) reliability in cardiac output (CO) measurement compared with Fick method and thermodilution. IGR is a noninvasive method for CO measurement; CO by IGR is calculated as pulmonary blood flow plus intrapulmonary shunt. IGR may be ideal for follow-up of patients with pulmonary hypertension (PH), sparing the need of repeated invasive right-sided cardiac catheterization. Right-sided cardiac catheterization with CO measurement by thermodilution, Fick method, and IGR was performed in 125 patients with possible PH by echocardiography. Patients were grouped according to right-sided cardiac catheterization-measured mean pulmonary and wedge pressures: normal pulmonary arterial pressure (n = 20, mean pulmonary arterial pressure = 18 ± 3 mm Hg, pulmonary capillary wedge pressure = 11 ± 5 mm Hg), PH and normal pulmonary capillary wedge pressure (PH-NW, n = 37 mean pulmonary arterial pressure = 42 ± 13 mm Hg, pulmonary capillary wedge pressure = 11 ± 6 mm Hg), and PH and high pulmonary capillary wedge pressure (PH-HW, n = 68, mean pulmonary arterial pressure = 37 ± 9 mm Hg, pulmonary capillary wedge pressure = 24 ± 6 mm Hg). Thermodilution and Fick measurements were comparable. Fick and IGR agreement was observed in normal pulmonary arterial pressure (CO = 4.10 ± 1.14 and 4.08 ± 0.97 L/min, respectively), whereas IGR overestimated Fick in patients with PH-NW and those with PH-HW because of intrapulmonary shunting overestimation in hypoxemic patients. When patients with arterial oxygen saturation (SO2) ?90% were excluded, IGR and Fick agreement improved in PH-NW (CO = 4.90 ± 1.70 and 4.76 ± 1.35 L/min, respectively) and PH-HW (CO = 4.05 ± 1.04 and 4.10 ± 1.17 L/min, respectively). In hypoxemic patients, we estimated pulmonary shunt as Fick - pulmonary blood flow and calculated shunt as: -0.2423 × arterial SO2 + 21.373 L/min. In conclusion, IGR is reliable for CO measurement in patients with PH with arterial SO2 >90%. For patients with arterial SO2 ?90%, a new formula for shunt calculation is proposed. PMID:24315114

Farina, Stefania; Teruzzi, Giovanni; Cattadori, Gaia; Ferrari, Cristina; De Martini, Stefano; Bussotti, Maurizio; Calligaris, Giuseppe; Bartorelli, Antonio; Agostoni, Piergiuseppe



Non-invasive beat-to-beat cardiac output monitoring by an improved method of transthoracic bioimpedance measurement  

Microsoft Academic Search

The report describes a method of impedance cardiography using an improved estimate of thoracic volume. The formulas and their implementation in hardware and software are explained and new shortband electrodes are described which generate a good homogeneous thoracic field. Examples of stroke volume and cardiac output curves underline the capabilities of the monitoring system “Task Force® Monitor”. In several experiments,

J. Fortin; W. Habenbacher; A. Heller; A. Hacker; R. Grüllenbergera; J. Innerhofer; H. Passath; Ch. Wagner; G. Haitchi; D. Flotzinger; R. Pacher; P. Wach



A comparison of dobutamine and levosimendan on hepatic blood flow in patients with a low cardiac output state after cardiac surgery: a randomised controlled study.  


Liver dysfunction due to a low cardiac output state after cardiac surgery is associated with a poor prognosis, but whether one inotrope is superior to another in improving hepatic perfusion remains uncertain. This study compared the systemic and hepatic haemodynamic effects of levosimendan to dobutamine in patients with a low cardiac output state (cardiac index < 2.2 l/min/m2) after on-pump cardiac surgery. A total of 25 patients were randomised to receive either an intravenous bolus of levosimendan (12 µg/kg) over 15 minutes, followed by an infusion of 0.2 µg/kg/min for 24 hours, or an infusion of dobutamine 7.5 µg/kg/min for 24 hours and completed the study. The systemic and hepatic haemodynamics at 24 and 48 hours were all better after levosimendan than dobutamine (dobutamine group: cardiac index (l/min/m2)=2.51 [standard deviation ±0.29], 2.40±0.23; portal vein flow (ml/min): 614.0±124.7, 585.9±144.8; pulsatility index: 2.02±0,28, 2.98±0.27 versus the levosimendan group: cardiac index: 3.02± 0.27, 2.98± 0.30; portal vein flow: 723.0± 143.5, 702.9±117.8; pulsatility index: 1.71±0.26, 1.73±0.27). The improvement in portal vein blood flow at 48 hours was significantly better after levosimendan than dobutamine (41% vs. 11% increment from baseline, P<0.05). In addition, there was a significant reduction in hepatic artery resistance after levosimendan but not dobutamine (resistance index reduction 6.5% vs. 0%, P<0.05). In summary, levosimendan can be considered as a selective liver vasodilator and can improve hepatic blood flow through both the hepatic artery and portal venous system, whereas dobutamine can only improve the portal venous blood flow without vasodilating the hepatic artery. PMID:24180712

Alvarez, J; Baluja, A; Selas, S; Otero, P; Rial, M; Veiras, S; Caruezo, V; Taboada, M; Rodriguez, I; Castroagudin, J; Tome, S; Rodriguez, A; Rodriguez, J



Pulmonary diffusing capacity, capillary blood volume, and cardiac output during sustained microgravity  

NASA Technical Reports Server (NTRS)

We measured pulmonary diffusing capacity (DL), diffusing capacity per unit lung volume, pulmonary capillary blood volume (Vc), membrane diffusing capacity (Dm), pulmonary capillary blood flow or cardiac output (Qc), and cardiac stroke volume (SV) in four subjects exposed to nine days of microgravity. DL in microgravity was elevated compared with preflight standing values and was higher than preflight supine because of the elevation of both Vc and Dm. The elevation in Vc was comparable to that measured supine in 1 G, but the increase in Dm was in sharp contrast to the supine value. We postulate that, in 0 G, pulmonary capillary blood is evenly distributed throughout the lung, providing for uniform capillary filling, leading to an increase in the surface area available for diffusion. By contrast, in the supine 1-G state, the capillaries are less evenly filled, and although a similar increase in blood volume is observed, the corresponding increase in surface area does not occur. DL and its subdivisions showed no adaptive changes from the first measurement 24 h after the start of 0 G to eight days later. Similarly, there were no trends in the postflight data, suggesting that the principal mechanism of these changes was gravitational. The increase in Dm suggests that subclinical pulmonary edema did not result from exposure to 0 G. Qc was modestly increased inflight and decreased postflight compared with preflight standing. Compared with preflight standing, SV was increased 46 percent inflight and decreased 14 percent in the 1st week postflight. There were temporal changes in Qc and SV during 0 G, with the highest values recorded at the first measurement, 24 h into the flight. The lowest values of Qc and SV occurred on the day of return.

Prisk, G. K.; Guy, Harold J. B.; Elliott, Ann R.; Deutschman, Robert A., III; West, John B.



Combined first pass and gated blood pool radionuclide studies in the hemodynamic-cardiac evaluation of patients with low cardiac output  

SciTech Connect

Cardiac output (CO) is frequently used in the evaluation of cardiac function but low CO does not necessarily reflect heart failure. Similarly, low ejection fraction (EF) can be present in compensated heart diseases. In order to evaluate cardiac performance in relation to systematic hemodynamics, the authors used a multifactorial approach for the determination of CO, EF, pulmonary mean transit time (MTT), ratio of cardiopulmonary volume over total blood volume (CPV/TBV as an index of venous tone) all obtained from a single injection of 99m Tc-HSA. Four different conditions associated with low CO (less than or equal to 2.1 L/min/m/sup 2/) were evaluated. The combined use of CO, EF, MTT and CPV/TBV allowed a better understanding of the myocardial and peripheral circulatory factors associated with low CO states. This is helpful in the selection and follow-up of appropriate therapeutic intervention.

Abi-Mansour, P.; Fouad, F.M.; Sheeler, L.R.; Bravo, E.L.; MacIntyre, W.J.; Tarazi, R.C.



Cardiac Output is Not a Significant Source of Low Frequency Mean Arterial Pressure Variability  

PubMed Central

Spontaneous mean arterial pressure (MAP) variability may be mainly due to fluctuations in cardiac output (CO) and total peripheral resistance (TPR). While high frequency (HF ~ 0.25 Hz) oscillations in MAP are ultimately driven by respiration, the source of low frequency (LF ~ 0.1 Hz) fluctuations has not been fully elucidated. It is known that CO buffers these oscillations, but there is no evidence on its potential role in also generating them. The main goal was to determine whether CO is a source of LF variability in MAP. Six dogs were chronically instrumented to obtain beat-to-beat measurements of CO and MAP while the dogs were fully awake and at rest. A causal dynamic model was identified to relate the fluctuations in CO to MAP. The model was then used to predict the MAP fluctuations from the CO fluctuations. The CO fluctuations were able to predict about 70% of the MAP oscillations in the HF band but showed no predictive value in the LF band. Hence, respiration induces CO fluctuations in the HF band that, in turn, cause MAP oscillations, while TPR fluctuations appear to be the dominant mediator of LF fluctuations of MAP. CO is not a significant source of these oscillations, and it may only be responsible for dampening them, likely through the baroreflex. PMID:23969898

Aletti, F; Hammond, RL; Sala-Mercado, JA; Chen, X; O’Leary, DS; Baselli, G; Mukkamala, R



Continuous, non-invasive techniques to determine cardiac output in children after cardiac surgery: evaluation of transesophageal Doppler and electric velocimetry  

Microsoft Academic Search

Background. Continuous and non-invasive measurement of cardiac output (CO) may contribute helpful information to the care and treatment\\u000a of the critically ill pediatric patient. Different methods are available but their clinical verification is still a major\\u000a problem. Aim. Comparison of reliability and safety of two continuous non-invasive methods with transthoracic echocardiography (TTE) for\\u000a CO measurement: electric velocimetry technique (EV, Aesculon™)

Stephan Schubert; Thomas Schmitz; Markus Weiss; Nicole Nagdyman; Michael Huebler; Vladimir Alexi-Meskishvili; Felix Berger; Brigitte Stiller



The effect of changes in cardiac output on middle cerebral artery mean blood velocity at rest and during exercise  

PubMed Central

We examined the relationship between changes in cardiac output and middle cerebral artery mean blood velocity (MCA Vmean) in seven healthy volunteer men at rest and during 50% maximal oxygen uptake steady-state submaximal cycling exercise. Reductions in were accomplished using lower body negative pressure (LBNP), while increases in were accomplished using infusions of 25% human serum albumin. Heart rate (HR), arterial blood pressure and MCA Vmean were continuously recorded. At each stage of LBNP and albumin infusion was measured using an acetylene rebreathing technique. Arterial blood samples were analysed for partial pressure of carbon dioxide tension (Pa,CO2. During exercise HR and were increased above rest (P < 0.001), while neither MCA Vmean nor Pa,CO2 was altered (P > 0.05). The MCA Vmean and were linearly related at rest (P < 0.001) and during exercise (P = 0.035). The slope of the regression relationship between MCA Vmean and at rest was greater (P = 0.035) than during exercise. In addition, the phase and gain between MCA Vmean and mean arterial pressure in the low frequency range were not altered from rest to exercise indicating that the cerebral autoregulation was maintained. These data suggest that the associated with the changes in central blood volume influence the MCA Vmean at rest and during exercise and its regulation is independent of cerebral autoregulation. It appears that the exercise induced sympathoexcitation and the change in the distribution of between the cerebral and the systemic circulation modifies the relationship between MCA Vmean and . PMID:16210355

Ogoh, Shigehiko; Brothers, R Matthew; Barnes, Quinton; Eubank, Wendy L; Hawkins, Megan N; Purkayastha, Sushmita; O-Yurvati, Albert; Raven, Peter B



Effect of measurement errors on cardiac output calculated with O 2 and modified CO 2 Fick methods  

Microsoft Academic Search

We have investigated the effect of measurement errors on cardiac output, calculated via three different Fick methods. In method\\u000a 1, the classic O2 Fick equation is expressed in terms of oxygen uptake (\\u000a $$\\\\dot Vo_2 $$\\u000a ), arterial pulse (Sao2) and venous oximetry (Svo2) saturations. The second method, a modified CO2 Fick method, is obtained by replacing\\u000a $$\\\\dot Vo_2 $$

C. Kees Mahutte; Michael B. Jaffe



High-output cardiac failure in a fetus with thanatophoric dysplasia associated with large placental chorioangioma: case report.  


Placental chorioangioma is an angioma arising from chorionic tissue. Fetal thanatophoric dysplasia is a lethal skeletal dysplasia due to mutation of fibroblast growth factor receptor 3 gene. These two conditions are rare and their coexistence in a given fetus is even rarer. We present a case of a fetus with thanatophoric dysplasia having high-output cardiac failure due to a large placental chorioangioma. PMID:22508320

Akercan, Fuat; Oncul Seyfettinoglu, Sevtap; Zeybek, Burak; Cirpan, Teksin



Non-invasive cardiac output evaluation during a maximal progressive exercise test, using a new impedance cardiograph device  

Microsoft Academic Search

.   One of the greatest challenges in exercise physiology is to develop a valid, reliable, non-invasive and affordable measurement\\u000a of cardiac output (CO). The purpose of this study was to evaluate the reproducibility and accuracy of a new impedance cardiograph\\u000a device, the Physio Flow, during a 1-min step incremental exercise test from rest to maximal peak effort. A group of

Ruddy Richard; Evelyne Lonsdorfer-Wolf; Anne Charloux; Stéphane Doutreleau; Martin Buchheit; Monique Oswald-Mammosser; Eliane Lampert; Bertrand Mettauer; Bernard Geny; Jean Lonsdorfer



Assessment of cardiac output with transpulmonary thermodilution during exercise in humans.  


The accuracy and reproducibility of transpulmonary thermodilution (TPTd) to assess cardiac output (Q?) in exercising men was determined using indocyanine green (ICG) dilution as a reference method. TPTd has been utilized for the assessment of Q? and preload indexes of global end-diastolic volume and intrathoracic blood volume, as well as extravascular lung water (EVLW) in resting humans. It remains unknown if this technique is also accurate and reproducible during exercise. Sixteen healthy men underwent catheterization of the right femoral vein (for iced saline injection), an antecubital vein (ICG injection), and femoral artery (thermistor) to determine their Q? by TPTd and ICG concentration during incremental one- and two-legged pedaling on a cycle ergometer and combined arm cranking with leg pedaling to exhaustion. There was a close relationship between TPTd-Q? and ICG-Q? (r = 0.95, n = 151, standard error of the estimate: 1.452 l/min, P < 0.001; mean difference of 0.06 l/min; limits of agreement -2.98 to 2.86 l/min), and TPTd-Q? and ICG-Q? increased linearly with oxygen uptake with similar intercepts and slopes. Both methods had mean coefficients of variation close to 5% for Q?, global end-diastolic volume, and intrathoracic blood volume. The mean coefficient of variation of EVLW, assessed with both indicators (ICG and thermal) was 17% and was sensitive enough to detect a reduction in EVLW of 107 ml when changing from resting supine to upright exercise. In summary, TPTd with bolus injection into the femoral vein is an accurate and reproducible method to assess Q? during exercise in humans. PMID:25359719

Calbet, José A L; Boushel, Robert



Dynamic device properties of pulse contour cardiac output during transcatheter aortic valve implantation.  


This prospective single-center study aimed to determine the responsiveness and diagnostic performance of continuous cardiac output (CCO) monitors based on pulse contour analysis compared with invasive mean arterial pressure (MAP) during predefined periods of acute circulatory deterioration in patients undergoing transcatheter aortic valve implantation (TAVI). The ability of calibrated (CCOCAL) and self-calibrated (CCOAUTOCAL) pulse contour analysis to detect the hemodynamic response to 37 episodes of balloon aortic valvuloplasty enabled by rapid ventricular pacing was quantified in 13 patients undergoing TAVI. A "low" and a "high" cut-off limit were predefined as a 15 or 25 % decrease from baseline respectively. We found no significant differences between CCOCAL and MAP regarding mean response time [low cut-off: 8.6 (7.1-10.5) vs. 8.9 (7.3-10.8) s, p = 0.76; high cut-off: 11.4 (9.7-13.5) vs. 12.6 (10.7-14.9) s, p = 0.32] or diagnostic performance [area under the receiver operating characteristics curve (AUC): 0.99 (0.98-1.0) vs. 1.0 (0.99-1.0), p = 0.46]. But CCOCAL had a significantly higher amplitude response [95.0 (88.7-98.8) % decrease from baseline] than MAP [41.2 (30.0-52.9) %, p < 0.001]. CCOAUTOCAL had a significantly lower AUC [0.83 (0.73-0.93), p < 0.001] than MAP. Moreover, CCOCAL detected hemodynamic recovery significantly earlier than MAP. In conclusion, CCOCAL and MAP provided equivalent responsiveness and diagnostic performance to detect acute circulatory depression, whereas CCOAUTOCAL appeared to be less appropriate. In contrast to CCOCAL the amplitude response of MAP was poor. Consequently even small response amplitudes of MAP could indicate severe decreases in CO. PMID:25355556

Petzoldt, Martin; Riedel, Carsten; Braeunig, Jan; Haas, Sebastian; Goepfert, Matthias S; Treede, Hendrik; Baldus, Stephan; Goetz, Alwin E; Reuter, Daniel A



Evaluation of a noninvasive continuous cardiac output monitoring system based on thoracic bioreactance.  


Noninvasive cardiac output (CO) measurement can be useful in many clinical settings where invasive monitoring is not desired. Bioimpedance (intrabeat measurement of changes in transthoracic voltage amplitude in response to an injected high-frequency current) has been explored for this purpose but is limited in some clinical settings because of inherently low signal-to-noise ratio. Since changes in fluid content also induce changes in thoracic capacitive and inductive properties, we tested whether a noninvasive CO measurement could be obtained through measurement of the relative phase shift of an injected current (i.e., bioreactance). We constructed a prototype device that applies a 75-kHz current and determines the relative phase shift (dPhi/dt) of the recorded transthoracic voltage. CO was related to the product of peak dPhi/dt, heart rate, and ventricular ejection time. The preclinical study was done in nine open-chest pigs put on right heart bypass so that CO could be varied at known values. This was followed by a feasibility study in 27 postoperative patients who had a Swan-Ganz catheter (SGC). The measurements of noninvasive CO measurement and cardiopulmonary bypass pump correlated to each other (r = 0.84) despite the large variation in CO and temperatures. Similarly, in patients, mean CO values were 5.18 and 5.17 l/min as measured by SGC and the noninvasive CO measurement system, respectively, and were highly correlated over the range of values studied (r = 0.90). Preclinical and clinical data demonstrate the feasibility of using blood flow-related phase shifts of transthoracic electric signals to perform noninvasive continuous CO monitoring. PMID:17384132

Keren, Hanan; Burkhoff, Daniel; Squara, Pierre



Assessment of the effect of vasodilators on the distribution of cardiac output by whole-body Thallium imaging  

SciTech Connect

Vasodilator therapy (tx) of congestive heart failure (CHF) has been shown to be effective in increasing cardiac output (CO) and lowering vascular resistance. Unfortunately, these hemodynamic effects are not usually accompanied by improved peripheral circulation of exercise capacity. To assess the effect of a new vasodilator, Cl-914, on the redistribution of CO to the peripheral circulation, the authors performed testing whole-body thallium scanning (WB-Th) on 6 patients (pts) with severe CHF. Immediately following i.v. injection of 1.5 mCi Th-201, WB scanning was performed from anterior and posterior views. Regions of interest were defined for the peripheral (P) muscles (legs and arms), central torso (C), and splanchnic bed (S). The geometric mean of activity in these regions was calculated from both views. Each pt was studied before tx and again, after 1 week on tx. Invasive measurements revealed that all pts had significant improvements in resting cardiac output (mean increase 49%) and vascular resistance (mean decrease 30%). Unlike other vasodilators, all CI-914 pts had a significant improvement in treadmill exercise capacity (mean increase 54%). WB-Th revealed a significant shift in CO to the peripheral circulation with P:C increased 33.2% (rho= .001) and P:S increased 29% (rho=.01). Vasoactive drugs may significantly alter the relative distribution of cardiac output. WB-Th scanning provides a simple quantitative means of following such changes.

Juni, J.E.; Wallis, J.; Diltz, E.; Nicholas, J.; Lahti, D.; Pitt, B.



Diesel exhaust inhalation increases cardiac output, bradyarrhythmias, and parasympathetic tone in aged heart failure-prone rats.  


Acute air pollutant inhalation is linked to adverse cardiac events and death, and hospitalizations for heart failure. Diesel engine exhaust (DE) is a major air pollutant suspected to exacerbate preexisting cardiac conditions, in part, through autonomic and electrophysiologic disturbance of normal cardiac function. To explore this putative mechanism, we examined cardiophysiologic responses to DE inhalation in a model of aged heart failure-prone rats without signs or symptoms of overt heart failure. We hypothesized that acute DE exposure would alter heart rhythm, cardiac electrophysiology, and ventricular performance and dimensions consistent with autonomic imbalance while increasing biochemical markers of toxicity. Spontaneously hypertensive heart failure rats (16 months) were exposed once to whole DE (4h, target PM(2.5) concentration: 500 µg/m(3)) or filtered air. DE increased multiple heart rate variability (HRV) parameters during exposure. In the 4h after exposure, DE increased cardiac output, left ventricular volume (end diastolic and systolic), stroke volume, HRV, and atrioventricular block arrhythmias while increasing electrocardiographic measures of ventricular repolarization (i.e., ST and T amplitudes, ST area, T-peak to T-end duration). DE did not affect heart rate relative to air. Changes in HRV positively correlated with postexposure changes in bradyarrhythmia frequency, repolarization, and echocardiographic parameters. At 24h postexposure, DE-exposed rats had increased serum C-reactive protein and pulmonary eosinophils. This study demonstrates that cardiac effects of DE inhalation are likely to occur through changes in autonomic balance associated with modulation of cardiac electrophysiology and mechanical function and may offer insights into the adverse health effects of traffic-related air pollutants. PMID:23047911

Carll, Alex P; Lust, Robert M; Hazari, Mehdi S; Perez, Christina M; Krantz, Quentin Todd; King, Charly J; Winsett, Darrell W; Cascio, Wayne E; Costa, Daniel L; Farraj, Aimen K



Diesel Exhaust Inhalation Increases Cardiac Output, Bradyarrhythmias, and Parasympathetic Tone in Aged Heart Failure–Prone Rats  

PubMed Central

Acute air pollutant inhalation is linked to adverse cardiac events and death, and hospitalizations for heart failure. Diesel engine exhaust (DE) is a major air pollutant suspected to exacerbate preexisting cardiac conditions, in part, through autonomic and electrophysiologic disturbance of normal cardiac function. To explore this putative mechanism, we examined cardiophysiologic responses to DE inhalation in a model of aged heart failure–prone rats without signs or symptoms of overt heart failure. We hypothesized that acute DE exposure would alter heart rhythm, cardiac electrophysiology, and ventricular performance and dimensions consistent with autonomic imbalance while increasing biochemical markers of toxicity. Spontaneously hypertensive heart failure rats (16 months) were exposed once to whole DE (4h, target PM2.5 concentration: 500 µg/m3) or filtered air. DE increased multiple heart rate variability (HRV) parameters during exposure. In the 4h after exposure, DE increased cardiac output, left ventricular volume (end diastolic and systolic), stroke volume, HRV, and atrioventricular block arrhythmias while increasing electrocardiographic measures of ventricular repolarization (i.e., ST and T amplitudes, ST area, T-peak to T-end duration). DE did not affect heart rate relative to air. Changes in HRV positively correlated with postexposure changes in bradyarrhythmia frequency, repolarization, and echocardiographic parameters. At 24h postexposure, DE-exposed rats had increased serum C-reactive protein and pulmonary eosinophils. This study demonstrates that cardiac effects of DE inhalation are likely to occur through changes in autonomic balance associated with modulation of cardiac electrophysiology and mechanical function and may offer insights into the adverse health effects of traffic-related air pollutants. PMID:23047911

Farraj, Aimen K.



RETRACTED ARTICLE: Noninvasive assessment of cardiac output using thoracic electrical bioimpedance in hemodynamically stable and unstable patients after cardiac surgery: a comparison with pulmonary artery thermodilution  

Microsoft Academic Search

Objective  To compare noninvasive cardiac output (CO)measurement obtained with a new thoracic electrical bioimpedance (TEB) device, using\\u000a a proprietary modification of the impedance equation, with invasive measurement obtained via pulmonary artery thermodilution.\\u000a \\u000a \\u000a \\u000a \\u000a Design  Prospective, observational study.\\u000a \\u000a \\u000a \\u000a Setting  Surgical intensive care unit (ICU) of a university-affiliated community hospital.\\u000a \\u000a \\u000a \\u000a Patients and participants  Seventy-four adult patients undergoing elective cardiac surgery with routine pulmonary artery catheter placement.\\u000a \\u000a \\u000a \\u000a Interventions  None.\\u000a \\u000a \\u000a \\u000a Measurements and results  Simultaneous

Stefan Suttner; Thilo Schöllhorn; Joachim Boldt; Jochen Mayer; Kerstin D. Röhm; Katrin Lang; Swen N. Piper



Treatment of high output cardiac failure by flow-adapted hepatic artery banding (FHAB) in patients with hereditary hemorrhagic telangiectasia.  


Involvement of abdominal organs in Osler's disease may lead to the development of hepatic arteriovenous shunts with a dilatation of the hepatic artery. Right and subsequent global heart failure due to cardiac valvular insufficiency, pulmonary artery hypertension, and hepatomegaly as well as increased cardiac output may result. This hyperdynamic hepatic blood flow can be reduced by ligature or banding of the hepatic artery or by orthotopic liver transplantation. We report on two female patients suffering from Osler's disease (68 and 76 years old) with severe heart insufficiency (NYHA III-IV) caused by the high hepatic shunt volumes. A gradual banding of the hepatic artery directed by intraoperative flow measurement in the hepatic artery and control of the systemic hemodynamics by Swan-Ganz or COLD catheters was performed in these patients. The banding was achieved by encasing the hepatic artery in a PTFE cuff (length, 1.0 cm). The high cardiac output could be reduced from 11.2 to 7.0 l/min and from 10.7 to 6.0 l/min, respectively. The respective hepatic artery flow was reduced from 2.0 to 0.3 l/min and from 4.0 to 0.7 l/min. An improvement of heart insufficiency, a reduction in the severity of the cardiac valvular insufficiency, and a reduction of the pulmonary arterial hypertension could be already observed intraoperatively. One patient died of right cardiac failure after an orthotopic liver transplantation 7 months later. The other one died 3 years after the banding. The banding of the hepatic artery controlled by hepatic arterial flow measurement can be considered as an effective and safe palliative procedure in intrahepatic HHT compared to therapeutic alternatives such as hepatic artery ligation or embolization. PMID:18027057

Koscielny, A; Willinek, W A; Hirner, A; Wolff, M



Mitofusin-2 Maintains Mitochondrial Structure and Contributes to Stress-Induced Permeability Transition in Cardiac Myocytes ? †  

PubMed Central

Mitofusin-2 (Mfn-2) is a dynamin-like protein that is involved in the rearrangement of the outer mitochondrial membrane. Research using various experimental systems has shown that Mfn-2 is a mediator of mitochondrial fusion, an evolutionarily conserved process responsible for the surveillance of mitochondrial homeostasis. Here, we find that cardiac myocyte mitochondria lacking Mfn-2 are pleiomorphic and have the propensity to become enlarged. Consistent with an underlying mild mitochondrial dysfunction, Mfn-2-deficient mice display modest cardiac hypertrophy accompanied by slight functional deterioration. The absence of Mfn-2 is associated with a marked delay in mitochondrial permeability transition downstream of Ca2+ stimulation or due to local generation of reactive oxygen species (ROS). Consequently, Mfn-2-deficient adult cardiomyocytes are protected from a number of cell death-inducing stimuli and Mfn-2 knockout hearts display better recovery following reperfusion injury. We conclude that in cardiac myocytes, Mfn-2 controls mitochondrial morphogenesis and serves to predispose cells to mitochondrial permeability transition and to trigger cell death. PMID:21245373

Papanicolaou, Kyriakos N.; Khairallah, Ramzi J.; Ngoh, Gladys A.; Chikando, Aristide; Luptak, Ivan; O'Shea, Karen M.; Riley, Dushon D.; Lugus, Jesse J.; Colucci, Wilson S.; Lederer, W. Jonathan; Stanley, William C.; Walsh, Kenneth



Blunted frequency-dependent upregulation of cardiac output is related to impaired relaxation in diastolic heart failure  

PubMed Central

Aims We tested the hypothesis that, in heart failure with normal ejection fraction (HFNEF), diastolic dysfunction is accentuated at increasing heart rates, and this contributes to impaired frequency-dependent augmentation of cardiac output. Methods and results In 17 patients with HFNEF (median age 69 years, 13 female) and seven age-matched control patients, systolic and diastolic function was analysed by pressure–volume loops at baseline heart rate and during atrial pacing to 100 and 120 min?1. At baseline, relaxation was prolonged and end-diastolic left ventricular stiffness was higher in HFNEF, whereas all parameters of systolic function were not different from control patients. This resulted in smaller end-diastolic volumes, higher end-diastolic pressure, and a lower stroke volume and cardiac index in HFNEF vs. control patients. During pacing, frequency-dependent upregulation of contractility indices (+dP/dtmax and Ees) occurred similarly in HFNEF and control patients, but frequency-dependent acceleration of relaxation (dP/dtmin) was blunted in HFNEF. In HFNEF, end-diastolic volume and stroke volume decreased with higher heart rates while both remained unchanged in control patients. Conclusion In HFNEF, frequency-dependent upregulation of cardiac output is blunted. This results from progressive volume unloading of the left ventricle due to limited relaxation reserve in combination with increased LV passive stiffness, despite preserved force–frequency relation. PMID:19720638

Wachter, Rolf; Schmidt-Schweda, Stephan; Westermann, Dirk; Post, Heiner; Edelmann, Frank; Kasner, Mario; Lüers, Claus; Steendijk, Paul; Hasenfuß, Gerd; Tschöpe, Carsten; Pieske, Burkert



Reliability of continuous cardiac output measurement during intra-abdominal hypertension relies on repeated calibrations: an experimental animal study  

PubMed Central

Introduction Monitoring cardiac output (CO) may allow early detection of haemodynamic instability, aiming to reduce morbidity and mortality in critically ill patients. Continuous cardiac output (CCO) monitoring is recommended in septic or postoperative patients with high incidences of intra-abdominal hypertension (IAH). The aim of the present study was to compare the agreement between three CCO methods and a bolus thermodilution CO technique during acute IAH and volume loading. Methods Ten pigs were anaesthetised and instrumented for haemodynamic measurements. Cardiac output was obtained using CCO by pulse power analysis (PulseCO; LiDCO monitor), using CCO by pulse contour analysis (PCCO; PiCCO monitor) and using CCO by pulmonary artery catheter thermodilution (CCOPAC), and was compared with bolus transcardiopulmonary thermodilution CO (COTCP) at baseline, after fluid loading, at IAH and after an additional fluid loading at IAH. Whereas PulseCO was only calibrated at baseline, PCCO was calibrated at each experimental step. Results PulseCO and PCCO underestimated CO, as the overall bias ± standard deviation was 1.0 ± 1.5 l/min and 1.0 ± 1.1 l/min compared with COTCP. A clinically accepted agreement between all of the CCO methods and COTCP was observed only at baseline. Whereas IAH did not influence the CO, increased CO following fluid loading at IAH was only reflected by CCOPAC and COTCP, not by uncalibrated PulseCO and PCCO. After recalibration, PCCO was comparable with COTCP. Conclusions The CO obtained by uncalibrated PulseCO and PCCO failed to agree with COTCP during IAH and fluid loading. In the critically ill patient, recalibration of continuous arterial waveform CO methods should be performed after fluid loading or before a major change in therapy is initiated. PMID:18957114

Gruenewald, Matthias; Renner, Jochen; Meybohm, Patrick; Höcker, Jan; Scholz, Jens; Bein, Berthold



Clinical review: Guyton - the role of mean circulatory filling pressure and right atrial pressure in controlling cardiac output  

PubMed Central

Arthur Guyton's concepts of the determinative role of right heart filling in cardiac output continue to be controversial. This paper reviews his seminal experiments in detail and clarifies the often confusing concepts underpinning his model. One primary criticism of Guyton's model is that the parameters describing venous return had not been measured in a functioning cardiovascular system in humans. Thus, concerns have been expressed in regard to the ability of Guyton's simplistic model, with few parameters, to model the complex human circulation. Further concerns have been raised in regard to the artificial experimental preparations that Guyton used. Recently reported measurements in humans support Guyton's theoretical and animal work. PMID:21144008



Femoral Blood Flow and Cardiac Output During Blood Flow Restricted Leg Press Exercise  

NASA Technical Reports Server (NTRS)

Low load blood flow restricted resistance exercise (LBFR) causes muscle hypertrophy that may be stimulated by the local ischemic environment created by the cuff pressure. However, local blood flow (BF) during such exercise is not well understood. PURPOSE: To characterize femoral artery BF and cardiac output (CO) during leg press exercise (LP) performed at a high load (HL) and low load (LL) with different levels of cuff pressure. METHODS: Eleven subjects (men/women 4/7, age 31.4+/-12.8 y, weight 68.9+/-13.2 kg, mean+/-SD) performed 3 sets of supine left LP to fatigue with 90 s of rest in 4 conditions: HL (%1-RM/cuff pressure: 80%/0); LL (20%/0); LBFR(sub DBP) (20%/1.3 x diastolic blood pressure, BP); LBFR(sub SBP) (20%/1.3 x supine systolic BP). The cuff remained inflated throughout the LBFR exercise sessions. Artery diameter, velocity time integral (VTI), and stroke volume (SV) were measured using Doppler ultrasound at rest and immediately after each set of exercise. Heart rate (HR) was monitored using a 3-lead ECG. BF was calculated as VTI x vessel cross-sectional area. CO was calculated as HR x SV. The data obtained after each set of exercise were averaged and used for analyses. Multi-level modeling was used to determine the effect of exercise condition on dependent variables. Statistical significance was set a priori at p< 0.05. RESULTS: Artery diameter did not change from baseline. BF increased (p<0.05) after exercise in each condition except LBFR(sub SBP) in the order of HL (12.73+/-1.42 cm3,mean+/-SE) > LL (9.92+/-0.82 cm3) > LBFR(sub dBP)(6.47+/-0.79 cm3) > LBFR(sub SBP) (3.51+/-0.59 cm3). Blunted exercise induced increases occurred in HR, SV, and CO after LBFR compared to HL and LL. HR increased 45% after HL and LL and 28% after LBFR (p<0.05), but SV increased (p<0.05) only after HL. Consequently, the increase (p<0.05) in CO was greater in HL and LL (approximately 3 L/min) than in LBFR (approximately 1 L/min). CONCLUSION: BF during LBFR(sub SBP) was 1/3 of that observed in LL, which supports the hypothesis that local ischemia stimulates the LBFR hypertrophic response. As the cuff did not compress the artery, the ischemia may have occurred because of the blunted rise in CO or because arterial BP cannot overcome the cuff pressure. As LBFR(sub DBP) effectively reduced BF and CO with cuff pressures less than systolic BP, future studies should investigate the hypertrophic potential of LBFR at even lower cuff pressures.

Everett, M. E.; Hackney, K.; Ploutz-Snyder, L.



The correlation between the first heart sound and cardiac output as measured by using digital esophageal stethoscope under anaesthesia  

PubMed Central

Objective: The use of an esophageal stethoscope is a basic heart sounds monitoring procedure performed in patients under general anesthesia. As the size of the first heart sound can express the left ventricle function, its correlation with cardiac output should be investigated. The aim of this study was to investigate the effects of cardiac output (CO) on the first heart sound (S1) amplitude. Methods : Six male beagles were chosen. The S1 was obtained with the newly developed esophageal stethoscope system. CO was measured using NICOM, a non-invasive CO measuring device. Ephedrine and beta blockers were administered to the subjects to compare changes in figures, and the change from using an inhalation anesthetic was also compared. Results: The S1 amplitude displayed positive correlation with the change rate of CO (r = 0.935, p < 0.001). The heart rate measured using the esophageal stethoscope and ECG showed considerably close figures through the Bland-Altman plot and showed a high positive correlation (r = 0.988, p < 0,001). Conclusion: In beagles, the amplitude of S1 had a significant correlation with changes in CO in a variety of situations. PMID:24772126

Duck Shin, Young; Hoon Yim, Kyoung; Hi Park, Sang; Wook Jeon, Yong; Ho Bae, Jin; Soo Lee, Tae; Hwan Kim, Myoung; Jin Choi, Young



Missed cardiac tamponade  

PubMed Central

Cardiac tamponade can have an insidious onset, becoming life threatening when an adequate cardiac output can no longer be maintained. This case provides an example of a presentation where all the classic signs were present but unfortunately they were missed, in this way providing good revision of what these signs are. It gives some anaesthetic and procedure based perspectives for this rare presentation. It is noteworthy for the speed at which symptoms and signs resolved after the tamponade was relieved. PMID:22679253

Thomson-Moore, Alexandra Louise



The neuromuscular transform of the lobster cardiac system explains the opposing effects of a neuromodulator on muscle output.  


Motor neuron activity is transformed into muscle movement through a cascade of complex molecular and biomechanical events. This nonlinear mapping of neural inputs to motor behaviors is called the neuromuscular transform (NMT). We examined the NMT in the cardiac system of the lobster Homarus americanus by stimulating a cardiac motor nerve with rhythmic bursts of action potentials and measuring muscle movements in response to different stimulation patterns. The NMT was similar across preparations, which suggested that it could be used to predict muscle movement from spontaneous neural activity in the intact heart. We assessed this possibility across semi-intact heart preparations in two separate analyses. First, we performed a linear regression analysis across 122 preparations in physiological saline to predict muscle movements from neural activity. Under these conditions, the NMT was predictive of contraction duty cycle but was unable to predict contraction amplitude, likely as a result of uncontrolled interanimal variability. Second, we assessed the ability of the NMT to predict changes in motor output induced by the neuropeptide C-type allatostatin. Wiwatpanit et al. (2012) showed that bath application of C-type allatostatin produced either increases or decreases in the amplitude of the lobster heart contractions. We show that an important component of these preparation-dependent effects can arise from quantifiable differences in the basal state of each preparation and the nonlinear form of the NMT. These results illustrate how properly characterizing the relationships between neural activity and measurable physiological outputs can provide insight into seemingly idiosyncratic effects of neuromodulators across individuals. PMID:24133260

Williams, Alex H; Calkins, Andrew; O'Leary, Timothy; Symonds, Renee; Marder, Eve; Dickinson, Patsy S



The Neuromuscular Transform of the Lobster Cardiac System Explains the Opposing Effects of a Neuromodulator on Muscle Output  

PubMed Central

Motor neuron activity is transformed into muscle movement through a cascade of complex molecular and biomechanical events. This nonlinear mapping of neural inputs to motor behaviors is called the neuromuscular transform (NMT). We examined the NMT in the cardiac system of the lobster Homarus americanus by stimulating a cardiac motor nerve with rhythmic bursts of action potentials and measuring muscle movements in response to different stimulation patterns. The NMT was similar across preparations, which suggested that it could be used to predict muscle movement from spontaneous neural activity in the intact heart. We assessed this possibility across semi-intact heart preparations in two separate analyses. First, we performed a linear regression analysis across 122 preparations in physiological saline to predict muscle movements from neural activity. Under these conditions, the NMT was predictive of contraction duty cycle but was unable to predict contraction amplitude, likely as a result of uncontrolled interanimal variability. Second, we assessed the ability of the NMT to predict changes in motor output induced by the neuropeptide C-type allatostatin. Wiwatpanit et al. (2012) showed that bath application of C-type allatostatin produced either increases or decreases in the amplitude of the lobster heart contractions. We show that an important component of these preparation-dependent effects can arise from quantifiable differences in the basal state of each preparation and the nonlinear form of the NMT. These results illustrate how properly characterizing the relationships between neural activity and measurable physiological outputs can provide insight into seemingly idiosyncratic effects of neuromodulators across individuals. PMID:24133260

Williams, Alex H.; Calkins, Andrew; O'Leary, Timothy; Symonds, Renee; Marder, Eve



[Regulation of cardiac output;an approximation at 3 levels: organic, cellular, and protein].  


The heart is the central point for adaptation of the organism to physical exercise because it is the center of the energy support system. Its activity is regulated at three levels; organ, cells and molecular and genetic components. During the development of the heart, the organ adapts in response to chronic and acute overloads by instantaneous functional and chronic changes, leading to a variable degree of cardiac growth. Physical exercise (acute and chronic) is the main example of physiologic overload. The acute response of the heart means a mechanical-hemodynamical and energetic modulation, driving to a final point where oxygen supply fits the increased need. Training, as response to chronic exercise, promotes an increase in energetic capacity (heart rate and stroke volume), structurally reflected in the physiological cardiac hypertrophy. Global functional and structural changes express what is happening at the cellular level. Different stimuli signal through specific receptors and second messengers to the nucleus, regulating gene expression and conditioning structural (size) and functional (contractile) changes. Changes in cellular size explain, by Starling mechanism, the increase in individual contractile strength and in reduction of the ventricular cavity in the systolic period. Other structural changes refer to the interstitium, myocardial vasculature and vascular reactivity. Changes in contractility affect the composition of the contractile elements (isoforms of heavy myosin, light myosin and/or modulatory proteins) and sarcoplasmic Ca2+ regulation, through the increase in Ca2+ flow. Many of the adaptations to chronic exercise studied in vivo in intact heart, isolated heart (Langendorf) or papillary muscle (multicellular preparation), are retained in the cardiomyocyte. Isolated cardiomyocytes can be precisely through the medium, temperature, ionic composition, active substances, etc. Shortening speed without load (Vmax), considered an inotropic index (Sonnenblick) can be measured independently of the initial length. Myocytes shorten against an internal load (restoration force) with viscous and elastic components, although they cannot be loaded externally (stretching is difficult). Cardiomyocyte isolation and maintenance requires strict and controlled conditions. This model offers many possibilities for studying dimensions, contraction-relaxation mechanics, Ca2+ and pH dynamics, beta-adrenergic receptors, electrophysiology, pharmacology, genetics, etc. This kind of studies can deal with normal myocytes or myocytes from trained animals, cardiomyopathies, etc. PMID:10386344

Martíenz Caro, D; Rodríguez García, J A; Munguía, L



Measurement of cardiac output in children by pressure-recording analytical method.  


We evaluated two pressure-recording analytical method (PRAM) software versions (v.1 and v.2) to measure cardiac index (CI) in hemodynamically stable critically ill children and investigate factors that influence PRAM values. The working hypothesis was that PRAM CI measurements would stay within normal limits in hemodynamically stable patients. Ninety-five CI PRAM measurements were analyzed in 47 patients aged 1-168 months. Mean CI was 4.1 ± 1.4 L/min/m(2) (range 2.0-7.0). CI was outside limits defined as normal (3-5 L/min/m(2)) in 53.7 % of measurements (47.8 % with software v.1 and 69.2 % with software v.2, p = 0.062). Moreover, 14.7 % of measurements were below 2.5 L/min/m(2), and 13.6 % were above 6 L/min/m(2). CI was significantly lower in patients with a clearly visible dicrotic notch than in those without (3.7 vs. 4.6 L/min/m(2), p = 0.004) and in children with a radial arterial catheter (3.5 L/min/m(2)) than in those with a brachial (4.4 L/min/m(2), p = 0.021) or femoral catheter (4.7 L/min/m(2), p = 0.005). By contrast, CI was significantly higher in children under 12 months (4.2 vs. 3.6 L/min/m(2), p = 0.034) and weighing under 10 kg (4.2 vs. 3.6 L/min/m(2), p = 0.026). No significant differences were observed between cardiac surgery patients and the rest of children. A high percentage of CI measurements registered by PRAM were outside normal limits in hemodynamically stable, critically ill children. CI measured by PRAM may be influenced by the age, weight, location of catheter, and presence of a dicrotic notch. PMID:25179459

Urbano, Javier; López, Jorge; González, Rafael; Solana, María José; Fernández, Sarah N; Bellón, José M; López-Herce, Jesús



Variations in arterial blood pressure are associated with parallel changes in FlowTrac\\/Vigileo®-derived cardiac output measurements: a prospective comparison study  

Microsoft Academic Search

ABSTRACT: INTRODUCTION: The reliability of autocalibrated pressure waveform analysis by the FloTrac-Vigileo® (FTV) system for the determination of cardiac output in comparison with intermittent pulmonary arterial thermodilution (IPATD) is controversial. The present prospective comparison study was designed to determine the effects of variations in arterial blood pressure on the reliability of the FTV system in patients undergoing coronary artery bypass

Savvas Eleftheriadis; Zisis Galatoudis; Vasilios Didilis; Ioannis Bougioukas; Julika Schön; Hermann Heinze; Klaus-Ulrich Berger; Matthias Heringlake



Influence of dobutamine and dopamine on hemodynamics and plasma concentrations of noradrenaline and renin in patients with low cardiac output following acute myocardial infarction  

Microsoft Academic Search

The comparative hemodynamic effects of dobutamine and dopamine were studied in 6 patients with low cardiac output resulting from acute myocardial infarction. Plasma levels of noradrenaline and renin were measured before and during a 5 µg\\/kg\\/min infusion of each of the drugs. Dobutamine had a more pronounced chronotropic effect, increased the systolic arterial pressure more and decreased the systemic vascular

T. L. Kho; J. W. Henquet; R. Punt; W. H. Birkenhäger; K. H. Rahn



Roles for Cardiac MyBP-C in Maintaining Myofilament Lattice Rigidity and Prolonging Myosin Cross-Bridge Lifetime  

SciTech Connect

We investigated the influence of cardiac myosin binding protein-C (cMyBP-C) and its constitutively unphosphorylated status on the radial and longitudinal stiffnesses of the myofilament lattice in chemically skinned myocardial strips of the following mouse models: nontransgenic (NTG), effective null for cMyBP-C (t/t), wild-type cMyBP-C expressed into t/t (WT{sub t/t}), and constitutively unphosphorylated cMyBP-C (AllP{sub -t/t}). We found that the absence of cMyBP-C in the t/t and the unphosphorylated cMyBP-C in the AllP{sub -t/t} resulted in a compressible cardiac myofilament lattice induced by rigor not observed in the NTG and WT{sub t/t}. These results suggest that the presence and phosphorylation of the N-terminus of cMyBP-C provides structural support and radial rigidity to the myofilament lattice. Examination of myofilament longitudinal stiffness under rigor conditions demonstrated a significant reduction in cross-bridge-dependent stiffness in the t/t compared with NTG controls, but not in the AllP{sub -t/t} compared with WT{sub t/t} controls. The absence of cMyBP-C in the t/t and the unphosphorylated cMyBP-C in the AllP{sub -t/t} both resulted in a shorter myosin cross-bridge lifetime when myosin isoform was controlled. These data collectively suggest that cMyBP-C provides radial rigidity to the myofilament lattice through the N-terminus, and that disruption of the phosphorylation of cMyBP-C is sufficient to abolish this structural role of the N-terminus and shorten cross-bridge lifetime. Although the presence of cMyBP-C also provides longitudinal rigidity, phosphorylation of the N-terminus is not necessary to maintain longitudinal rigidity of the lattice, in contrast to radial rigidity.

Palmer, B.M.; Sadayappan, S.; Wang, Y.; Weith, A.E.; Previs, M.J.; Bekyarova, T.; Irving, T.C.; Robbins, J.; Maughan, D.W. (Vermont)



Roles for Cardiac MyBP-C in Maintaining Myofilament Lattice Rigidity and Prolonging Myosin Cross-Bridge Lifetime  

PubMed Central

We investigated the influence of cardiac myosin binding protein-C (cMyBP-C) and its constitutively unphosphorylated status on the radial and longitudinal stiffnesses of the myofilament lattice in chemically skinned myocardial strips of the following mouse models: nontransgenic (NTG), effective null for cMyBP-C (t/t), wild-type cMyBP-C expressed into t/t (WTt/t), and constitutively unphosphorylated cMyBP-C (AllP-t/t). We found that the absence of cMyBP-C in the t/t and the unphosphorylated cMyBP-C in the AllP-t/t resulted in a compressible cardiac myofilament lattice induced by rigor not observed in the NTG and WTt/t. These results suggest that the presence and phosphorylation of the N-terminus of cMyBP-C provides structural support and radial rigidity to the myofilament lattice. Examination of myofilament longitudinal stiffness under rigor conditions demonstrated a significant reduction in cross-bridge-dependent stiffness in the t/t compared with NTG controls, but not in the AllP-t/t compared with WTt/t controls. The absence of cMyBP-C in the t/t and the unphosphorylated cMyBP-C in the AllP-t/t both resulted in a shorter myosin cross-bridge lifetime when myosin isoform was controlled. These data collectively suggest that cMyBP-C provides radial rigidity to the myofilament lattice through the N-terminus, and that disruption of the phosphorylation of cMyBP-C is sufficient to abolish this structural role of the N-terminus and shorten cross-bridge lifetime. Although the presence of cMyBP-C also provides longitudinal rigidity, phosphorylation of the N-terminus is not necessary to maintain longitudinal rigidity of the lattice, in contrast to radial rigidity. PMID:21961592

Palmer, Bradley M.; Sadayappan, Sakthivel; Wang, Yuan; Weith, Abbey E.; Previs, Michael J.; Bekyarova, Tanya; Irving, Thomas C.; Robbins, Jeffrey; Maughan, David W.



Cardiac output by Doppler echocardiography in the premature baboon: Comparison with radiolabeled microspheres  

SciTech Connect

Pulsed-Doppler echocardiography (PDE) is a useful noninvasive method for determining left ventricular output (LVO). However, despite increasingly widespread use in neonatal intensive care units, validation studies in prematures with cardiopulmonary disease are lacking. The purpose of this study was to compare radiolabeled microsphere (RLM) and PDE measurements of LVO, using the critically ill premature baboon as a model of the human neonate. Twenty-two paired RLM and PDE measurements of LVO were obtained in 14 animals between 3 and 24 h of age. Average PDE LVO was 152 ml/min/kg (range, 40-258 ml/min/kg) compared to 158 ml/min/kg (range, 67-278 ml/min/kg) measured by RLM. Linear regression analysis of the paired measurements showed good correlation with a slope near unity (gamma = 0.94x + 4.20, r = 0.91, SEE = 25.7 ml). The authors conclude that PDE determinations of LVO compare well with those measured by RLM in the premature baboon. PDE appears to provide a valid estimate of LVO and should be useful in human prematures with cardiopulmonary distress.

Kinsella, J.P.; Morrow, W.R.; Gerstmann, D.R.; Taylor, A.F.; deLemos, R.A. (Wilford Hall U.S.A.F. Medical Center, San Antonio, TX (USA))



Diesel Exhaust Inhalation Increases Cardiac Output, Bradyarrhythmias, and Parasympathetic Tone in Aged Heart Failure-Prone Rats  

EPA Science Inventory

Acute air pollutant inhalation is linked to adverse cardiac events and death, and hospitalizations for heart failure. Diesel exhaust (DE) is a major air pollutant suspected to exacerbate preexisting cardiac conditions, in part, through autonomic and electrophysiologic disturbance...


First in vivo application and evaluation of a novel method for non-invasive estimation of cardiac output.  


Surgical or critically ill patients often require continuous assessment of cardiac output (CO) for diagnostic purposes or for guiding therapeutic interventions. A new method of non-invasive CO estimation has been recently developed, which is based on pressure wave analysis. However, its validity has been examined only in silico. Aim of this study was to evaluate in vivo the reproducibility and accuracy of the "systolic volume balance" method (SVB). Twenty two subjects underwent 2-D transthoracic echocardiography for CO measurement (reference value of CO). The application of SVB method required aortic pressure wave analysis and estimation of total arterial compliance. Aortic pulses were derived by mathematical transformation of radial pressure waves recorded by applanation tonometry. Total compliance was estimated by the "pulse pressure" method. The agreement, association, variability, bias and precision between Doppler and SVB measures of CO were evaluated by intraclass correlation coefficient (ICC), mean difference, SD of differences, percentage error (PR) and Bland-Altman analysis. SVB yielded very reproducible CO estimates (ICC=0.84, mean difference 0.27 ± 0.73 L/min, PR = 16.7%). SVB-derived CO was comparable with Doppler measurements, indicating a good agreement and accuracy (ICC = 0.74, mean difference = -0.22 ± 0.364 L/min, PR ? 15). The basic mathematical and physical principles of the SVB method provide highly reproducible and accurate estimates of CO compared with echocardiography. PMID:25108554

Papaioannou, Theodore G; Soulis, Dimitrios; Vardoulis, Orestis; Protogerou, Athanase; Sfikakis, Petros P; Stergiopulos, Nikolaos; Stefanadis, Christodoulos



Servo Control of High Degree of Linear Polarization Output from Polarization-Maintaining Fiber and its Application in Fiber-Component Based Frequency Modulation Spectroscopy  

NASA Astrophysics Data System (ADS)

A novel servo control method has been developed to output a highly linear state of polarization (SOP) from a polarization-maintaining (PM) fiber. The correction signal is obtained using an SOP detection setup invented by Hänsch and Couillaud. This servo control method was then applied to fiber-component based frequency modulation spectroscopy experimentally to reduce the residual amplitude modulation (RAM) induced by nonlinear SOP incident to an electro-optic modulator. With active servo control, stable linear SOP output of PM fiber and pure frequency modulation lineshapes are obtained. Finally, long-term measurements of the dispersion background signal with feedback loop on and off are performed to evaluate the stability of RAM reduction.

Ma, Weiguang; Li, Zhixin; Tan, Wei; Zhao, Gang; Fu, Xiaofang; Zhang, Lei; Dong, Lei; Yin, Wangbao; Jia, Suotang



The 24 h pattern of arterial pressure in mice is determined mainly by heart rate?driven variation in cardiac output  

PubMed Central

Abstract Few studies have systematically investigated whether daily patterns of arterial blood pressure over 24 h are mediated by changes in cardiac output, peripheral resistance, or both. Understanding the hemodynamic mechanisms that determine the 24 h patterns of blood pressure may lead to a better understanding of how such patterns become disturbed in hypertension and influence risk for cardiovascular events. In conscious, unrestrained C57BL/6J mice, we investigated whether the 24 h pattern of arterial blood pressure is determined by variation in cardiac output, systemic vascular resistance, or both and also whether variations in cardiac output are mediated by variations in heart rate and or stroke volume. As expected, arterial pressure and locomotor activity were significantly (P < 0.05) higher during the nighttime period compared with the daytime period when mice are typically sleeping (+12.5 ± 1.0 mmHg, [13%] and +7.7 ± 1.3 activity counts, [254%], respectively). The higher arterial pressure during the nighttime period was mediated by higher cardiac output (+2.6 ± 0.3 mL/min, [26%], P < 0.05) in association with lower peripheral resistance (?1.5 ± 0.3 mmHg/mL/min, [?13%] P < 0.05). The increased cardiac output during the nighttime was mainly mediated by increased heart rate (+80.0 ± 16.5 beats/min, [18%] P < 0.05), as stroke volume increased minimally at night (+1.6 ± 0.5 ?L per beat, [6%] P < 0.05). These results indicate that in C57BL/6J mice, the 24 h pattern of blood pressure is hemodynamically mediated primarily by the 24 h pattern of cardiac output which is almost entirely determined by the 24 h pattern of heart rate. These findings suggest that the differences in blood pressure between nighttime and daytime are mainly driven by differences in heart rate which are strongly correlated with differences in locomotor activity. PMID:25428952

Kurtz, Theodore W.; Lujan, Heidi L.; DiCarlo, Stephen E.



Comparing the accuracy of ES-BC, EIS-GS, and ES Oxi on body composition, autonomic nervous system activity, and cardiac output to standardized assessments  

PubMed Central

Background and purpose The Electro Sensor Complex (ESC) is software that combines three devices using bioelectrical impedance, galvanic skin response, and spectrophotometry: (1) ES-BC (Electro Sensor-Body Composition; LD Technology, Miami, FL) to assess body composition, (2) EIS-GS (Electro Interstitial Scan-Galvanic Skin; LD Technology) to predict autonomic nervous system activity, and (3) ES Oxi (Electro Sensor Oxi; LD Technology) to assess cardiac output. The objective of this study was to compare each to a standardized assessment: ES-BC to dual-energy X-ray absorptiometry (DXA), EIS-GS to heart rate variability, and ES Oxi to BioZ Dx Diagnostic System (BioZ Dx; SonoSite Inc, Bothell, WA). Patients and methods The study was conducted in two waves. Fifty subjects were assessed for body composition and autonomic nervous system activity. Fifty-one subjects were assessed for cardiac output. Results We found adequate relative and absolute agreement between ES-BC and DXA for fat mass (r = 0.97, P < 0.001) with ES-BC overestimating fat mass by 0.1 kg and for body fat percentage (r = 0.92, P < 0.001) with overestimation of fat percentage by 0.4%. For autonomic nervous system activity, we found marginal relative agreement between EIS-GS and heart rate variability by using EIS-GS as the predictor in a linear regression equation (adjusted R2 = 0.56, P = 0.03). For cardiac output, adequate relative and absolute agreement was found between ES Oxi and BioZ Dx at baseline (r = 0.60, P < 0.001), after the first exercise stage (r = 0.79, P < 0.001), and after the second exercise stage (r = 0.86, P < 0.001). Absolute agreement was found at baseline and after both bouts of exercise; ES Oxi overestimated baseline and stage 1 exercise cardiac output by 0.3 L/minute and 0.1 L/minute, respectively, but exactly estimated stage 2 exercise cardiac output. Conclusion ES-BC and ES Oxi accurately assessed body composition and cardiac output compared to standardized instruments, whereas EIS-GS showed marginal predictive ability for autonomic nervous system activity. The ESC software managing the three devices would be useful to help detect complications related to metabolic syndrome, diabetes, and cardiovascular disease and to noninvasively and rapidly manage treatment follow-up. PMID:22915943

Lewis, John E; Tannenbaum, Stacey L; Gao, Jinrun; Melillo, Angelica B; Long, Evan G; Alonso, Yaima; Konefal, Janet; Woolger, Judi M; Leonard, Susanna; Singh, Prabjot K; Chen, Lawrence; Tiozzo, Eduard



8-Oxoguanine DNA glycosylase 1 (ogg1) maintains the function of cardiac progenitor cells during heart formation in zebrafish  

SciTech Connect

Genomic damage may devastate the potential of progenitor cells and consequently impair early organogenesis. We found that ogg1, a key enzyme initiating the base-excision repair, was enriched in the embryonic heart in zebrafish. So far, little is known about DNA repair in cardiogenesis. Here, we addressed the critical role of ogg1 in cardiogenesis for the first time. ogg1 mainly expressed in the anterior lateral plate mesoderm (ALPM), the primary heart tube, and subsequently the embryonic myocardium by in situ hybridisation. Loss of ogg1 resulted in severe cardiac morphogenesis and functional abnormalities, including the short heart length, arrhythmia, decreased cardiomyocytes and nkx2.5{sup +} cardiac progenitor cells. Moreover, the increased apoptosis and repressed proliferation of progenitor cells caused by ogg1 deficiency might contribute to the heart phenotype. The microarray analysis showed that the expression of genes involved in embryonic heart tube morphogenesis and heart structure were significantly changed due to the lack of ogg1. Among those, foxh1 is an important partner of ogg1 in the cardiac development in response to DNA damage. Our work demonstrates the requirement of ogg1 in cardiac progenitors and heart development in zebrafish. These findings may be helpful for understanding the aetiology of congenital cardiac deficits. - Highlights: • A key DNA repair enzyme ogg1 is expressed in the embryonic heart in zebrafish. • We found that ogg1 is essential for normal cardiac morphogenesis in zebrafish. • The production of embryonic cardiomyocytes requires appropriate ogg1 expression. • Ogg1 critically regulated proliferation of cardiac progenitor cells in zebrafish. • foxh1 is a partner of ogg1 in the cardiac development in response to DNA damage.

Yan, Lifeng [State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing Medical University, Nanjing 210029 (China); Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 210029 (China); Zhou, Yong [Key Laboratory of Stem Cell Biology, Institute of Health Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences and Shanghai Jiao Tong University School of Medicine, Shanghai 200025 (China); Yu, Shanhe [Shanghai Institute of Hematology, RuiJin Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai 200025 (China); Ji, Guixiang [Nanjing Institute of Environmental Sciences/Key Laboratory of Pesticide Environmental Assessment and Pollution Control, Ministry of Environmental Protection, Nanjing 210042 (China); Wang, Lei [Key Laboratory of Stem Cell Biology, Institute of Health Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences and Shanghai Jiao Tong University School of Medicine, Shanghai 200025 (China); Liu, Wei [State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing Medical University, Nanjing 210029 (China); Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 210029 (China); Gu, Aihua, E-mail: [State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing Medical University, Nanjing 210029 (China); Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 210029 (China)



Pharmacokinetics, hemodynamic and metabolic effects of epinephrine to prevent post-operative low cardiac output syndrome in children  

PubMed Central

Introduction The response to exogenous epinephrine (Ep) is difficult to predict given the multitude of factors involved such as broad pharmacokinetic and pharmacodynamic between-subject variabilities, which may be more pronounced in children. We investigated the pharmacokinetics and pharmacodynamics of Ep, co-administered with milrinone, in children who underwent open heart surgical repair for congenital defects following cardiopulmonary bypass, including associated variability factors. Methods Thirty-nine children with a high risk of low cardiac output syndrome were prospectively enrolled. Ep pharmacokinetics, hemodynamic and metabolic effects were analyzed using the non-linear mixed effects modeling software MONOLIX. According to the final model, an Ep dosing simulation was suggested. Results Ep dosing infusions ranged from 0.01 to 0.23 ? in children whose weight ranged from 2.5 to 58 kg. A one-compartment open model with linear elimination adequately described the Ep concentration-time courses. Bodyweight (BW) was the main covariate influencing clearance (CL) and endogenous Ep production rate (q0) via an allometric relationship: CL(BWi)?=??CL x (BWi)3/4 and q0(BWi)?=??q0 x (BWi )3/4. The increase in heart rate (HR) and mean arterial pressure (MAP) as a function of Ep concentration were well described using an Emax model. The effect of age was significant on HR and MAP basal level parameters. Assuming that Ep stimulated the production rate of plasma glucose, the increases in plasma glucose and lactate levels were well described by turnover models without any significant effect of age, BW or exogenous glucose supply. Conclusions According to this population analysis, the developmental effects of BW and age explained a part of the pharmacokinetic and pharmacodynamics between-subject variabilities of Ep administration in critically ill children. This approach ultimately leads to a valuable Ep dosing simulation which should help clinicians to determine an appropriate a priori dosing regimen. PMID:24456639



PKPD modelling of the interrelationship between mean arterial BP, cardiac output and total peripheral resistance in conscious rats  

PubMed Central

Background and Purpose The homeostatic control of arterial BP is well understood with changes in BP resulting from changes in cardiac output (CO) and/or total peripheral resistance (TPR). A mechanism-based and quantitative analysis of drug effects on this interrelationship could provide a basis for the prediction of drug effects on BP. Hence, we aimed to develop a mechanism-based pharmacokinetic-pharmacodynamic (PKPD) model in rats that could be used to characterize the effects of cardiovascular drugs with different mechanisms of action (MoA) on the interrelationship between BP, CO and TPR. Experimental Approach The cardiovascular effects of six drugs with diverse MoA, (amlodipine, fasudil, enalapril, propranolol, hydrochlorothiazide and prazosin) were characterized in spontaneously hypertensive rats. The rats were chronically instrumented with ascending aortic flow probes and/or aortic catheters/radiotransmitters for continuous recording of CO and/or BP. Data were analysed in conjunction with independent information on the time course of drug concentration using a mechanism-based PKPD modelling approach. Key Results By simultaneous analysis of the effects of six different compounds, the dynamics of the interrelationship between BP, CO and TPR were quantified. System-specific parameters could be distinguished from drug-specific parameters indicating that the model developed is drug-independent. Conclusions and Implications A system-specific model characterizing the interrelationship between BP, CO and TPR was obtained, which can be used to quantify and predict the cardiovascular effects of a drug and to elucidate the MoA for novel compounds. Ultimately, the proposed PKPD model could be used to predict the effects of a particular drug on BP in humans based on preclinical data. PMID:23849040

Snelder, N; Ploeger, B A; Luttringer, O; Rigel, D F; Webb, R L; Feldman, D; Fu, F; Beil, M; Jin, L; Stanski, D R; Danhof, M



Cardiac Function and Architecture Are Maintained in a Model of Cardiorestricted Overexpression of the Prorenin-Renin Receptor  

PubMed Central

The (pro)renin-renin receptor, (P)RR has been claimed to be a novel element of the renin-angiotensin system (RAS). The function of (P)RR has been widely studied in renal and vascular pathology but the cardio-specific function of (P)RR has not been studied in detail. We therefore generated a transgenic mouse (Tg) with cardio-restricted (P)RR overexpression driven by the alpha-MHC promotor. The mRNA expression of (P)RR was ?170-fold higher (P<0.001) and protein expression ?5-fold higher (P<0.001) in hearts of Tg mice as compared to non-transgenic (wild type, Wt) littermates. This level of overexpression was not associated with spontaneous cardiac morphological or functional abnormalities in Tg mice. To assess whether (P)RR could play a role in cardiac hypertrophy, we infused ISO for 28 days, but this caused an equal degree of cardiac hypertrophy and fibrosis in Wt and Tg mice. In addition, ischemia-reperfusion injury was performed in Langendorff perfused isolated mouse hearts. We did not observe differences in parameters of cardiac function or damage between Wt and Tg mouse hearts under these conditions. Finally, we explored whether the hypoxia sensing response would be modulated by (P)RR using HeLa cells with and without (P)RR overexpression. We did not establish any effect of (P)RR on expression of genes associated with the hypoxic response. These results demonstrate that cardio-specific overexpression of (P)RR does not provoke phenotypical differences in the heart, and does not affect the hearts’ response to stress and injury. It is concluded that increased myocardial (P)RR expression is unlikely to have a major role in pathological cardiac remodeling. PMID:24587131

Mahmud, Hasan; Candido, Wellington Mardoqueu; van Genne, Linda; Vreeswijk-Baudoin, Inge; Yu, Hongjuan; van de Sluis, Bart; van Deursen, Jan; van Gilst, Wiek H.; Silljé, Herman H. W.; de Boer, Rudolf A.



Human cardiac stem cells exhibit mesenchymal features and are maintained through Akt/GSK-3{beta} signaling  

SciTech Connect

Recent evidence suggested that human cardiac stem cells (hCSCs) may have the clinical application for cardiac repair; however, their characteristics and the regulatory mechanisms of their growth have not been fully investigated. Here, we show the novel property of hCSCs with respect to their origin and tissue distribution in human heart, and demonstrate the signaling pathway that regulates their growth and survival. Telomerase-active hCSCs were predominantly present in the right atrium and outflow tract of the heart (infant > adult) and had a mesenchymal cell-like phenotype. These hCSCs expressed the embryonic stem cell markers and differentiated into cardiomyocytes to support cardiac function when transplanted them into ischemic myocardium. Inhibition of Akt pathway impaired the hCSC proliferation and induced apoptosis, whereas inhibition of glycogen synthase kinase-3 (GSK-3) enhanced their growth and survival. We conclude that hCSCs exhibit mesenchymal features and that Akt/GSK-3{beta} may be crucial modulators for hCSC maintenance in human heart.

Tateishi, Kento [Department of Experimental Therapeutics, Translational Research Center, Kyoto University Hospital, Kyoto 606-8507 (Japan)]|[Department of Cardiovascular Medicine, Kyoto Prefectural University School of Medicine, Kyoto 602-8566 (Japan); Ashihara, Eishi [Department of Experimental Therapeutics, Translational Research Center, Kyoto University Hospital, Kyoto 606-8507 (Japan); Honsho, Shoken [Department of Experimental Therapeutics, Translational Research Center, Kyoto University Hospital, Kyoto 606-8507 (Japan)]|[Department of Cardiovascular Medicine, Kyoto Prefectural University School of Medicine, Kyoto 602-8566 (Japan); Takehara, Naofumi [Department of Experimental Therapeutics, Translational Research Center, Kyoto University Hospital, Kyoto 606-8507 (Japan); Nomura, Tetsuyaital [Department of Experimental Therapeutics, Translational Research Center, Kyoto University Hospital, Kyoto 606-8507 (Japan)]|[Department of Cardiovascular Medicine, Kyoto Prefectural University School of Medicine, Kyoto 602-8566 (Japan); Takahashi, Tomosaburo [Department of Cardiovascular Medicine, Kyoto Prefectural University School of Medicine, Kyoto 602-8566 (Japan); Ueyama, Tomomi [Department of Experimental Therapeutics, Translational Research Center, Kyoto University Hospital, Kyoto 606-8507 (Japan); Yamagishi, Masaaki; Yaku, Hitoshi [Department of Cardiovascular Surgery, Kyoto Prefectural University School of Medicine, Kyoto 602-8566 (Japan); Matsubara, Hiroaki [Department of Experimental Therapeutics, Translational Research Center, Kyoto University Hospital, Kyoto 606-8507 (Japan)]|[Department of Cardiovascular Medicine, Kyoto Prefectural University School of Medicine, Kyoto 602-8566 (Japan)]. E-mail:; Oh, Hidemasa [Department of Experimental Therapeutics, Translational Research Center, Kyoto University Hospital, Kyoto 606-8507 (Japan)]. E-mail:



Identification of sources of low frequency variability of arterial blood pressure: cardiac output acts as a buffer and not as a source  

PubMed Central

Arterial blood pressure (ABP) short term variability is due to beat-by-beat fluctuations in cardiac output (CO) and total peripheral resistance (TPR), which have distinct effects at low and high frequencies. In particular, it was shown that CO is able to buffer TPR slow oscillations in the LF band, but it has not been addressed if CO can contribute to oscillations of ABP in this band. In this paper, we propose a model for the identification of ABP variability sources, in order to show evidence that CO fluctuations are not a source of ABP LF oscillations, but they only buffer ABP variability of vasomotor origin. PMID:21097024

Aletti, Federico; Chen, Xiaoxiao; Sala-Mercado, Javier A.; Hammond, Robert L.; O’Leary, Donal S.; Cerutti, Sergio; Baselli, Giuseppe; Mukkamala, Ramakrishna



Serum uric acid is inversely proportional to estimated stroke volume and cardiac output in a large sample of pharmacologically untreated subjects: data from the Brisighella Heart Study.  


Serum uric acid is representative for xanthine-oxidase, the key enzyme involved in the production of uric acid, which is up-regulated in the failing heart, and may play an important role in the pathophysiologic process that leads to heart failure. In our study, we investigated the relation between stroke volume, cardiac output and serum uric acid in a large sample of overall healthy pharmacologically untreated subjects. The Brisighella Heart Study included 2,939 men and women between the ages of 14-84 without prior coronary heart disease or cerebrovascular disease who were not taking antihypertensive therapy at baseline. For this study, we selected 734 adult subjects enrolled in the last Brisighella population survey not taking antihypertensive, antidiabetic, lipid-lowering and uric acid-lowering drugs, and who were also not affected by chronic heart failure or by gout. The main predictors of cardiac functionality parameters were mean arterial pressure (MAP), HR, SUA and age (all p < 0.001), while gender, BMI, LDL-cholesterol, HDL-cholesterol, triglycerides, fasting plasma glucose, creatinine, estimated glomerular filtration rate, physical activity and smoking habit were not significantly associated (all p > 0.05). In particular, there is a strong relation between estimated cardiac output and serum uric acid (B = -0.219, p < 0.001) and between stroke volume and serum uric acid (B = -3.684, p < 0.001). These observations might have an impact on future considerations about serum uric acid as an early inexpensive marker of heart function decline in the general population. PMID:24214336

Cicero, Arrigo Francesco Giuseppe; Rosticci, Martina; Parini, Angelo; Baronio, Cristina; D'Addato, Sergio; Borghi, Claudio



Coconut Haustorium Maintains Cardiac Integrity and Alleviates Oxidative Stress in Rats Subjected to Isoproterenol-induced Myocardial Infarction  

PubMed Central

The present study evaluates the effect of aqueous extract of coconut haustorium on isoproterenol-induced myocardial infarction in Sprague Dawley rats. Rats were pretreated with aqueous extract of coconut haustorium (40 mg/100 g) orally for 45 days. After pretreatment, myocardial infarction was induced by injecting isoproterenol subcutaneously (20 mg/100 g body weight) twice at an interval of 24 h. Activity of marker enzymes like lactate dehydrogenase, creatinine kinase-MB, aspartate transaminase and alanine transaminase were increased in the serum and decreased in the heart of isoproterenol treated rats indicating cardiac damage. These changes were significantly reduced in haustorium pretreated rats. Moreover, an increase in the activities of antioxidant enzymes and decrease in the levels of peroxidation products were observed in the myocardium of coconut haustorium pretreated rats. Histopathology of the heart of these rats showed almost normal tissue morphology. From these results, it is clear that aqueous extract of coconut haustorium possess significant cardioprotective and antioxidant properties during isoproterenol-induced myocardial infarction in rats. PMID:23716867

Chikku, A. M.; Rajamohan, T.



The feasibility and applications of non-invasive cardiac output monitoring, thromboelastography and transit-time flow measurement in living-related renal transplantation surgery: results of a prospective pilot observational study  

PubMed Central

Introduction Delayed graft function (DGF) remains a significant and detrimental postoperative phenomenon following living-related renal allograft transplantation, with a published incidence of up to 15%. Early therapeutic vasodilatory interventions have been shown to improve DGF, and modifications to immunosuppressive regimens may subsequently lessen its impact. This pilot study assesses the potential applicability of perioperative non-invasive cardiac output monitoring (NICOM), transit-time flow monitoring (TTFM) of the transplant renal artery and pre-/perioperative thromboelastography (TEG) in the early prediction of DGF and perioperative complications. Methods Ten consecutive living-related renal allograft recipients were studied. Non-invasive cardiac output monitoring commenced immediately following induction of anaesthesia and was maintained throughout the perioperative period. Doppler-based TTFM was performed during natural haemostatic pauses in the transplant surgery: immediately following graft reperfusion and following ureteric implantation. Central venous blood sampling for TEG was performed following induction of anaesthesia and during abdominal closure. Results A single incidence of DGF was seen within the studied cohort and one intra-operative (thrombotic) complication noted. NICOM confirmed a predictable trend of increased cardiac index (CI) following allograft reperfusion (mean CI - clamped: 3.17?±?0.29 L/min/m2, post-reperfusion: 3.50?±?0.35 L/min/m2; P?



Non-invasive in vivo measurement of cardiac output in C57BL/6 mice using high frequency transthoracic ultrasound: evaluation of gender and body weight effects.  


Even though mice are being increasingly used as models for human cardiovascular diseases, non-invasive monitoring of cardiovascular parameters such as cardiac output (CO) in this species is challenging. In most cases, the effects of gender and body weight (BW) on these parameters have not been studied. The objective of this study was to provide normal reference values for CO in C57BL/6 mice, and to describe possible gender and/or BW associated differences between them. We used 30-MHz transthoracic Doppler ultrasound to measure hemodynamic parameters in the ascending aorta [heart rate (HR), stroke volume (SV), stroke index (SI), CO, and cardiac index (CI)] in ten anesthetized mice of either sex. No differences were found for HR, SV, and CO. Both SI and CI were statistically lower in males. However, after normalization for BW, these differences disappeared. These results suggest that if comparisons of cardiovascular parameters are to be made between male and female mice, values should be standardized for BW. PMID:24852337

Domínguez, Elisabet; Ruberte, Jesús; Ríos, José; Novellas, Rosa; Del Alamo, Maria Montserrat Rivera; Navarro, Marc; Espada, Yvonne



A Case of Femoral Arteriovenous Fistula Causing High-Output Cardiac Failure, Originally Misdiagnosed as Chronic Fatigue Syndrome  

PubMed Central

Percutaneous arterial catheterisation is commonly undertaken for a range of diagnostic and interventional procedures. Iatrogenic femoral arteriovenous fistulas are an uncommon complication of these procedures. Most are asymptomatic and close spontaneously, but can rarely increase in size leading to the development of symptoms. We report a case of an iatrogenic femoral arteriovenous fistula, causing worsening congestive cardiac failure, in a 34-year-old marathon runner. This was originally diagnosed as chronic fatigue syndrome. Following clinical examination, duplex ultrasound, and CT angiography a significant arteriovenous fistula was confirmed. Elective open surgery was performed, leading to a dramatic and rapid improvement in symptoms. Femoral arteriovenous fistulas have the potential to cause significant haemodynamic effects and can present many years after the initial procedure. Conservative, endovascular, and open surgical management strategies are available. PMID:24959370

Porter, J.; Al-Jarrah, Q.; Richardson, S.



Estimation of cardiac output and systemic vascular resistance using a multivariate regression model with features selected from the finger photoplethysmogram and routine cardiovascular measurements  

PubMed Central

Background Cardiac output (CO) and systemic vascular resistance (SVR) are two important parameters of the cardiovascular system. The ability to measure these parameters continuously and noninvasively may assist in diagnosing and monitoring patients with suspected cardiovascular diseases, or other critical illnesses. In this study, a method is proposed to estimate both the CO and SVR of a heterogeneous cohort of intensive care unit patients (N=48). Methods Spectral and morphological features were extracted from the finger photoplethysmogram, and added to heart rate and mean arterial pressure as input features to a multivariate regression model to estimate CO and SVR. A stepwise feature search algorithm was employed to select statistically significant features. Leave-one-out cross validation was used to assess the generalized model performance. The degree of agreement between the estimation method and the gold standard was assessed using Bland-Altman analysis. Results The Bland-Altman bias ±precision (1.96 times standard deviation) for CO was -0.01 ±2.70 L min-1 when only photoplethysmogram (PPG) features were used, and for SVR was -0.87 ±412 when only one PPG variability feature was used. Conclusions These promising results indicate the feasibility of using the method described as a non-invasive preliminary diagnostic tool in supervised or unsupervised clinical settings. PMID:23452705



Unification of input and output ends in polarization-maintaining optical fiber stress sensor by synthesis of optical coherence function (Invited Paper)  

NASA Astrophysics Data System (ADS)

We have developed a functional distributed fiber-optic stress sensor by synthesis of the optical coherence function (SOCF). The technique determines the location of stress-induced polarization mode coupling in a polarizationmaintaining fiber (PMF) by measuring the optical path difference (OPD) between the fast mode and the slow mode in PMF with SOCF. By modulating the frequency of the lightwave from a super-structure-grating distributed Bragg reflector laser diode (SSG-DBR-LD) in a stepwise waveform, the coherence function is synthesized into a series of periodical peaks in the meaning of time-integration. The period is controlled to allow only one coherence peak enter the range of the PM fiber under test. Then we can measure the polarization mode coupling at the position corresponding to the peak. The position of the peak is adjusted by using a phase modulation proportional to the frequency modulation. Therefore, polarization mode coupling distribution along the fiber can be obtained. Up to date, one end of the sensing fiber is used as the input end, and the other as the output end. This scheme is generally not convenient for remote applications. In this presentation, we report two new effective methods that unify the input and the output to one end of the fiber. In one scheme, a mirror plus a polarizer is attached to the far end of the PM fiber. The other scheme employs a polarization beam splitter (PBS) attached to the far end of the PM fiber. The light beam output from the PBS in one polarization direction is fed back into the fiber through the PBS in the perpendicular polarization direction. Experimental demonstrations for both schemes are presented.

He, Zuyuan; Horie, Shingo; Hotate, Kazuo; Ishikawa, Mitsuaki; Yoshikuni, Yuzo



Heart mass and the maximum cardiac output of birds and mammals: implications for estimating the maximum aerobic power input of flying animals  

PubMed Central

Empirical studies of cardiovascular variables suggest that relative heart muscle mass (relative Mh) is a good indicator of the degree of adaptive specialization for prolonged locomotor activities, for both birds and mammals. Reasonable predictions for the maximum oxygen consumption of birds during flight can be obtained by assuming that avian heart muscle has the same maximum physiological and biomechanical performance as that of terrestrial mammals. Thus, data on Mh can be used to provide quantitative estimates for the maximum aerobic power input (aerobic Pi,max) available to animals during intense levels of locomotor activity. The maximum cardiac output of birds and mammals is calculated to scale with respect to Mh (g) as 213 Mh0.88+-0.04 (ml min-1), while aerobic Pi,max is estimated to scale approximately as 11 Mh0.88+-0.09 (W). In general, estimated inter-species aerobic Pi,max, based on Mh for all bird species (excluding hummingbirds), is calculated to scale with respect to body mass (Mb in kg) as 81 Mb0.82+-0.11 (W). Comparison of family means for Mh indicate that there is considerable diversity in aerobic capacity among birds and mammals, for example, among the medium to large species of birds the Tinamidae have the smallest relative Mh (0.25 per cent) while the Otidae have unusually large relative Mh (1.6 per cent). Hummingbirds have extremely large relative Mh (2.28 per cent), but exhibit significant sexual dimorphism in their scaling of Mh and flight muscle mass, so that when considering hummingbird flight performance it may be useful to control for sexual differences in morphology. The estimated scaling of aerobic Pi,max (based on Mh and Mb in g) for male and female hummingbirds is 0.51 Mb0.83 +/-0.07 and 0.44 Mb0.85+- 0.11 (W), respectively. Locomotory muscles are dynamic structures and it might be anticipated that where additional energetic 'costs' occur seasonally (e.g. due to migratory fattening or the development of large secondary sexual characteristics) then the relevant cardiac and locomotor musculature might also be regulated seasonally. This is an important consideration, both due to the intrinsic interest of studying muscular adaptation to changes in energy demand, but also as a confounding variable in the practical use of heart rate to estimate the energetics of animals. Haemoglobin concentration (or haematocrit) may also be a confounding variable. Thus, it is concluded that data on the cardiovascular and flight muscle morphology of animals provides essential information regarding the behavioural, ecological and physiological significance of the flight performance of animals.

Bishop, C. M.



Preserved heart function and maintained response to cardiac stresses in a genetic model of cardiomyocyte-targeted deficiency of cyclooxygenase-2  

PubMed Central

Cyclooxygenase-1 and -2 are rate-limiting enzymes in the formation of a wide array of bioactive lipid mediators collectively known as prostanoids (prostaglandins, prostacyclins, thromboxanes). Evidence from clinical trials shows that selective inhibition of the second isoenzyme (cyclooxygenase-2, or Cox-2) is associated with increased risk for serious cardiovascular events and findings from animal-based studies have suggested protective roles of Cox-2 for the heart. To further characterize the function of Cox-2 in the heart, mice with loxP sites flanking exons 4 and 5 of Cox-2 were rendered knockout specifically in cardiac myocytes (Cox-2 CKO mice) via cre-mediated recombination. Baseline cardiac performance of CKO mice remained unchanged and closely resembled that of control mice. Furthermore, myocardial infarct size induced after in vivo ischemia/reperfusion (I/R) injury was comparable between CKO and control mice. In addition, cardiac hypertrophy and function four weeks after transverse aortic constriction (TAC) was found to be similar between the two groups. Assessment of Cox-2 expression in purified adult cardiac cells isolated after I/R and TAC suggests that the dominant source of Cox-2 is found in the non-myocyte fraction. In conclusion, our animal-based analyses together with the cell-based observations portray a limited role of cardiomyocyte-produced Cox-2 at baseline and in the context of ischemic or hemodynamic challenge. PMID:20399788

Papanicolaou, Kyriakos N.; Streicher, John M.; Ishikawa, Tomo-o; Herschman, Harvey; Wang, Yibin; Walsh, Kenneth



Effects of levosimendan/furosemide infusion on Plasma Brain Natriuretic Peptide, echocardiographic parameters and cardiac output in end-stage heart failure patients  

PubMed Central

Summary Background Acute decompensation heart failure (ADHF) remains a cause of hospitalization in patients with end-stage congestive HF. The administration of levosimendan in comparison with a standard therapy in CHF patients admitted for ADHF was analysed. Material/Methods Consecutive patients admitted for ADHF (NYHA class III–IV) were treated with levosimendan infusion 0.1 ?g/kg/min or with furosemide infusion 100–160 mg per day for 48 hours (control group). All subjects underwent determination of brain natriuretic peptide (BNP), non-invasive cardiac output (CO), and echocardiogram at baseline, at the end of therapy and 1 week after therapy. Results Seven patients admitted for 20 treatments in 16 months (age 66 years; mean admission/year 5.4) were treated with levosimendan and compared with 7 patients admitted for 15 treatments (age 69.1 years; mean admission/year 6.1). At the end of levosimendan therapy, BNP decreased (from 679.7±512.1 pg/ml to 554.2±407.6 pg/ml p=0.03), and 6MWT and LVEF improved (from 217.6±97.7 m to 372.2±90.4 m p=0.0001; from 22.8±9.1% to 25.4±9.8% p=0.05). Deceleration time, E/A, E/E’, TAPSE, pulmonary pressure and CO did not change significantly after levosimendan therapy and after 1 week. At follow-up, only 6-min WT and NYHA class showed a significant improvement (p=0.0001, p=0.001 respectively). The furosemide infusion reduced NYHA class and body weight (from 3.4±0.6 to 2.3±0.5 p=0.001; from 77.5±8.6 kg to 76±6.6 kg p=0.04), but impaired renal function (clearances from 56.3±21.9 ml/min to 41.2±10.1 ml/min p=0.04). Conclusions Treating end-stage CHF patients with levosimendan improved BNP and LVEF, but this effect disappeared after 1 week. The amelioration of 6MWT and NYHA class lasted longer after levosimendan infusion. PMID:21358614

Feola, Mauro; Lombardo, Enrico; Taglieri, Camillo; Vallauri, Paola; Piccolo, Salvatore; Valle, Roberto



Autophagy-mediated degradation is necessary for regression of cardiac hypertrophy during ventricular unloading.  


Cardiac hypertrophy occurs in response to a variety of stresses as a compensatory mechanism to maintain cardiac output and normalize wall stress. Prevention or regression of cardiac hypertrophy can be a major therapeutic target. Although regression of cardiac hypertrophy occurs after control of etiological factors, the molecular mechanisms remain to be clarified. In the present study, we investigated the role of autophagy in regression of cardiac hypertrophy. Wild-type mice showed cardiac hypertrophy after continuous infusion of angiotensin II for 14 days using osmotic minipumps, and regression of cardiac hypertrophy was observed 7 days after removal of the minipumps. Autophagy was induced during regression of cardiac hypertrophy, as evidenced by an increase in microtubule-associated protein 1 light chain 3 (LC3)-II protein level. Then, we subjected cardiac-specific Atg5-deficient (CKO) and control mice (CTL) to angiotensin II infusion for 14 days. CKO and CTL developed cardiac hypertrophy to a similar degree without contractile dysfunction. Seven days after removal of the minipumps, CKO showed significantly less regression of cardiac hypertrophy compared with CTL. Regression of pressure overload-induced cardiac hypertrophy after unloading was also attenuated in CKO. These results suggest that autophagy is necessary for regression of cardiac hypertrophy during unloading of neurohumoral and hemodynamic stress. PMID:24211573

Oyabu, Jota; Yamaguchi, Osamu; Hikoso, Shungo; Takeda, Toshihiro; Oka, Takafumi; Murakawa, Tomokazu; Yasui, Hiroki; Ueda, Hiromichi; Nakayama, Hiroyuki; Taneike, Manabu; Omiya, Shigemiki; Shah, Ajay M; Nishida, Kazuhiko; Otsu, Kinya



Cardiac gated ventilation  

NASA Astrophysics Data System (ADS)

There are several theoretic advantages to synchronizing positive pressure breaths with the cardiac cycle, including the potential for improving distribution of pulmonary and myocardial blood flow and enhancing cardiac output. We evaluated the effects of synchronizing respiration to the cardiac cycle using a programmable ventilator and electron beam CT (EBCT) scanning. The hearts of anesthetized dogs were imaged during cardiac gated respiration with a 50msec scan aperture. Multislice, short axis, dynamic image data sets spanning the apex to base of the left ventricle were evaluated to determine the volume of the left ventricular chamber at end-diastole and end-systole during apnea, systolic and diastolic cardiac gating. We observed an increase in cardiac output of up to 30% with inspiration gated to the systolic phase of the cardiac cycle in a nonfailing model of the heart.

Hanson, C. William, III; Hoffman, Eric A.



Cardiac gated ventilation  

SciTech Connect

There are several theoretic advantages to synchronizing positive pressure breaths with the cardiac cycle, including the potential for improving distribution of pulmonary and myocardial blood flow and enhancing cardiac output. The authors evaluated the effects of synchronizing respiration to the cardiac cycle using a programmable ventilator and electron beam CT (EBCT) scanning. The hearts of anesthetized dogs were imaged during cardiac gated respiration with a 50 msec scan aperture. Multi slice, short axis, dynamic image data sets spanning the apex to base of the left ventricle were evaluated to determine the volume of the left ventricular chamber at end-diastole and end-systole during apnea, systolic and diastolic cardiac gating. The authors observed an increase in cardiac output of up to 30% with inspiration gated to the systolic phase of the cardiac cycle in a non-failing model of the heart.

Hanson, C.W. III [Hospital of the Univ. of Pennsylvania, Philadelphia, PA (United States). Dept. Anesthesia; Hoffman, E.A. [Univ. of Iowa College of Medicine, Iowa City, IA (United States). Div. of Physiologic Imaging



Auditory stimulation of opera music induced prolongation of murine cardiac allograft survival and maintained generation of regulatory CD4+CD25+ cells  

PubMed Central

Background Interactions between the immune response and brain functions such as olfactory, auditory, and visual sensations are likely. This study investigated the effect of sounds on alloimmune responses in a murine model of cardiac allograft transplantation. Methods Naïve CBA mice (H2k) underwent transplantation of a C57BL/6 (B6, H2b) heart and were exposed to one of three types of music--opera (La Traviata), classical (Mozart), and New Age (Enya)--or one of six different single sound frequencies, for 7 days. Additionally, we prepared two groups of CBA recipients with tympanic membrane perforation exposed to opera for 7 days and CBA recipients exposed to opera for 7 days before transplantation (pre-treatment). An adoptive transfer study was performed to determine whether regulatory cells were generated in allograft recipients. Immunohistochemical, cell-proliferation, cytokine, and flow cytometry assessments were also performed. Results CBA recipients of a B6 cardiac graft that were exposed to opera music and Mozart had significantly prolonged allograft survival (median survival times [MSTs], 26.5 and 20 days, respectively), whereas those exposed to a single sound frequency (100, 500, 1000, 5000, 10,000, or 20,000 Hz) or Enya did not (MSTs, 7.5, 8, 9, 8, 7.5, 8.5 and 11 days, respectively). Untreated, CBA mice with tympanic membrane perforations and CBA recipients exposed to opera for 7 days before transplantation (pre-treatment) rejected B6 cardiac grafts acutely (MSTs, 7, 8 and 8 days, respectively). Adoptive transfer of whole splenocytes, CD4+ cells, or CD4+CD25+ cells from opera-exposed primary allograft recipients resulted in significantly prolonged allograft survival in naive secondary recipients (MSTs, 36, 68, and > 100 days, respectively). Proliferation of splenocytes, interleukin (IL)-2 and interferon (IFN)-? production was suppressed in opera-exposed mice, and production of IL-4 and IL-10 from opera-exposed transplant recipients increased compared to that from splenocytes of untreated recipients. Flow cytometry studies showed an increased CD4+CD25+ Forkhead box P3 (Foxp3)+ cell population in splenocytes from those mice. Conclusion Our findings indicate that exposure to opera music, such as La traviata, could affect such aspects of the peripheral immune response as generation of regulatory CD4+CD25+ cells and up-regulation of anti-inflammatory cytokines, resulting in prolonged allograft survival. PMID:22445281



Cardiac and peripheral vascular contributions to hypotension in spinal cats.  


On transection of the cervical spinal cord, substantial decreases in systemic arterial pressure and in discharge of many sympathetic nerves suggest the absence of sympathetic support to the cardiovascular system. However, discharge of mesenteric and splenic nerves is well maintained in spinal cats (R. L. Meckler and L. C. Weaver. J. Physiol. Lond. 396: 139-153, 1988; R. D. Stein and L. C. Weaver. J. Physiol. Lond. 396: 155-172, 1988). We proposed that the low arterial pressure in spinal animals was caused predominantly by decreased cardiac output and vasodilation in muscle and some visceral vascular beds but that sustained mesenteric and splenic discharge was causing significant splanchnic vasoconstriction and partial support of arterial pressure. Therefore, changes in cardiac output, total peripheral resistance, and resistance of constant-flow-perfused mesenteric visceral and hindlimb skeletal muscle vascular beds caused by interruption of cervical spinal pathways were assessed. Blockade of cervical pathways decreased arterial pressure as much by decreasing cardiac output as by decreasing total peripheral resistance. Resistances of the muscle and mesenteric vascular beds decreased equally. In conclusion, hypotension in spinal cats is caused by decreased cardiac output and by vasodilation, which is as prominent in mesenteric as it is in muscle vascular beds. The maintained mesenteric sympathetic discharge in spinal cats appears unable to produce significant support of vascular arterial resistance. PMID:2589489

Yardley, C P; Fitzsimons, C L; Weaver, L C



Epo deficiency alters cardiac adaptation to chronic hypoxia.  


The involvement of erythropoietin in cardiac adaptation to acute and chronic (CHx) hypoxia was investigated in erythropoietin deficient transgenic (Epo-TAg(h)) and wild-type (WT) mice. Left (LV) and right ventricular functions were assessed by echocardiography and hemodynamics. HIF-1?, VEGF and Epo pathways were explored through RT-PCR, ELISA, Western blot and immunocytochemistry. Epo gene and protein were expressed in cardiomyocytes of WT mice in normoxia and hypoxia. Increase in blood hemoglobin, angiogenesis and functional cardiac adaptation occurred in CHx in WT mice, allowing a normal oxygen delivery (O2T). Epo deficiency induced LV hypertrophy, increased cardiac output (CO) and angiogenesis, but O2T remained lower than in WT mice. In CHx Epo-TAg(h) mice, LV hypertrophy, CO and O2T decreased. HIF-1? and Epo receptor pathways were depressed, suggesting that Epo-TAg(h) mice could not adapt to CHx despite activation of cardioprotective pathways (increased P-STAT-5/STAT-5). HIF/Epo pathway is activated in the heart of WT mice in hypoxia. Chronic hypoxia induced cardiac adaptive responses that were altered with Epo deficiency, failing to maintain oxygen delivery to tissues. PMID:23333855

El Hasnaoui-Saadani, Raja; Marchant, Dominique; Pichon, Aurélien; Escoubet, Brigitte; Pezet, Mylène; Hilfiker-Kleiner, Denise; Hoch, Melanie; Pham, Isabelle; Quidu, Patricia; Voituron, Nicolas; Journé, Clément; Richalet, Jean-Paul; Favret, Fabrice




PubMed Central

Background Plasma expander (PE) based on polyethylene glycol (PEG) conjugated to albumin has shown positive results maintaining blood volume (BV) during hemodilution and restoring BV during resuscitation from hemorrhagic shock. PEG conjugation to human serum albumin (HSA), PEG-HSA, increasing size, weigh and colloidal osmotic pressure (COP), with minor effects on solution viscosity. Methods This study was designed to test the hypothesis that PEG-HSA (2 g/dL) produced by direct PEGylation chemistry improves cardiac function during two experimental models, i) moderate hemodilution and ii) resuscitation from hemorrhagic shock, compared to a conventional colloidal plasma expander (dextran 70 kDa, D×70, 6 g/dL). Cardiac function was studied using a miniaturized pressure volume (PV) conductance catheter implanted in the left ventricle (LV) and evaluated in terms of cardiac indices derived from the PV measurements. Results PEG-HSA increased cardiac output (CO), stroke volume (SV) and stroke work (SW), and decreased systemic vascular resistance (SVR) compared to D×70, in both experimental models. The improvements induced by PEG-HSA in cardiac function were sustained over the observation time. PEG-HSA cardiac mechanoenergetics changes are the result of increased energy transferred per stroke, and decreased resistance of the vasculature connecting the heart. In summary, PEG-HSA decreased LV ejection impedance. Conclusion Ejection of blood diluted with PEG-HSA presented a reduced load to the heart, increased contractile function, and lowered the energy consumed per unit volume compared to D×70. Our results emphasize the importance of heart function as a parameter to be included in the evaluation changes induced by new PEs. PMID:22867830

Chatpun, Surapong; Nacharaju, Parimala; Cabrales, Pedro



Redox Control of Cardiac Excitability  

PubMed Central

Abstract Reactive oxygen species (ROS) have been associated with various human diseases, and considerable attention has been paid to investigate their physiological effects. Various ROS are synthesized in the mitochondria and accumulate in the cytoplasm if the cellular antioxidant defense mechanism fails. The critical balance of this ROS synthesis and antioxidant defense systems is termed the redox system of the cell. Various cardiovascular diseases have also been affected by redox to different degrees. ROS have been indicated as both detrimental and protective, via different cellular pathways, for cardiac myocyte functions, electrophysiology, and pharmacology. Mostly, the ROS functions depend on the type and amount of ROS synthesized. While the literature clearly indicates ROS effects on cardiac contractility, their effects on cardiac excitability are relatively under appreciated. Cardiac excitability depends on the functions of various cardiac sarcolemal or mitochondrial ion channels carrying various depolarizing or repolarizing currents that also maintain cellular ionic homeostasis. ROS alter the functions of these ion channels to various degrees to determine excitability by affecting the cellular resting potential and the morphology of the cardiac action potential. Thus, redox balance regulates cardiac excitability, and under pathological regulation, may alter action potential propagation to cause arrhythmia. Understanding how redox affects cellular excitability may lead to potential prophylaxis or treatment for various arrhythmias. This review will focus on the studies of redox and cardiac excitation. Antioxid. Redox Signal. 18, 432–468. PMID:22897788

Aggarwal, Nitin T.



Cardiac Arrest  


... or it can stop beating. Sudden cardiac arrest (SCA) occurs when the heart develops an arrhythmia that ... is blocked. There are many possible causes of SCA. They include coronary heart disease, physical stress, and ...


Cardiac Paragangliomas.  


Cardiac paraganglioma is a rare entity. We review the clinical data from 158 patients reported in 132 isolated papers, and discuss clinical presentations, imaging findings, pathology, location, therapy, and outcomes. PMID:25331372

Wang, Ji-Gang; Han, Jing; Jiang, Tao; Li, Yu-Jun



Cardiac Catheterization  


... done during a cardiac catheterization include: closing small holes inside the heart repairing leaky or narrow heart ... bandage. It's normal for the site to be black and blue, red, or slightly swollen for a ...


Cardiac factors in orthostatic hypotension  

NASA Astrophysics Data System (ADS)

Cardiac function is determined by preload, afterload, heart rate and contractility. During orthostatic stress, the footward blood shift is compensated for by an increase of afterload. LBNP is widely used to analyze effects of volume displacement during orthostatic stress. Comparisons of invasive ( right heart catheterization) and non-invasive approach (echocardiography) yielded similar changes. Preload and afterload change with graded LBNP, heart rate increases, and stroke volume and cardiac output decrease. Thus, the working point on the left ventricular function curve is shifted to the left and downward, similar to hypovolemia. However, position on the Frank-Starling curve, the unchanged ejection fraction, and the constant Vcf indicate a normal contractile state during LBNP. A decrease of arterial oxygen partial pressure during LBNP shwos impaired ventilation/perfusion ratio. Finally, LBNP induced cardiac and hemodynamic changes can be effectively countermeasured by dihydroergotamine, a potent venoconstrictor. Comparison of floating catheter data with that of echocardiography resulted in close correlation for cardiac output and stroke volume. In addition, cardiac dimensions changed in a similar way during LBNP. From our findings, echocardiography as a non-invasive procedure can reliably used in LBNP and orthostatic stress tests. Some informations can be obtained on borderline values indicating collaps or orthostatic syncope. Early fainters can be differentiated from late fainters by stroke volume changes.

Löllgen, H.; Dirschedl, P.; Koppenhagen, K.; Klein, K. E.


Maintaining a Healthy Weight  


... and drink Other ways to maintian a healthy weight? Limit portion size to control calorie intake. Add ... Go4Life Maintaining a Healthy Weight Maintaining a healthy weight is important for overall health and well-being. ...


Cardiac Regenerative Capacity and Mechanisms  

PubMed Central

The heart holds the monumental yet monotonous task of maintaining circulation. Although cardiac function is critical to other organs and to life itself, mammals are not equipped with significant natural capacity to replace heart muscle that has been lost by injury. This deficiency plays a role in leaving millions worldwide each year vulnerable to heart failure. By contrast, certain other vertebrate species like zebrafish are strikingly good at heart regeneration. A cellular and molecular understanding of endogenous regenerative mechanisms, combined with advances in methodology to transplant cells, together project a future in which cardiac muscle regeneration can be therapeutically stimulated in injured human hearts. This review will focus on what has been discovered recently about cardiac regenerative capacity and how natural mechanisms of heart regeneration in model systems are stimulated and maintained. PMID:23057748

Kikuchi, Kazu; Poss, Kenneth D.



Mastering temporary invasive cardiac pacing.  


Competent management of patients with an invasive temporary pacemaker is an important skill for nurses who provide care for critically ill patients with cardiac disease. Such management requires familiarity with normal cardiovascular anatomy and physiology, conduction system defects, and rhythm interpretation. With an understanding of the basic concepts of rate, output, chambers, sensitivity, and capture, pacing can be done with ease. Care of patients with a temporary invasive pacemaker requires monitoring cardiac tissue and hemodynamic status, observing for changes that would indicate the need for modifications in the pacemaker settings. Nursing interventions include physical assessment, care of the insertion site, routine threshold testing, and management of the pulse generator. PMID:15206293

Overbay, Devorah; Criddle, Laura



Downregulation of OPA1 alters mouse mitochondrial morphology, PTP function, and cardiac adaptation to pressure overload  

E-print Network

, mitochondrial functional properties were maintained, but direct energy channeling between mitochondria1 Downregulation of OPA1 alters mouse mitochondrial morphology, PTP function, and cardiac adaptation to pressure overload Running title: OPA1 deficit and cardiac mitochondria Jerome Piquereau1, 2

Boyer, Edmond


Cardiac cell proliferation assessed by EdU, a novel analysis of cardiac regeneration.  


Emerging evidence suggests that mammalian hearts maintain the capacity for cardiac regeneration. Rapid and sensitive identification of cardiac cellular proliferation is prerequisite for understanding the underlying mechanisms and strategies of cardiac regeneration. The following immunologically related markers of cardiac cells were analyzed: cardiac transcription factors Nkx2.5 and Gata 4; specific marker of cardiomyocytes TnT; endothelial cell marker CD31; vascular smooth muscle marker smooth muscle myosin IgG; cardiac resident stem cells markers IsL1, Tbx18, and Wt1. Markers were co-localized in cardiac tissues of embryonic, neonatal, adult, and pathological samples by 5-ethynyl-2'-deoxyuridine (EdU) staining. EdU was also used to label isolated neonatal cardiomyocytes in vitro. EdU robustly labeled proliferating cells in vitro and in vivo, co-immunostaining with different cardiac cells markers. EdU can rapidly and sensitively label proliferating cardiac cells in developmental and pathological states. Cardiac cell proliferation assessed by EdU is a novel analytical tool for investigating the mechanism and strategies of cardiac regeneration in response to injury. PMID:25480318

Zeng, Bin; Tong, Suiyang; Ren, Xiaofeng; Xia, Hao



Maintaining Plant Genebanks  

NSDL National Science Digital Library

This lesson explores the benefits and problems of maintaining plant genebanks globally. Students can plan a genebank or agricultural cryopreservation business venture, write a biography about a famous botanist, present views at a genebank symposium for developing nations and more!

Brian R. Shmaefsky (Kingwood College;)



Early loss of cardiac function in acute myocardial infarction is associated with redox imbalance  

PubMed Central

BACKGROUND: The loss of viable myocardium subsequent to myocardial infarction (MI) impairs cardiac function, and oxidative stress is considered to be critical in this process. OBJECTIVES: To assess cardiac function and correlate it with oxidative stress and antioxidant levels in cardiac tissue at 48 h post-MI. METHODS: Adult male Wistar rats (n=6 per group) with a mean (± SD) weight of 229±24 g were randomly assigned to either an infarcted group or a control group. MI was induced by occlusion of the left coronary artery. Cardiac function was evaluated by measuring left ventricular (LV) ejection fraction, LV fractional shortening, cardiac output, myocardial performance index and the peak early diastolic velocity/peak atrial velocity ratio using echocardiography. The myocardial oxidative stress profile was assessed by measuring the reduced glutathione/oxidized glutathione ratio, H2O2 levels, peroxiredoxin-6 protein levels and activity levels of superoxide dismutase, catalase and glutathione peroxidase. Lipid peroxidation was quantified using chemiluminescence, and protein oxidation was determined by measuring protein carbonyl levels. RESULTS: LV ejection fraction and LV fractional shortening were lower in the infarcted group compared with the sham group, whereas the peak early diastolic velocity/peak atrial velocity ratio and myocardial performance index were significantly increased, indicating systolic dysfunction. Lipid peroxidation, protein carbonyls and superoxide dismutase and catalase activity levels did not differ between the groups. Peroxyredoxin-6 levels were increased in the infarcted group, while H2O2 levels were reduced. The reduced glutathione/oxidized glutathione ratio and the glutathione peroxidase activity were reduced in the infarcted group compared with control. DISCUSSION AND CONCLUSION: These data suggest that MI-induced cardiac dysfunction and impaired redox balance may be associated with the activation of counter-regulatory responses to maintain reduced H2O2 concentrations and, thereby, prevent further oxidative damage at this early time point. PMID:23592951

Tavares, Angela Maria Vicente; da Rosa Araujo, Alex Sander; Llesuy, Susana; Khaper, Neelam; Rohde, Luis Eduardo; Clausell, Nadine; Belló-Klein, Adriane



Aging impairs myocardial fatty acid and ketone oxidation and modifies cardiac functional and metabolic responses to insulin in mice.  


Aging presumably initiates shifts in substrate oxidation mediated in part by changes in insulin sensitivity. Similar shifts occur with cardiac hypertrophy and may contribute to contractile dysfunction. We tested the hypothesis that aging modifies substrate utilization and alters insulin sensitivity in mouse heart when provided multiple substrates. In vivo cardiac function was measured with microtipped pressure transducers in the left ventricle from control (4-6 mo) and aged (22-24 mo) mice. Cardiac function was also measured in isolated working hearts along with substrate and anaplerotic fractional contributions to the citric acid cycle (CAC) by using perfusate containing (13)C-labeled free fatty acids (FFA), acetoacetate, lactate, and unlabeled glucose. Stroke volume and cardiac output were diminished in aged mice in vivo, but pressure development was preserved. Systolic and diastolic functions were maintained in aged isolated hearts. Insulin prompted an increase in systolic function in aged hearts, resulting in an increase in cardiac efficiency. FFA and ketone flux were present but were markedly impaired in aged hearts. These changes in myocardial substrate utilization corresponded to alterations in circulating lipids, thyroid hormone, and reductions in protein expression for peroxisome proliferator-activated receptor (PPAR)alpha and pyruvate dehydrogenase kinase (PDK)4. Insulin further suppressed FFA oxidation in the aged. Insulin stimulation of anaplerosis in control hearts was absent in the aged. The aged heart shows metabolic plasticity by accessing multiple substrates to maintain function. However, fatty acid oxidation capacity is limited. Impaired insulin-stimulated anaplerosis may contribute to elevated cardiac efficiency, but may also limit response to acute stress through depletion of CAC intermediates. PMID:20601465

Hyyti, Outi M; Ledee, Dolena; Ning, Xue-Han; Ge, Ming; Portman, Michael A



Cardiac sarcoidosis.  


The prognosis of sarcoidosis often considered as "benign" is significantly changed in the presence of a cardiac localization. An in-depth interview, a clinical examination together with ECG are often for most of sarcoidosis. Certain conditions (severe multisystemic sarcoidosis, rares localizations in particular neurological, renal, gastric) lead to necessary investigations: Holter ECG, echocardiography, thallium scintigraphy with dipyridamole test, PET scanner and MRI in order to identify infraclinical presentations. Diagnosis relies on guidelines of Japansese criteria, but can benefit from MRI and PET scanner even though their place is not yet clearly defined in clinical pratice. Diagnosing cardiac sarcoidosis means deciding an immunosuppressive treatment. It is highly important to gather all criteria to validate a consistent diagnosis or at least a high probability. In order to best adapt therapy, a coordinated patient care involving the cardiologist and the sarcoidosis specialist is necessary. PMID:22608949

Chapelon-Abric, Catherine



Hexokinase-mitochondrial interaction in cardiac tissue: implications for cardiac glucose uptake, the 18 FDG lumped constant and cardiac protection  

Microsoft Academic Search

The hexokinases are fundamental regulators of cardiac glucose uptake; by phosphorylating free intracellular glucose, they\\u000a maintain the concentration gradient driving myocardial extraction of glucose from the bloodstream. Hexokinases are highly\\u000a regulated proteins, subject to activation by insulin, hypoxia or ischaemia, and inhibition by their enzymatic product glucose-6-phosphate.\\u000a In vitro and in many non-cardiac cell types, hexokinases have been shown to

Richard Southworth



Cardiac optogenetics  

PubMed Central

Optogenetics is an emerging technology for optical interrogation and control of biological function with high specificity and high spatiotemporal resolution. Mammalian cells and tissues can be sensitized to respond to light by a relatively simple and well-tolerated genetic modification using microbial opsins (light-gated ion channels and pumps). These can achieve fast and specific excitatory or inhibitory response, offering distinct advantages over traditional pharmacological or electrical means of perturbation. Since the first demonstrations of utility in mammalian cells (neurons) in 2005, optogenetics has spurred immense research activity and has inspired numerous applications for dissection of neural circuitry and understanding of brain function in health and disease, applications ranging from in vitro to work in behaving animals. Only recently (since 2010), the field has extended to cardiac applications with less than a dozen publications to date. In consideration of the early phase of work on cardiac optogenetics and the impact of the technique in understanding another excitable tissue, the brain, this review is largely a perspective of possibilities in the heart. It covers the basic principles of operation of light-sensitive ion channels and pumps, the available tools and ongoing efforts in optimizing them, overview of neuroscience use, as well as cardiac-specific questions of implementation and ideas for best use of this emerging technology in the heart. PMID:23457014



Regulation of the cardiac sodium pump.  


In cardiac muscle, the sarcolemmal sodium/potassium ATPase is the principal quantitative means of active transport at the myocyte cell surface, and its activity is essential for maintaining the trans-sarcolemmal sodium gradient that drives ion exchange and transport processes that are critical for cardiac function. The 72-residue phosphoprotein phospholemman regulates the sodium pump in the heart: unphosphorylated phospholemman inhibits the pump, and phospholemman phosphorylation increases pump activity. Phospholemman is subject to a remarkable plethora of post-translational modifications for such a small protein: the combination of three phosphorylation sites, two palmitoylation sites, and one glutathionylation site means that phospholemman integrates multiple signaling events to control the cardiac sodium pump. Since misregulation of cytosolic sodium contributes to contractile and metabolic dysfunction during cardiac failure, a complete understanding of the mechanisms that control the cardiac sodium pump is vital. This review explores our current understanding of these mechanisms. PMID:22955490

Fuller, W; Tulloch, L B; Shattock, M J; Calaghan, S C; Howie, J; Wypijewski, K J



Increase in cardiac myosin heavy-chain (MyHC) alpha protein isoform in hibernating ground squirrels, with echocardiographic visualization of ventricular wall hypertrophy and prolonged contraction.  


Deep hibernators such as golden-mantled ground squirrels (Callospermophilus lateralis) have multiple challenges to cardiac function during low temperature torpor and subsequent arousals. As heart rates fall from over 300 beats min(-1) to less than 10, chamber dilation and reduced cardiac output could lead to congestive myopathy. We performed echocardiography on a cohort of individuals prior to and after several months of hibernation. The left ventricular chamber exhibited eccentric and concentric hypertrophy during hibernation and thus calculated ventricular mass was ~30% greater. Ventricular ejection fraction was mildly reduced during hibernation but stroke volumes were greater due to the eccentric hypertrophy and dramatically increased diastolic filling volumes. Globally, the systolic phase in hibernation was ~9.5 times longer, and the diastolic phase was 28× longer. Left atrial ejection generally was not observed during hibernation. Atrial ejection returned weakly during early arousal. Strain echocardiography assessed the velocity and total movement distance of contraction and relaxation for regional ventricular segments in active and early arousal states. Myocardial systolic strain during early arousal was significantly greater than the active state, indicating greater total contractile movement. This mirrored the increased ventricular ejection fraction noted with early arousal. However, strain rates were slower during early arousal than during the active period, particularly systolic strain, which was 33% of active, compared with the rate of diastolic strain, which was 67% of active. As heart rate rose during the arousal period, myocardial velocities and strain rates also increased; this was matched closely by cardiac output. Curiously, though heart rates were only 26% of active heart rates during early arousal, the cardiac output was nearly 40% of the active state, suggesting an efficient pumping system. We further analyzed proportions of cardiac myosin heavy-chain (MyHC) isoforms in a separate cohort of squirrels over 5 months, including time points before hibernation, during hibernation and just prior to emergence. Hibernating individuals were maintained in both a 4°C cold room and a 20°C warm room. Measured by SDS-PAGE, relative percentages of cardiac MyHC alpha were increased during hibernation, at both hibernacula temperatures. A potential increase in contractile speed, and power, from more abundant MyHC alpha may aid force generation at low temperature and at low heart rates. Unlike many models of cardiomyopathies where the alpha isoform is replaced by the beta isoform in order to reduce oxygen consumption, ground squirrels demonstrate a potential cardioprotective mechanism to maintain cardiac output during torpor. PMID:24072796

Nelson, O Lynne; Rourke, Bryan C



Increase in cardiac myosin heavy-chain (MyHC) alpha protein isoform in hibernating ground squirrels, with echocardiographic visualization of ventricular wall hypertrophy and prolonged contraction  

PubMed Central

SUMMARY Deep hibernators such as golden-mantled ground squirrels (Callospermophilus lateralis) have multiple challenges to cardiac function during low temperature torpor and subsequent arousals. As heart rates fall from over 300 beats min?1 to less than 10, chamber dilation and reduced cardiac output could lead to congestive myopathy. We performed echocardiography on a cohort of individuals prior to and after several months of hibernation. The left ventricular chamber exhibited eccentric and concentric hypertrophy during hibernation and thus calculated ventricular mass was ~30% greater. Ventricular ejection fraction was mildly reduced during hibernation but stroke volumes were greater due to the eccentric hypertrophy and dramatically increased diastolic filling volumes. Globally, the systolic phase in hibernation was ~9.5 times longer, and the diastolic phase was 28× longer. Left atrial ejection generally was not observed during hibernation. Atrial ejection returned weakly during early arousal. Strain echocardiography assessed the velocity and total movement distance of contraction and relaxation for regional ventricular segments in active and early arousal states. Myocardial systolic strain during early arousal was significantly greater than the active state, indicating greater total contractile movement. This mirrored the increased ventricular ejection fraction noted with early arousal. However, strain rates were slower during early arousal than during the active period, particularly systolic strain, which was 33% of active, compared with the rate of diastolic strain, which was 67% of active. As heart rate rose during the arousal period, myocardial velocities and strain rates also increased; this was matched closely by cardiac output. Curiously, though heart rates were only 26% of active heart rates during early arousal, the cardiac output was nearly 40% of the active state, suggesting an efficient pumping system. We further analyzed proportions of cardiac myosin heavy-chain (MyHC) isoforms in a separate cohort of squirrels over 5 months, including time points before hibernation, during hibernation and just prior to emergence. Hibernating individuals were maintained in both a 4°C cold room and a 20°C warm room. Measured by SDS-PAGE, relative percentages of cardiac MyHC alpha were increased during hibernation, at both hibernacula temperatures. A potential increase in contractile speed, and power, from more abundant MyHC alpha may aid force generation at low temperature and at low heart rates. Unlike many models of cardiomyopathies where the alpha isoform is replaced by the beta isoform in order to reduce oxygen consumption, ground squirrels demonstrate a potential cardioprotective mechanism to maintain cardiac output during torpor. PMID:24072796

Nelson, O. Lynne; Rourke, Bryan C.



Software Maintainability Index Revisited  

SciTech Connect

For many years now, software practitioners have been collecting metrics from source code in an effort to better understand the software they are developing or changing. Maintainability Index (MI) is a composite metric that incorporates a number of traditional source code metrics into a single number that indicates relative maintainability. As originally proposed by Oman and Hagemeister, the MI is comprised of weighted Halstead metrics (effort or volume), McCabe's Cyclomatic Complexity, lines of code (LOC), and number of comments [1, 2]. Two equations were presented: one that considered comments and one that did not.

Welker, Kurt Dean



Diversity & Community: Maintaining Allegiances.  

ERIC Educational Resources Information Center

The quest for diversity must overcome the resistance of traditional White, male faculty to redefining the mission and curriculum of the liberal arts college. Change will be difficult, but it must occur if liberal arts colleges are to survive and maintain a central and relevant place in multicultural America. (MSE)

Pena, Devon G.



Maintaining DACUM Quality.  

ERIC Educational Resources Information Center

This document discusses the importance of maintaining the quality of DACUM (Developing a Curriculum) occupational analyses and presents a 2-page checklist detailing DACUM quality performance criteria. The introduction to the checklist discusses various "infractions" discovered during an analyses of some curriculum/program developers' attempts to…

Norton, Robert E.


Different Contribution of Splanchnic Organs to Hyperlactatemia in Fecal Peritonitis and Cardiac Tamponade  

PubMed Central

Background. Changes in hepatosplanchnic lactate exchange are likely to contribute to hyperlactatemia in sepsis. We hypothesized that septic and cardiogenic shock have different effects on hepatosplanchnic lactate exchange and its contribution to hyperlactatemia. Materials and Methods. 24 anesthetized pigs were randomized to fecal peritonitis (P), cardiac tamponade (CT), and to controls (n = 8 per group). Oxygen transport and lactate exchange were calculated during 24 hours. Results. While hepatic lactate influx increased in P and in CT, hepatic lactate uptake remained unchanged in P and decreased in CT. Hepatic lactate efflux contributed 20% (P) and 33% (CT), respectively, to whole body venous efflux. Despite maintained hepatic arterial blood flow, hepatic oxygen extraction did not increase in CT. Conclusions. Whole body venous lactate efflux is of similar magnitude in hyperdynamic sepsis and in cardiogenic shock. Although jejunal mucosal pCO2 gradients are increased, enhanced lactate production from other tissues is more relevant to the increased arterial lactate. Nevertheless, the liver fails to increase hepatic lactate extraction in response to rising hepatic lactate influx, despite maintained hepatic oxygen consumption. In cardiac tamponade, regional, extrasplanchnic lactate production is accompanied by hepatic failure to increase oxygen extraction and net hepatic lactate output, despite maintained hepatic arterial perfusion. PMID:24228242

Gorrasi, José; Eleftheriadis, Anestis; Takala, Jukka; Brandt, Sebastian; Djafarzadeh, Siamak; Bruegger, Lukas E.; Bracht, Hendrik; Jakob, Stephan M.



Cardiac failure and left ventricular assist devices  

Microsoft Academic Search

Congestive heart failure (CHF) is a clinical syndrome defined as chronic, in- adequate myocardial contraction and relaxation that results in decreased cardiac output. It has multiple etiologies, including coronary artery disease causing is- chemic changes, valvular heart disease, viral cardiomyopathies, and congenital disease.Amajorcause of morbidityand mortality inthe United States,CHF affects more than 4 million people each year and causes approximately

Douglas J. Hirsch; John R. Cooper


Cardiac abnormalities in liver cirrhosis.  

PubMed Central

Cirrhosis is associated with several circulatory abnormalities. A hyperkinetic circulation characterized by increased cardiac output and decreased arterial pressure and peripheral resistance is typical. Despite this hyperkinetic circulation, some patients with alcoholic cirrhosis have subclinical cardiomyopathy with evidence of abnormal ventricular function unmasked by physiologic or pharmacologic stress. Florid congestive alcoholic cardiomyopathy develops in a small percentage, but the concurrent presence of cirrhosis seems to retard the occurrence of overt heart failure. Even nonalcoholic cirrhosis may be associated with latent cardiomyopathy, although overt heart failure is not observed. Tense ascites is associated with some cardiac compromise, and removing or mobilizing ascitic fluid by paracentesis or peritoneovenous shunting results in short-term increases in cardiac output. Cirrhosis also appears to be associated with a decreased risk of major coronary atherosclerosis and an increased risk of bacterial endocarditis. Small hemodynamically insignificant pericardial effusions may be seen in ascitic patients. The release of atrial natriuretic peptide appears to be unimpaired in cirrhosis, although the kidney may be hyporesponsive to its natriuretic effects. PMID:2690463

Lee, S S



Central Venous Saturation: A Prognostic Tool in Cardiac Surgery patients  

Microsoft Academic Search

Background: Central venous oxygen saturation (ScvO2) is a valuable prognostic marker in sepsis. However, its value in cardiac surgery has not been assessed yet. This study aimed at evaluating ScvO2 as a tool for predicting short-term organ dysfunction (OD) after cardiac surgery. Methods: A prospective cohort including cardiac surgery patients submitted to a goal-oriented therapy to maintain ScvO2 above 70%

Pedro M. Nogueira; Hugo T. Mendonça-Filho; Luiz Antonio Campos; Renato V. Gomes; Alexandre R. Felipe; Marco A. Fernandes; Cristiane A. Villela-Nogueira; José R. Rocco



Quantified maintainability requirements  

E-print Network

Yiateriel Command Organization Chart Commodity Command Organizational Chart 4. Availability Distributions for Lognormal Repair and Meibull Failures Si;andard Curves of Availability Reference for the Lognormal Distribution 30 35 CHAPTER INTRDDJCTIDH... requirements and their use by the Department of the Army. A method of converting the primary maintainability requirement, availability, into more meaningful design related requirements, such as mean time to repair and mean time before failure i" required...

Morris, Ronald Scott



Cardiac Cells Beating in Culture: A Laboratory Exercise  

ERIC Educational Resources Information Center

This article describes how to establish a primary tissue culture, where cells are taken directly from an organ of a living animal. Cardiac cells are taken from chick embryos and transferred to culture dishes. These cells are not transformed and therefore have a limited life span. However, the unique characteristics of cardiac cells are maintained

Weaver, Debora



Visualization of Model Output  

NSDL National Science Digital Library

Visualization of output from mathematical or statistical models is one of the best ways to introduce introductory geoscience students to the results and behavior of sophisticated models. Example of good sites ...


Cardiac risk stratification in renal transplantation using a form of artificial intelligence.  


The purpose of this study was to determine if an expert network, a form of artificial intelligence, could effectively stratify cardiac risk in candidates for renal transplant. Input into the expert network consisted of clinical risk factors and thallium-201 stress test data. Clinical risk factor screening alone identified 95 of 189 patients as high risk. These 95 patients underwent thallium-201 stress testing, and 53 had either reversible or fixed defects. The other 42 patients were classified as low risk. This algorithm made up the "expert system," and during the 4-year follow-up period had a sensitivity of 82%, specificity of 77%, and accuracy of 78%. An artificial neural network was added to the expert system, creating an expert network. Input into the neural network consisted of both clinical variables and thallium-201 stress test data. There were 5 hidden nodes and the output (end point) was cardiac death. The expert network increased the specificity of the expert system alone from 77% to 90% (p < 0.001), the accuracy from 78% to 89% (p < 0.005), and maintained the overall sensitivity at 88%. An expert network based on clinical risk factor screening and thallium-201 stress testing had an accuracy of 89% in predicting the 4-year cardiac mortality among 189 renal transplant candidates. PMID:9052342

Heston, T F; Norman, D J; Barry, J M; Bennett, W M; Wilson, R A



Origin of Cardiac Fibroblasts and the Role of Periostin  

PubMed Central

Cardiac fibroblasts are the most populous non-myocyte cell type within the mature heart and are required for extracellular matrix synthesis and deposition, generation of the cardiac skeleton, and to electrically insulate the atria from the ventricles. Significantly, cardiac fibroblasts have also been shown to play an important role in cardiomyocyte growth and expansion of the ventricular chambers during heart development. Although there are currently no cardiac fibroblast-restricted molecular markers, it is generally envisaged that the majority of the cardiac fibroblasts are derived from the proepicardium via epithelial-to-mesenchymal transformation. However, still relatively little is known about when and where the cardiac fibroblasts cells are generated, the lineage of each cell, and how cardiac fibroblasts move to reside in their final position throughout all four cardiac chambers. In this review we summarize the current understanding regarding the function of Periostin, a useful marker of the non-cardiomyocyte lineages, and its role during cardiac morphogenesis. Characterization of the cardiac fibroblast lineage and identification of the signals that maintain, expand and regulate their differentiation will be required to improve our understanding of cardiac function in both normal and pathophysiological states. PMID:19893021

Snider, Paige; Standley, Kara N.; Wang, Jian; Azhar, Mohamad; Doetschman, Thomas; Conway, Simon J.



Linear output nitinol engine  

SciTech Connect

This patent describes a linear output nitinol engine consisting of a number of integrated communicating parts. The engine has an external support framework which is described in detail. The patent further describes a wire transport mechanism, a pair of linkage levers with a loom secured to them, a number of nitinol wires strung between the looms, and a power takeoff block secured to the linkage levers. A pulley positioned in a flip-flop supporting bracket and a power takeoff modality including a tension member connected to a power output cable in order to provide linear power output transmission is described. A method for biasing the timing and the mechanism for timing the synchronization of the throw over arms and the flip-flop of the pulley are also described.

Banks, R.M.



Dynamic NMR cardiac imaging in a piglet.  


NMR echo-planar imaging (EPI) has been used in a realtime mode to visualise the thorax of a live piglet. Moving pictures are available on an immediate image display system which demonstrates dynamic cardiac function. Frame rates vary from one per cardiac cycle in a prospective stroboscopic mode with immediate visual output to a maximum of 10 frames per second yielding up to six looks in one piglet heart cycle, but using a visual playback mode. A completely new system has been used to obtain these images, features of which include a probe assembly with 22 cm access and an AP400 array processor for real-time data processing. PMID:6652414

Doyle, M; Rzedzian, R; Mansfield, P; Coupland, R E



Diodes stabilize LED output  

NASA Technical Reports Server (NTRS)

Small-signal diodes are placed in series with light-emitting diodes (LED's) to stabilize LED output against temperature fluctuations. Simple inexpensive method compensates for thermal fluctuations over a broad temperature range. Requiring few components, technique is particularly useful where circuit-board space is limited.

Deters, R. A.




E-print Network

AN INTEGRATEDMICROELECTROMECHANICALRESONANT OUTPUT GYROSCOPE - Ashwin A. Seshia*,Roger T. Howe vibratory rate gyroscope based on resonant sensing of the Coriolis force. The new design has several advantages over rate gyroscopes that utilize open-loop displacement sensing for rotation rate measurement

Tang, William C


Maintaining the unmethylated state  

PubMed Central

Background A remarkable correspondence exists between the cytogenetic locations of the known fragile sites and frequently reported sites of hypermethylation. The best-known features of fragile sites are sequence motifs that are prone to the spontaneous formation of a non-B DNA structure. These facts, coupled with the known enzymological specificities of DNA methyltransferase 1 (DNMT1), the ATP-dependent and actin-dependent helicases, and the ten-eleven translocation (TET) dioxygenases, suggest that these enzymes are involved in an epigenetic cycle that maintains the unmethylated state at these sites by resolving non-B structure, preventing both the sequestration of DNA methyltransferases (DNMTs) and hypermethylation in normal cells. Presentation of the hypothesis The innate tendency of DNA sequences present at fragile sites to form non-B DNA structures results in de novo methylation of DNA at these sites that is held in check in normal cells by the action of ATP-dependent and actin-dependent helicases coupled with the action of TET dioxygenases. This constitutes a previously unrecognized epigenetic repair cycle in which spontaneously forming non-B DNA structures formed at fragile sites are methylated by DNMTs as they are removed by the action of ATP-dependent and actin-dependent helicases, with the resulting nascent methylation rendered non-transmissible by TET dioxygenases. Testing the hypothesis A strong prediction of the hypothesis is that knockdown of ATP-dependent and actin-dependent helicases will result in enhanced bisulfite sensitivity and hypermethylation at non-B structures in multiple fragile sites coupled with global hypomethylation. Implications of the hypothesis A key implication of the hypothesis is that helicases, like the lymphoid-specific helicase and alpha thalassemia/mental retardation syndrome X-linked helicase, passively promote accurate maintenance of DNA methylation by preventing the sequestration of DNMTs at sites of unrepaired non-B DNA structure. When helicase action is blocked due to mutation or downregulation of the respective genes, DNMTs stall at unrepaired non-B structures in fragile sites after methylating them and are unable to methylate other sites in the genome, resulting in hypermethylation at non-B DNA-forming sites, along with hypomethylation elsewhere. PMID:24079333



Increase of ventricular output inducing ventricular afterpotential sensing and ventricular safety pacing in a biventricular implanted cardioverter defibrillator.  


Programming maximum right ventricular output in a patient with a biventricular implanted cardioverter defibrillator resulted in ventricular oversensing and ventricular safety pacing in the same cardiac cycle. PMID:19801565

van Elsäcker, André; Nikolic, Tanja; Scheffer, Mike G; van Gelder, Berry M



A pharmacologic review of cardiac arrest.  


Cardiac arrest is manifested by arrhythmias (ventricular fibrillation or pulseless ventricular tachycardia, pulseless electrical activity, or asystole) resulting in minimal to no forward blood flow to the body's oxygen-dependent tissues. Defibrillation and cardiopulmonary resuscitation (CPR) should be initiated immediately as they have been shown to increase return of spontaneous circulation and survival to discharge rates. Cardiac arrest in the surgical patient population has devastating consequences. Data specific to the surgical patient found that 1 in 203 surgical patients experienced cardiac arrest requiring CPR within 30 days after surgery. A subgroup analysis found that 1 in 1,020 plastic surgery patients required CPR in this same time frame. Thirty-day mortality in the general surgery patient population was 72%. The American Heart Association updates the advanced cardiac life support (ACLS) guidelines every 5 years. Their latest publication in 2010 recommended that the resuscitative protocol be transitioned from its basic life support sequence of airway-breathing-chest compressions to chest compressions-airway-breathing. All health care professionals should have an understanding of the clinical presentation and medical management of cardiac arrest. Maintaining biannual basic life support and ACLS certification ensures that health care professionals remain current with American Heart Association guideline recommendations. Guideline-directed management of cardiac arrest should include timely implementation of the ACLS algorithm to maximize patient outcomes. PMID:25188852

Wagner, Bradley J; Yunker, Nancy S



The output amplitude prediction of crystal oscillator  

NASA Astrophysics Data System (ADS)

Crystal oscillator is an important component of the microwave and RF devices. One of the most important characteristics of crystal oscillators is phase noise spectrum. Phase noise within the half-bandwidth of the loop is closely related to the loaded quality factor QL. According to our research about Pierce oscillator circuit, we can derive that phase noise improves with increasing QL and an appropriate increase in the value of collector-to-ground capacitance C1 can improve QL. However, to change the value of C1 also affects the output amplitude of oscillation circuit. In the paper, the method of predicting output amplitude is presented and a prototype 50 MHz AT-cut 3rd overtone Pierce low phase noise crystal oscillator is designed. The output amplitude variation versus the value of C1 can be obtained with MATLAB. On the premise of specific value of C1, the values of other circuit parameters are changed to make sure that output amplitude is maintained in the required value range. A design of the prototype 50MHz Pierce crystal oscillator is presented and the experiments are carried out. The measurement phase noise results are -126 dBc/Hz@100Hz and -151 dBc/Hz@1KHz. Experimental result shows it is necessary to predict the output amplitude of crystal oscillators.

Wang, Yan; Huang, Xianhe



Cardiac output and cardiac contractility by impedance cardiography during exercise of runners  

NASA Technical Reports Server (NTRS)

Most of the solid state electronic engineering of the system now generally known as the Minnesota Impedance Cardiograph was performed with the support of a five-year contract, NAS9-4500, with the NASA Lyndon B. Johnson Space Center, Houston, Texas. This contract ran from 1965 to 1970. In addition to the engineering design and development of the hardware, the contract called for testing on both animals and human subjects. This project also provided funds to construct twenty impedance cardiographs and place them in selected research and clinical facilities for further evaluation. This, then, led to the First Symposium on Impedance Cardiography, held at the NASA Lyndon B. Johnson Space Center, Houston, Texas, 2-4 June 1969. Twenty-four excellent papers were presented.

Kubicek, W. G.; Tracy, R. A.



Cardiac Effects of Persistent Hemodialysis Arteriovenous Access in Recipients of Renal Allograft  

Microsoft Academic Search

In hemodialysis patients, large arteriovenous (AV) fistulas for vascular access may cause ventricular hypertrophy and high-output cardiac failure. The long-term cardiac consequences of functional AV fistulas in renal transplant patients are unclear. A precise knowledge of these consequences is important to decide if and when such fistulas should be closed in successfully transplanted patients. In this retrospective study including 61

José Jayme G. De Lima; Marcelo Luis Campos Vieira; Laszlo J. Molnar; Caio Jorge Medeiros; Luís Estevan Ianhez; Eduardo M. Krieger



Time-varying stroke volume using sonomicrometry with direct cardiac compression (DCC)  

Microsoft Academic Search

Implantable direct cardiac compression (DCC) systems such as our Heart Patch Pump can assist the failing heart without the risk of blood contact. To provide realtime, accurate support of pumping function, these devices need to assess hemodynamic variables such as cardiac output. For the Heart Patch Pump, we have based our control algorithm on time-varying stroke volume (SV(t)) estimates using

A. A. Martinez-Coll; H. T. Nguyen; R. Zielinski; Y. F. Huang; S. Plekhanov; S. N. Hunyor



Cardiac and vascular adaptation to 0g with and without thigh cuffs (Antares 14 and Altair 21 day Mir spaceflights)  

NASA Astrophysics Data System (ADS)

Cardiovascular Actaptation was evaluated on 2 astronauts: one wearing thigh cuffs from flight day 1 to 8 (14d flight), the second without cuffs (21d flight). Ultrasound investigations were performed at rest and during LBNP. Results: Without thigh cuffs the cardiovascular Actaptation consists in (1) the development of a hypovolemia with an increase of the heart rate and the cardiac output, (2) the decrease of the vascular tone in the deep (mesenteric and splanchnic) and peripheral (Lower limbs) vascular areas. The use of thigh cuffs maintains the volemia and the cardiac output at the preflight level (without heart rate increase) and prevents the loss of vascular tone in the deep and peripheral areas. Moreover the adaptative process changes since the cuffs are removed and even the volemia seems to be unaffected at this stage the vascular tone decreases to a comparable extend as during the flight without cuffs. Nevertheless during the flight without cuffs or 3 days after removing the cuffs hemodynamic signs of decreased orthostatic tolerance are present during the inflight and the 3 days post flight LBNP. Presently the possible contribution of the thigh cuffs to the reduction of the vascular deconditioning has not been tested yet.

Arbeille, Ph.; Fomina, G.; Achaibou, F.; Pottier, J.; Kotovskaya, A.



Microsoft Academic Search

The extreme anoxia-tolerance of freshwater turtles under cold conditions is well documented, but little is known about their cardiac performance in such situations. Using chronic catheterization techniques, we measured systemic cardiac power output (POsys), systemic cardiac output (Q. sys), heart rate (fH), systemic stroke volume (Vs,sys), systemic resistance (Rsys) and mean arterial pressure (Psys) in red-eared sliders (Trachemys scripta). The



Cardiac Procedures and Surgeries  


Cardiac Procedures and Surgeries Updated:Oct 24,2014 If you've had a heart attack, you may have already had certain procedures to ... artery disease (CAD) you have. Cardiac Procedures and Surgeries Angioplasty Also known as Percutaneous Coronary Interventions [PCI], ...


Cardiac sarcoidosis: contemporary review.  


Cardiac sarcoidosis can occur in up to 25% of patients with sarcoidosis in other organ systems and may present with conduction abnormalities, ventricular arrhythmias, or heart failure. This review will summarize the state of current knowledge and key questions that remain to be answered. Because cardiac sarcoidosis is a rare, complex disease, the most meaningful research will include interdisciplinary, multicenter collaborations. PMID:25231794

Kron, Jordana; Ellenbogen, Kenneth A



Cardiac Resynchronization Therapy Upregulates Cardiac Autonomic Control  

PubMed Central

Objective: To determine the effect of cardiac resynchronization therapy (CRT) on sympathetic nervous function in heart failure (HF). Background: Neurohormonal dysregulation and cardiac autonomic dysfunction are associated with HF and contribute to HF progression and its poor prognosis. We hypothesized that mechanical resynchronization improves cardiac sympathetic function in HF. Methods: Sixteen consecutive patients receiving CRT for advanced cardiomyopathy and 10 controls were included in this prospective study. NYHA class, 6-minute walk distance, echocardiographic parameters, plasma norepinephrine (NE) were assessed at baseline, 3-month and 6-month follow-up. Cardiac sympathetic function was determined by 123iodine metaiodobenzylguanidine (123I-MIBG) scintigraphy and 24-hour ambulatory electrocardiography. Results: Along with improvement in NYHA class (3.1 ± 0.3 to 2.1 ± 0.4, P < 0.001) and LVEF (23 ± 6% to 33 ± 12%, P < 0.001 delayed heart/mediastinum (H/M) 123 I-MIBG ratio increased significantly (1.8 ± 0.7 to 2.1 ± 0.6, P = 0.04) while the H/M 123I-MIBG washout rate decreased significantly (54 ± 25% to 34± 24%, P = 0.01) from baseline to 6-month follow-up. The heart rate variability (HRV) measured in SD of normal-to-normal intervals also increased significantly from baseline (82 ± 30 ms) to follow-up (111 ± 32 ms, P = 0.04). The improvement in NYHA after CRT was significantly associated with baseline 123I-MIBG H/M washout rate (r = 0.65, P = 0.03). The improvement in LVESV index was associated with baseline 123I-MIBG delayed H/M ratio (r = ?0.67, P = 0.02) and H/M washout rate (r = 0.65, P = 0.03). Conclusion: After CRT, improvements in cardiac symptoms and LV function were accompanied by rebalanced cardiac autonomic control as measured by 123I-MIBG and HRV. PMID:18479331




Cardiac Hegemony of Senescence  

PubMed Central

Cardiac senescence and age-related disease development have gained general attention and recognition in the past decades due to increased accessibility and quality of health care. The advancement in global civilization is complementary to concerns regarding population aging and development of chronic degenerative diseases. Cardiac degeneration has been rigorously studied. The molecular mechanisms of cardiac senescence are on multiple cellular levels and hold a multilayer complexity level, thereby hampering development of unambiguous treatment protocols. In particular, the synergistic exchange of the senescence phenotype through a senescence secretome between myocytes and stem cells appears complicated and is of great future therapeutic value. The current review article will highlight hallmarks of senescence, cardiac myocyte and stem cell senescence, and the mutual exchange of senescent secretome. Future cardiac cell therapy approaches require a comprehensive understanding of myocardial senescence to improve therapeutic efficiency as well as efficacy. PMID:24349878

Siddiqi, Sailay; Sussman, Mark A.



Cardiac Hegemony of Senescence.  


Cardiac senescence and age-related disease development have gained general attention and recognition in the past decades due to increased accessibility and quality of health care. The advancement in global civilization is complementary to concerns regarding population aging and development of chronic degenerative diseases. Cardiac degeneration has been rigorously studied. The molecular mechanisms of cardiac senescence are on multiple cellular levels and hold a multilayer complexity level, thereby hampering development of unambiguous treatment protocols. In particular, the synergistic exchange of the senescence phenotype through a senescence secretome between myocytes and stem cells appears complicated and is of great future therapeutic value. The current review article will highlight hallmarks of senescence, cardiac myocyte and stem cell senescence, and the mutual exchange of senescent secretome. Future cardiac cell therapy approaches require a comprehensive understanding of myocardial senescence to improve therapeutic efficiency as well as efficacy. PMID:24349878

Siddiqi, Sailay; Sussman, Mark A



Lightweight multiple output converter development  

NASA Technical Reports Server (NTRS)

A high frequency, multiple output power conditioner was developed and breadboarded using an eight-stage capacitor diode voltage multiplier to provide +1200 Vdc, and a three-stage for -350 Vdc. In addition, two rectifier bridges were capacitively coupled to the eight-stage multiplier to obtain 0.5 and 0.65 a dc constant current outputs referenced to +1200 Vdc. Total power was 120 watts, with an overall efficiency of 85 percent at the 80 kHz operating frequency. All outputs were regulated to three percent or better, with complete short circuit protection. The power conditioner component weight and efficiency were compared to the equivalent four outputs of the 10 kHz conditioner for the 8 cm ion engine. Weight reduction for the four outputs was 557 grams; extrapolated in the same ratio to all nine outputs, it would be 1100 to 1400 grams.

Kisch, J. J.; Martinelli, R. M.



Cardiac fiber unfolding by semidefinite programming.  


Diffusion-tensor imaging allows noninvasive assessment of the myocardial fiber architecture, which is fundamental in understanding the mechanics of the heart. In this context, tractography techniques are often used for representing and visualizing cardiac fibers, but their output is only qualitative. We introduce here a new framework toward a more quantitative description of the cardiac fiber architecture from tractography results. The proposed approach consists in taking three-dimensional (3-D) fiber tracts as inputs, and then unfolding these fibers in the Euclidean plane under local isometry constraints using semidefinite programming. The solution of the unfolding problem takes the form of a Gram matrix which defines the two-dimensional (2-D) embedding of the fibers and whose spectrum provides quantitative information on their organization. Experiments on synthetic and real data show that unfolding makes it easier to observe and to study the cardiac fiber architecture. Our conclusion is that 2-D embedding of cardiac fibers is a promising approach to supplement 3-D rendering for understanding the functioning of the heart. PMID:25291787

Li, Hongying; Robini, Marc C; Yang, Feng; Magnin, Isabelle; Zhu, Yuemin



Matrix metalloproteinase expression in cardiac myocytes following myocardial infarction in the rabbit  

Microsoft Academic Search

Myocardial infarction (MI), leads to cardiac remodeling, thinning of the ventricle wall, ventricular dilation, and heart failure, and is a leading cause of death. Interactions between the contractile elements of the cardiac myocytes and the extracellular matrix (ECM) help maintain myocyte alignment required for the structural and functional integrity of the heart. Following MI, reorganization of the ECM and the

Anne M. Romanic; Cynthia L. Burns-Kurtis; Bernard Gout; Isabelle Berrebi-Bertrand; Eliot H. Ohlstein



Tuning hierarchical architecture of 3D polymeric scaffolds for cardiac tissue engineering  

Microsoft Academic Search

Tissue engineering combines the fields of engineering, chemistry, biology, and medicine to fabricate replacement tissues able to restore, maintain, or improve structurally and functionally damaged organs. The approach of regenerative medicine is of paramount importance for treating patients with severe cardiac diseases. For successful exploitation, the challenge for cardiac regenerative medicine is to identify the suitable combination between the best

E. Traversa; B. Mecheri; C. Mandoli; S. Soliman; A. Rinaldi; S. Licoccia; G. Forte; F. Pagliari; S. Pagliari; F. Carotenuto; M. Minieri; P. di Nardo



Serial Input Output  

SciTech Connect

Serial Input/Output (SIO) is designed to be a long term storage format of a sophistication somewhere between simple ASCII files and the techniques provided by inter alia Objectivity and Root. The former tend to be low density, information lossy (floating point numbers lose precision) and inflexible. The latter require abstract descriptions of the data with all that that implies in terms of extra complexity. The basic building blocks of SIO are streams, records and blocks. Streams provide the connections between the program and files. The user can define an arbitrary list of streams as required. A given stream must be opened for either reading or writing. SIO does not support read/write streams. If a stream is closed during the execution of a program, it can be reopened in either read or write mode to the same or a different file. Records represent a coherent grouping of data. Records consist of a collection of blocks (see next paragraph). The user can define a variety of records (headers, events, error logs, etc.) and request that any of them be written to any stream. When SIO reads a file, it first decodes the record name and if that record has been defined and unpacking has been requested for it, SIO proceeds to unpack the blocks. Blocks are user provided objects which do the real work of reading/writing the data. The user is responsible for writing the code for these blocks and for identifying these blocks to SIO at run time. To write a collection of blocks, the user must first connect them to a record. The record can then be written to a stream as described above. Note that the same block can be connected to many different records. When SIO reads a record, it scans through the blocks written and calls the corresponding block object (if it has been defined) to decode it. Undefined blocks are skipped. Each of these categories (streams, records and blocks) have some characteristics in common. Every stream, record and block has a name with the condition that each stream, record or block name must be unique in its category (i.e. all streams must have different names, but a stream can have the same name as a record). Each category is an arbitrary length list which is handled by a 'manager' and there is one manager for each category.

Waite, Anthony; /SLAC



Thyroid hormone regulates cardiac performance during cold acclimation in zebrafish (Danio rerio).  


Limitations to oxygen transport reduce aerobic scope and thereby activity at thermal extremes. Oxygen transport in fish is facilitated to a large extent by cardiac function so that climate variability may reduce fitness by constraining the performance of the heart. In zebrafish (Danio rerio), thyroid hormone (TH) regulates skeletal muscle function and metabolism in response to thermal acclimation. Here, we aimed to determine whether TH also regulates cardiac function during acclimation. We used propylthiouracil and iopanoic acid to induce hypothyroidism in zebrafish over a 3 week acclimation period to either 18 or 28°C. We found that cold-acclimated fish had higher maximum heart rates and sarco-endoplasmic reticulum Ca(2+)-ATPase (SERCA) activity than warm-acclimated fish. Hypothyroid treatment significantly decreased these responses in the cold-acclimated fish, but it did not affect the warm-acclimated fish. TH did not influence SERCA gene transcription, nor did it increase metabolic rate, of isolated whole hearts. To verify that physiological changes following hypothyroid treatment were in fact due to the action of TH, we supplemented hypothyroid fish with 3,5-diiodothryronine (T2) or 3,5,3'-triiodothyronine (T3). Supplementation of hypothyroid fish with T2 or T3 restored heart rate and SERCA activity to control levels. We also show that, in zebrafish, changes in cardiac output in response to warming are primarily mediated by heart rate, rather than by stroke volume. Thus, changes in heart rate are important for the overall aerobic capacity of the fish. In addition to its local effects on heart phenotype, we show that TH increases sympathetic tone on the heart at rest and during maximum exercise. Our findings reveal a new pathway through which fish can mitigate the limiting effects of temperature variability on oxygen transport to maintain aerobic scope and promote thermal tolerance. PMID:24265422

Little, Alexander G; Seebacher, Frank



Cardiac ryanodine receptor in metabolic syndrome: is JTV519 (K201) future therapy?  

PubMed Central

Metabolic syndrome is characterized by a combination of obesity, hypertension, insulin resistance, dyslipidemia, and impaired glucose tolerance. This multifaceted syndrome is often accompanied by a hyperdynamic circulatory state characterized by increased blood pressure, total blood volume, cardiac output, and metabolic tissue demand. Experimental, epidemiological, and clinical studies have demonstrated that patients with metabolic syndrome have significantly elevated cardiovascular morbidity and mortality rates. One of the main and frequent complications seen in metabolic syndrome is cardiovascular disease. The primary endpoints of cardiometabolic risk are coronary and peripheral arterial disease, myocardial infarction, congestive heart failure, arrhythmia, and stroke. Alterations in expression and/or functioning of several key proteins involved in regulating and maintaining ionic homeostasis can cause cardiac disturbances. One such group of proteins is known as ryanodine receptors (intracellular calcium release channels), which are the major channels through which Ca2+ ions leave the sarcoplasmic reticulum, leading to cardiac muscle contraction. The economic cost of metabolic syndrome and its associated complications has a significant effect on health care budgets. Improvements in body weight, blood lipid profile, and hyperglycemia can reduce cardiometabolic risk. However, constant hyperadrenergic stimulation still contributes to the burden of disease. Normalization of the hyperdynamic circulatory state with conventional therapies is the most reasonable therapeutic strategy to date. JTV519 (K201) is a newly developed 1,4-benzothiazepine drug with antiarrhythmic and cardioprotective properties. It appears to be very effective in not only preventing but also in reversing the characteristic myocardial changes and preventing lethal arrhythmias. It is also a unique candidate to improve diastolic heart failure in metabolic syndrome. PMID:22563249

Dincer, U Deniz



A case series of real-time hemodynamic assessment of high output heart failure as a complication of arteriovenous access in dialysis patients.  


Congestive heart failure (CHF) is an important source of morbidity and mortality in end-stage renal disease patients. Although CHF is commonly associated with low cardiac output (CO), it may also occur in high CO states. Multiple conditions are associated with increased CO including congenital or acquired arteriovenous fistulae or arteriovenous grafts. Increased CO resulting from permanent AV access in dialysis patients has been shown to induce structural and functional cardiac changes, including the development of eccentric left ventricle hypertrophy. Often, the diagnosis of high output heart failure requires invasive right heart monitoring in the acute care setting such as a medical or cardiac intensive care unit. The diagnosis of an arteriovenous access causing high output heart failure is usually confirmed after the access is ligated surgically. We present for the first time, a case for real-time hemodynamic assessment of high output heart failure due to AV access by interventional nephrology in the cardiac catheterization suite. PMID:24673654

Singh, Sarguni; Elramah, Mohsen; Allana, Salman S; Babcock, Michael; Keevil, Jon G; Johnson, Maryl R; Yevzlin, Alexander S; Chan, Micah R



Molecular Basis of Cardiac Myxomas  

PubMed Central

Cardiac tumors are rare, and of these, primary cardiac tumors are even rarer. Metastatic cardiac tumors are about 100 times more common than the primary tumors. About 90% of primary cardiac tumors are benign, and of these the most common are cardiac myxomas. Approximately 12% of primary cardiac tumors are completely asymptomatic while others present with one or more signs and symptoms of the classical triad of hemodynamic changes due to intracardiac obstruction, embolism and nonspecific constitutional symptoms. Echocardiography is highly sensitive and specific in detecting cardiac tumors. Other helpful investigations are chest X-rays, magnetic resonance imaging and computerized tomography scan. Surgical excision is the treatment of choice for primary cardiac tumors and is usually associated with a good prognosis. This review article will focus on the general features of benign cardiac tumors with an emphasis on cardiac myxomas and their molecular basis. PMID:24447924

Singhal, Pooja; Luk, Adriana; Rao, Vivek; Butany, Jagdish



Institutional causes of output volatility  

Microsoft Academic Search

The authors investigate the relationship between the quality of institutions and output volatility. Using instrumental variable regressions, they address whether higher entry barriers and lower property rights protection lead to higher volatility. They find that a 1-standard-deviation increase in entry costs increases the standard deviation of output growth by roughly 40 percent of its average value in the sample. In

Levon Barseghyan; Riccardo DiCecio



Effects of Lifestyle Modification Programs on Cardiac Risk Factors  

PubMed Central

Medicare conducted a payment demonstration to evaluate the effectiveness of two intensive lifestyle modification programs in patients with symptomatic coronary artery disease: the Dr. Dean Ornish Program for Reversing Heart Disease (Ornish) and Cardiac Wellness Program of the Benson-Henry Mind Body Institute. This report describes the changes in cardiac risk factors achieved by each program during the active intervention year and subsequent year of follow-up. The demonstration enrolled 580 participants who had had an acute myocardial infarction, had undergone coronary artery bypass graft surgery or percutaneous coronary intervention within 12 months, or had documented stable angina pectoris. Of these, 98% completed the intense 3-month intervention, 71% the 12-month intervention, and 56% an additional follow-up year. Most cardiac risk factors improved significantly during the intense intervention period in both programs. Favorable changes in cardiac risk factors and functional cardiac capacity were maintained or improved further at 12 and 24 months in participants with active follow-up. Multivariable regressions found that risk-factor improvements were positively associated with abnormal baseline values, Ornish program participation for body mass index and systolic blood pressure, and with coronary artery bypass graft surgery. Expressed levels of motivation to lose weight and maintain weight loss were significant independent predictors of sustained weight loss (p?=?0.006). Both lifestyle modification programs achieved well-sustained reductions in cardiac risk factors. PMID:25490202

Razavi, Moaven; Fournier, Stephen; Shepard, Donald S.; Ritter, Grant; Strickler, Gail K.; Stason, William B.



Enhanced performance CCD output amplifier  


A low-noise FET amplifier is connected to amplify output charge from a che coupled device (CCD). The FET has its gate connected to the CCD in common source configuration for receiving the output charge signal from the CCD and output an intermediate signal at a drain of the FET. An intermediate amplifier is connected to the drain of the FET for receiving the intermediate signal and outputting a low-noise signal functionally related to the output charge signal from the CCD. The amplifier is preferably connected as a virtual ground to the FET drain. The inherent shunt capacitance of the FET is selected to be at least equal to the sum of the remaining capacitances.

Dunham, Mark E. (Los Alamos, NM); Morley, David W. (Santa Fe, NM)



Cardiac Risk Assessment  


... helpful? Formal name: Cardiac Risk Assessment Related tests: Lipid Profile , VLDL Cholesterol , hs-CRP , Lp(a) Overview | ... on Coronary artery disease: Tests and diagnosis .) The lipid profile is the most important blood test for ...


Autonomic cardiac innervation  

PubMed Central

Autonomic cardiac neurons have a common origin in the neural crest but undergo distinct developmental differentiation as they mature toward their adult phenotype. Progenitor cells respond to repulsive cues during migration, followed by differentiation cues from paracrine sources that promote neurochemistry and differentiation. When autonomic axons start to innervate cardiac tissue, neurotrophic factors from vascular tissue are essential for maintenance of neurons before they reach their targets, upon which target-derived trophic factors take over final maturation, synaptic strength and postnatal survival. Although target-derived neurotrophins have a central role to play in development, alternative sources of neurotrophins may also modulate innervation. Both developing and adult sympathetic neurons express proNGF, and adult parasympathetic cardiac ganglion neurons also synthesize and release NGF. The physiological function of these “non-classical” cardiac sources of neurotrophins remains to be determined, especially in relation to autocrine/paracrine sustenance during development.   Cardiac autonomic nerves are closely spatially associated in cardiac plexuses, ganglia and pacemaker regions and so are sensitive to release of neurotransmitter, neuropeptides and trophic factors from adjacent nerves. As such, in many cardiac pathologies, it is an imbalance within the two arms of the autonomic system that is critical for disease progression. Although this crosstalk between sympathetic and parasympathetic nerves has been well established for adult nerves, it is unclear whether a degree of paracrine regulation occurs across the autonomic limbs during development. Aberrant nerve remodeling is a common occurrence in many adult cardiovascular pathologies, and the mechanisms regulating outgrowth or denervation are disparate. However, autonomic neurons display considerable plasticity in this regard with neurotrophins and inflammatory cytokines having a central regulatory function, including in possible neurotransmitter changes. Certainly, neurotrophins and cytokines regulate transcriptional factors in adult autonomic neurons that have vital differentiation roles in development. Particularly for parasympathetic cardiac ganglion neurons, additional examinations of developmental regulatory mechanisms will potentially aid in understanding attenuated parasympathetic function in a number of conditions, including heart failure. PMID:23872607

Hasan, Wohaib



Cardiac Rehabilitation After Acute Myocardial Infarction Resuscitated From Cardiac Arrest  

PubMed Central

Objective To examine the safety and effectiveness of cardiac rehabilitation on patients resuscitated from cardiac arrest due to acute myocardial infarction. Methods The study included 23 subjects, including 8 with history of cardiac arrest and 15 without history of cardiac arrest. Both groups underwent initial graded exercise test (GXT) and subsequent cardiac rehabilitation for 6 weeks. After 6 weeks, both groups received follow-up GXT. Results Statistically significant (p<0.05) increase of VO2peak and maximal MVO2 but significant (p<0.05) decrease of submaximal MVO2 and resting heart rate were observed in both groups after 6 weeks of cardiac rehabilitation. An increasing trend of maximal heart rates was observed in both groups. However, the increase was not statistically significant (p>0.05). There was no statistically significant change of resting heart rate, maximal heart rate, maximal MVO2, or submaximal MVO2 in both groups after cardiac rehabilitation. Fatal cardiac complications, such as abnormal ECG, cardiac arrest, death or myocardial infarction, were not observed. All subjects finished the cardiac rehabilitation program. Conclusion Improvement was observed in the exercise capacity of patients after aerobic exercise throughout the cardiac rehabilitation program. Therefore, cardiac rehabilitation can be safely administered for high-risk patients with history of cardiac arrest. Similar improvement in exercise capacity can be expected in patients without cardiac arrest experience. PMID:25566479

Kim, Chul; Choi, Hee Eun; Kang, Seong Hoon



Impairment of cardiac function and energetics in experimental renal failure.  

PubMed Central

Cardiac function and energetics in experimental renal failure in the rat (5/6 nephrectomy) have been investigated by means of an isolated perfused working heart preparation and an isometric Langendorff preparation using 31P nuclear magnetic resonance (31P NMR). 4 wk after nephrectomy cardiac output of isolated hearts perfused with Krebs-Henseleit buffer was significantly lower (P < 0.0001) at all levels of preload and afterload in the renal failure groups than in the pair-fed sham operated control group. In control hearts, cardiac output increased with increases in perfusate calcium from 0.73 to 5.61 mmol/liter whereas uremic hearts failed in high calcium perfusate. Collection of 31P NMR spectra from hearts of renal failure and control animals during 30 min normoxic Langendorff perfusion showed that basal phosphocreatine was reduced by 32% to 4.7 mumol/g wet wt (P < 0.01) and the phosphocreatine to ATP ratio was reduced by 32% (P < 0.01) in uremic hearts. During low flow ischemia, there was a substantial decrease in phosphocreatine in the uremic hearts and an accompanying marked increase in release of inosine into the coronary effluent (14.9 vs 6.1 microM, P < 0.01). We conclude that cardiac function is impaired in experimental renal failure, in association with abnormal cardiac energetics and increased susceptibility to ischemic damage. Disordered myocardial calcium utilization may contribute to these derangements. PMID:8254048

Raine, A E; Seymour, A M; Roberts, A F; Radda, G K; Ledingham, J G



Net cardiac shunts in anuran amphibians: physiology or physics?  


Amphibians have a single ventricle and common conus arteriosus that produces an equal pressure to the parallel pulmocutaneous and systemic vascular circuits. The distribution of blood flows between the pulmocutaneous (Qpul) and systemic (Qsys) circuits (net cardiac shunt) varies with a number of environmental conditions and behaviours; although autonomic regulation of pulmonary vascular resistance conductance has been emphasized, little attention has been paid to the possible contribution of the passive physical characteristics of the two circuits to pressure changes associated with variation in cardiac output. In this study, we re-analysed three recent studies that recorded net cardiac shunts in the cane toad (Rhinella marina) under a variety of conditions and treatments. In all three studies, Qpul and Qsys were linearly related to cardiac output (Qtot), but the slope was threefold higher for Qpul compared with Qsys as predicted by relative conductance increases associated with increases in pressure from perfused preparations where autonomic regulation and humoral control were eliminated. Our analysis indicates that the net cardiac shunt in the cane toad is predicted primarily by the physical, rather than physiological, characteristics of the parallel pulmonary and systemic vascular circuits. PMID:24902743

Hillman, Stanley S; Hedrick, Michael S; Kohl, Zachary F



Abnormal Cardiac Autonomic Regulation in Mice Lacking ASIC3  

PubMed Central

Integration of sympathetic and parasympathetic outflow is essential in maintaining normal cardiac autonomic function. Recent studies demonstrate that acid-sensing ion channel 3 (ASIC3) is a sensitive acid sensor for cardiac ischemia and prolonged mild acidification can open ASIC3 and evoke a sustained inward current that fires action potentials in cardiac sensory neurons. However, the physiological role of ASIC3 in cardiac autonomic regulation is not known. In this study, we elucidate the role of ASIC3 in cardiac autonomic function using Asic3?/? mice. Asic3?/? mice showed normal baseline heart rate and lower blood pressure as compared with their wild-type littermates. Heart rate variability analyses revealed imbalanced autonomic regulation, with decreased sympathetic function. Furthermore, Asic3?/? mice demonstrated a blunted response to isoproterenol-induced cardiac tachycardia and prolonged duration to recover to baseline heart rate. Moreover, quantitative RT-PCR analysis of gene expression in sensory ganglia and heart revealed that no gene compensation for muscarinic acetylcholines receptors and beta-adrenalin receptors were found in Asic3?/? mice. In summary, we unraveled an important role of ASIC3 in regulating cardiac autonomic function, whereby loss of ASIC3 alters the normal physiological response to ischemic stimuli, which reveals new implications for therapy in autonomic nervous system-related cardiovascular diseases. PMID:24804235

Cheng, Ching-Feng; Kuo, Terry B. J.; Chen, Wei-Nan



Predictive value of the stomach wall pH for complications after cardiac operations: comparison with other monitoring  

Microsoft Academic Search

The ability to predict impending complications after elective cardiac operations from measurements of BP, cardiac index, arterial pH, and urine output on the day of operation was compared with that of indirect measurement of stomach wall pH in 85 patients. We found that acidosis in the stomach wall was the most sensitive predictor for complications. The specificity of this predictive

Richard G. Fiddian-Green; Stephen P. Baker



The Impairment of ILK Related Angiogenesis Involved in Cardiac Maladaptation after Infarction  

PubMed Central

Background Integrin linked kinase (ILK), as an important component of mechanical stretch sensor, can initiate cellular signaling response in the heart when cardiac preload increases. Previous work demonstrated increased ILK expression could induce angiogenesis to improved heart function after MI. However the patholo-physiological role of ILK in cardiac remodeling after MI is not clear. Method and Results Hearts were induced to cardiac remodeling by infarction and studied in Sprague-Dawley rats. Until 4 weeks after infarction, ILK expression was increased in non-ischemic tissue in parallel with myocytes hypertrophy and compensatory cardiac function. 8 weeks later, when decompensation of heart function occurred, ILK level returned to baseline. Followed ILK alternation, vascular endothelial growth factor (VEGF) expression and phosphorylation of endothelial nitric oxide synthase (eNOS) was significantly decreased 8 weeks after MI. Histology study also showed significantly microvessel decreased and myocytes loss 8 weeks paralleled with ILK down-regualtion. While ILK expression was maintained by gene delivery, tissue angiogenesis and cardiac function was preserved during cardiac remodeling. Conclusion Temporally up-regulation of ILK level in non-ischemic myocytes by increased external load is associated with beneficial angiogenesis to maintain infarction-induced cardiac hypertrophy. When ILK expression returns to normal, this cardiac adaptive response for infarction is weaken. Understanding the ILK related mechanism of cardiac maladaptation leads to a new strategy for treatment of heart failure after infarction. PMID:21949693

Xie, Jun; Lu, Wen; Gu, Rong; Dai, Qin; Zong, Bin; Ling, Lin; Xu, Biao



NMG documentation, part 3: maintainer`s guide  

SciTech Connect

This is the third of a three-part report documenting NMG, the Numerical Mathematics Guide. Part I is aimed at the user of the systenL It contains an introduction, with an out- line of the complete report, and Chapter 1, User`s Point of View. Part II is aimed at the programmer and contains Chapter 2, How It Works. Part III is aimed at the maintainer of NMG and contains Chapter 3, Maintenance, and Chapter 4, Validation. Because its contents are so specialized, Part III will receive only limited distribution. Note that each chapter has its own page numbering and table of contents.

Fritsch, F.N.; Dickinson, R.P. Jr.



Haemodynamic responses to stimulation of the cardiac autonomic nerves in the anaesthetized cat with closed chest  

PubMed Central

1. The changes in cardiac output and mean right atrial pressure (R.A.P.) evoked by stimulation of the cardiac autonomic nerves were investigated in cats under chloralose anaesthesia, with unopened chests and spontaneous respiration, and with active vascular reflexes. Cardiac output was measured by thermal dilution; the technique used was calibrated against the direct Fick method. 2. The initial values of R.A.P. and output were varied by infusion of dextran-saline solution followed by withdrawal of blood. At positive values of R.A.P. withdrawal of blood caused a fall in R.A.P. with no change in cardiac output. At negative R.A.P. blood withdrawal caused a fall in output with little change in R.A.P.: the linear regression coefficient for output on R.A.P. was 48·2 ml./ (S.E. 2·06, n = 63, nine cats). 3. Stimulation of the right cardiac sympathetic nerve increased heart rate by 69·2 beats/min (S.E. 4·0) from the resting rate of 158 beats/min (S.E. 6·3, ten cats). The acceleration was accompanied in most instances by a rise in cardiac output and a fall in R.A.P. and the magnitude of the rise in output was related to that of the fall in R.A.P. 4. In no experiment could R.A.P. be reduced below -2·5 mmHg either by withdrawal of blood or by sympathetic stimulation. At negative values of R.A.P. the fall in R.A.P. and rise in output evoked by sympathetic stimulation were small; substantial changes could be obtained only from positive initial values of R.A.P. The proportional increase in output evoked by a given proportional increase in heart rate during near-maximal sympathetic stimulation had a linear relationship to the initial value of R.A.P. over the range -2 to +8 mmHg. The output increment was less than proportional to the rate increment at all values of R.A.P. below +3 mmHg. 5. In five experiments stimulation of the left cardiac sympathetic nerve evoked a greater increase in output for a given increase in heart rate than did stimulation of the right nerve; on the other hand both nerves gave similar increments of output for a given fall in R.A.P. 6. Stimulation of the distal end of the right vagus nerve slowed the heart and caused a fall in cardiac output and a rise in R.A.P. The change in output associated with a given change in R.A.P. was significantly greater (P = 0·05) during sympathetic than during vagal stimulation in 14 out of 18 tests; the difference increased as circulating volume was reduced. 7. It is concluded that the relationship between cardiac output and R.A.P. during sympathetic and vagal stimulation is consistent with the hypothesis that neurally evoked changes in cardiac performance vary output mainly, but not exclusively, by inducing changes in R.A.P. which alter the pressure gradient for the return of blood to the right atrium from the periphery. PMID:7381778

Barnes, R. J.; Bower, E. A.; Rink, T. J.



Cardiac radiology: centenary review.  


During the past century, cardiac imaging technologies have revolutionized the diagnosis and treatment of acquired and congenital heart disease. Many important contributions to the field of cardiac imaging were initially reported in Radiology. The field developed from the early stages of cardiac imaging, including the use of coronary x-ray angiography and roentgen kymography, to nowadays the widely used echocardiographic, nuclear medicine, cardiac computed tomographic (CT), and magnetic resonance (MR) applications. It is surprising how many of these techniques were not recognized for their potential during their early inception. Some techniques were described in the literature but required many years to enter the clinical arena and presently continue to expand in terms of clinical application. The application of various CT and MR contrast agents for the diagnosis of myocardial ischemia is a case in point, as the utility of contrast agents continues to expand the noninvasive characterization of myocardium. The history of cardiac imaging has included a continuous process of advances in our understanding of the anatomy and physiology of the cardiovascular system, along with advances in imaging technology that continue to the present day. PMID:25340434

de Roos, Albert; Higgins, Charles B



A Slew-Rate\\/Impedance-Controlled Output Driver With Single-Cycle Compensation Time  

Microsoft Academic Search

This brief introduces a low-noise slew-rate\\/impedance-controlled high-speed output driver in 0.18-¿m CMOS process. The output driver adopts an open-loop structure that enables the system to take only a single cycle to control the signal slew-rate or driver impedance. The control blocks consume 4.907 mA at 1 Gb\\/s. The proposed output driver is designed to maintain the data slew rate in

Young-Ho Kwak; Inhwa Jung; Chulwoo Kim



Fetal cardiac tumors: prenatal diagnosis and outcome.  


We present our experience in the management of fetuses diagnosed with huge cardiac tumors. These cases illustrate that the size of the tumor likely does not impact on survival as much as the location of the tumor and how it compromises blood flow into and out of the ventricles. We speculate that obstruction of right-sided inflow and/or simultaneous obstruction to outflow from both ventricles may lead to diminished cardiac output, atrial and caval hypertension, and hydrops fetalis. Obstruction can occur at any point in gestation and depends on both the size and the location of the tumor in relation to all cardiac structures. We therefore suggest serial assessment of these fetuses throughout gestation, particularly after the point of postnatal viability, to assess the hemodynamic effects that the tumor has on the heart. If obstruction to blood flow and/or early fetal compromise is noted, then the decision of whether to deliver early can be made. At the time of birth, if obstruction to blood flow persists, surgery can be considered, keeping in mind that the natural history of these tumors is to shrink and become clinically less important over time. PMID:17308946

Lacey, S R; Donofrio, M T



Influence of gravity on cardiac performance.  


Results obtained by the investigators in ground-based experiments and in two parabolic flight series of tests aboard the NASA KC-135 aircraft with a hydraulic simulator of the human systemic circulation have confirmed that a simple lack of hydrostatic pressure within an artificial ventricle causes a decrease in stroke volume of 20%-50%. A corresponding drop in stroke volume (SV) and cardiac output (CO) was observed over a range of atrial pressures (AP), representing a rightward shift of the classic CO versus AP cardiac function curve. These results are in agreement with echocardiographic experiments performed on space shuttle flights, where an average decrease in SV of 15% was measured following a three-day period of adaptation to weightlessness. The similarity of behavior of the hydraulic model to the human system suggests that the simple physical effects of the lack of hydrostatic pressure may be an important mechanism for the observed changes in cardiac performance in astronauts during the weightlessness of space flight. PMID:9846932

Pantalos, G M; Sharp, M K; Woodruff, S J; O'Leary, D S; Lorange, R; Everett, S D; Bennett, T E; Shurfranz, T



Effects of intracoronary and intravenous amrinone infusions in patients with cardiac failure and patients with near normal cardiac function.  

PubMed Central

The effects of intracoronary and intravenous infusions of amrinone were studied to distinguish the drug's direct cardiac actions from its peripheral vascular and neuroendocrine properties. Intracoronary infusions of amrinone were found to have no haemodynamic effect other than producing a slight reduction in the left ventricular ejection fraction and some suggestion of coronary vasodilatation in patients with impaired left ventricular function. They did not improve contractility, cardiac output, or filling pressures and had no significant effect on myocardial metabolism, although therapeutic concentrations of the drug were detected in coronary sinus blood. Intravenously administered amrinone reduced filling pressures and improved the cardiac index in all patients, but haemodynamic improvements were most pronounced in the patients with the worst cardiac function. These changes were accompanied by improvements in the indices of contractility only in patients in whom alterations in concentrations of free fatty acid, glycerol, and glucose suggested peripheral catecholamine release. In the patients with the best basal cardiac function intravenously administered amrinone produced a reduction in myocardial work and evidence of myocardial ischaemia, as a result of excessive reduction of coronary perfusion pressure and increased heart rate, without any appreciable increase in cardiac index. It is concluded that, at the concentrations of the drug that can be achieved in man without adverse effects, amrinone has no direct positive inotropic effect. Haemodynamic changes are predominantly the result of vasodilatation, although catecholamines may be released in some patients. PMID:3994862

Wilmshurst, P T; Thompson, D S; Juul, S M; Dittrich, H C; Dawson, J R; Walker, J M; Jenkins, B S; Coltart, D J; Webb-Peploe, M M



Cardiac transthyretin amyloidosis.  


Cardiac amyloidosis of transthyretin fibril protein (ATTR) type is an infiltrative cardiomyopathy characterised by ventricular wall thickening and diastolic heart failure. Increased access to cardiovascular magnetic resonance imaging has led to a marked increase in referrals to our centre of Caucasian patients with wild-type ATTR (senile systemic) amyloidosis and Afro-Caribbean patients with the hereditary ATTR V122I type. Both subtypes present predominantly as isolated cardiomyopathy. The differential diagnosis includes cardiac amyloid light-chain (AL) amyloidosis, which has a poorer prognosis and can be amenable to chemotherapy. We review here the clinical features of cardiac ATTR amyloidosis and describe the diagnostic tests to determine ATTR type. Correct diagnosis is ever more crucial given that several novel therapies for ATTR amyloidosis are on the near horizon. PMID:22888163

Dungu, Jason N; Anderson, Lisa J; Whelan, Carol J; Hawkins, Philip N



A New Frontier for Cardiac Monitoring  

NASA Technical Reports Server (NTRS)

CardioDynamics International Corporation (CDIC) has created the BioZ(TM) System through a Small Business Innovation Research (SBIR) award from Johnson Space Center, providing patients and physicians with a cost-effective and highly accurate monitoring system.The BioZ non-invasive heart monitor is based on a technology known as Impedance Cardiography (ICG). BioZ provides the physician with vital information about the heart's ability to deliver blood to the body, the force one's heart exerts with each beat, and the amount of fluid in the chest. Specially designed bioimpedance sensors placed on the neck and chest monitor 12 different parameters, including cardiac output, contractility, systemic vascular resistance, and thoracic fluid content. These sensors monitor the electrical conductivity of the body-information that is converted into blood flow data and is displayed in real time on a monitoring screen. and BioZ.pc(TM) are two additional products that incorporate the same sensors present in the original BioZ system. The "com" in stands for cardiac output monitor. This fully integrated system is essentially a smaller version of the BioZ, combining the same abilities with a compact, lightweight design, while providing greater portability.



Cardiac Tumors: A Brief Commentary  

PubMed Central

Patients with cardiac tumors may present with cardiovascular related or constitutional symptoms, but more often than not a cardiac mass is discovered incidentally during an imaging examination performed for an unrelated indication. Cardiac myxoma is generally considered to be a surgical emergency. Echocardiography, including the transesophageal approach, is the most important means of diagnosis; computed tomography and magnetic resonance imaging. The clinical presentation has changed, and the management of cardiac myxoma now needs to be reviewed.

Roever, Leonardo; Casella-Filho, Antonio; Dourado, Paulo Magno Martins; Resende, Elmiro Santos; Chagas, Antônio Carlos Palandri



Emergency Cardiac Care: An Update  

PubMed Central

The authors review the new guidelines for basic life support and advanced cardiac life support and the recommended changes to the standards. The changes recommended for basic life support will simplify the psychomotor skills required. The recommended changes to the guidelines for advanced cardiac life support, which include discontinuing the use of isoproterenol and limiting the use of sodium bicarbonate in cardiac arrest, are likely to improve survival rates. Controversies in the management of cardiac arrest are also discussed. PMID:21253157

Swanson, Richard W.



Friction-Maintained Dynamic Stability  

NASA Astrophysics Data System (ADS)

Mechanical systems relying on Coulomb friction to maintain dynamic stability may suffer a dynamic instability if exposed to an initial displacement exceeding a system-specific threshold. In fluid systems, even small values of negative damping are sufficient to drive the dynamic instability with sufficiently large initial displacement. The Tainter gate failures at the Folsom dam in 1995 and at the Wachi dam in 1967 are two well-known failures. To aid in preventing a recurrence, the authors engaged in a decade long research program that provided evidence that both gates failed due to an essential dynamic instability mechanism that all Tainter-gates may possess. This paper presents measurements suggesting "friction-maintained dynamic stability" of a full-scale 50-ton Tainter gate. Accompanying gate model studies showed that the gate can fail when exposed to an initial displacement exceeding a threshold value. The present study should serve to alert gate designers, owners and operators that many Tainter gates which have not yet failed may, nonetheless, have a high susceptibility to failure if and when they are exposed to a sudden input of energy resulting in an initial displacement exceeding the gate-specific threshold displacement.

Anami, Keiko; Ishii, Noriaki; Knisely, Charles W.; Tsuji, Takuma; Oku, Tatsuya; Sato, Shigeki


Pregnancy-induced physiological hypertrophy protects against cardiac ischemia-reperfusion injury  

PubMed Central

Objective: Cardiac hypertrophy is a compensatory response of the heart to maintain its pumping capacity. Cardiac hypertrophy can be divided into pathological hypertrophy and physiological hypertrophy. The major forms of physiological hypertrophy include developing in response to developmental maturation, exercise, and pregnancy, which is adaptive and beneficial. Exercise has well-known beneficial cardiovascular effects and has recently been shown to be protective for myocardial ischemia-reperfusion injury. However, there are conflicting reports for the cardiac protective effects of pregnancy-induced hypertrophy. In the present study, we investigated the effects of pregnancy-induced physiological hypertrophy in cardiac ischemia-reperfusion injury and if cardiac progenitor cells were activated during pregnancy. Methods: Physiological hypertrophy was induced in pregnancy and the mRNA levels of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) were determined by real-time polymerase chain reactions (RT-PCRs) analysis. Triphenyltetrazolium chloride staining was used to determine the cardiac ischemia-reperfusion injury. c-Kit and Nkx2.5 levels were determined by RT-PCRs, western blot and immunofluorescent staining. Results: Heart weight (HW) and the ratio of HW to tibia length were increased while mRNA levels of ANP and BNP remained unchanged. Pregnancy-induced physiological hypertrophy protected against cardiac ischemia-reperfusion injury. In pregnancy, c-Kit positive cardiac progenitor cells were activated. Conclusion: This study presents that pregnancy-induced physiological hypertrophy activates cardiac progenitor cells and thereafter protects against cardiac ischemia-reperfusion injury. PMID:24427343

Xiao, Junjie; Li, Jin; Xu, Tianzao; Lv, Dongcao; Shen, Bo; Song, Yang; Xu, Jiahong



Impact of obesity and weight loss on cardiac performance and morphology in adults.  


Obesity, particularly severe obesity is capable of producing hemodynamic alterations that predispose to changes in cardiac morphology and ventricular function. These include increased cardiac output, left ventricular hypertrophy and diastolic and systolic dysfunction of both ventricles. Facilitated by co-morbidities such as hypertension, the sleep apnea/obesity hypoventilation syndrome, and possibly certain neurohormonal and metabolic alterations, these abnormalities may predispose to left and right heart failure, a disorder known as obesity cardiomyopathy. PMID:24438730

Alpert, Martin A; Omran, Jad; Mehra, Ankit; Ardhanari, Sivakumar



Explicit feedback maintains implicit knowledge.  


The role of feedback was investigated with respect to conscious and unconscious knowledge acquired during artificial grammar learning (AGL). After incidental learning of training sequences, participants classified further sequences in terms of grammaticality and reported their decision strategy with or without explicit veridical feedback. Sequences that disobeyed the learning structure conformed to an alternative structure. Feedback led to an increase in the amount of reported conscious knowledge of structure (derived rules and recollections) but did not increase its accuracy. Conversely, feedback maintained the accuracy of unconscious knowledge of structure (intuition or familiarity-based responses) which otherwise degraded. Results support a dual-process account of AGL. They suggest that implicit learning of the to-be-rejected structure at test contaminates familiarity-based classifications whereas feedback allows competing familiarity signals to be contextualised, which is incompatible with theories that consider familiarity context-insensitive. PMID:23770696

Mealor, Andy D; Dienes, Zoltan



Maintaining consistency in distributed systems  

NASA Technical Reports Server (NTRS)

In systems designed as assemblies of independently developed components, concurrent access to data or data structures normally arises within individual programs, and is controlled using mutual exclusion constructs, such as semaphores and monitors. Where data is persistent and/or sets of operation are related to one another, transactions or linearizability may be more appropriate. Systems that incorporate cooperative styles of distributed execution often replicate or distribute data within groups of components. In these cases, group oriented consistency properties must be maintained, and tools based on the virtual synchrony execution model greatly simplify the task confronting an application developer. All three styles of distributed computing are likely to be seen in future systems - often, within the same application. This leads us to propose an integrated approach that permits applications that use virtual synchrony with concurrent objects that respect a linearizability constraint, and vice versa. Transactional subsystems are treated as a special case of linearizability.

Birman, Kenneth P.



Melatonin and cardiac pathophysiology  

Microsoft Academic Search

Melatonin, an indole produced in several organs but most notably in the pineal gland, has a variety of effects that influence cardiac pathophysiology. Herein, we summarize the findings that illustrate the ability of melatonin to attenuate the severity of hypertension, limit myocardial damage, improve the function of the ischemic-reperfused heart, protect the heart from the toxicity of anthracycline drugs and

Russel J. Reiter; Dun X. Tan


Fetal cardiac anomalies  

Microsoft Academic Search

Fetal cardiac anomalies are increasingly identified during regular obstetric scanning. About 21000 pregnancies will have an abnormality of the four chamber view and a further 11000 will have an abnormality of the great arteries. These cases can then be referred to the specialist in fetal cardiology for further evaluation and counselling. There is a higher rate of chromosomal and other

Lindsey D. Allan



Cardiac fibroma in adults.  


We present the case of a 61-year-old woman with nonspecific symptoms who on investigation and treatment had a fibroma of the right ventricular free wall. She underwent surgical resection of the mass and is doing well. The literature pertaining to cardiac fibromas in adults is reviewed and discussed. PMID:20934889

Nwachukwu, Harriet; Li, Alice; Nair, Vidhya; Nguyen, Elsie; David, Tirone E; Butany, Jagdish



Cardiac function monitoring system  

Microsoft Academic Search

An IBM-PC controlled system has been developed to evaluate the cardiac function in the catheterization room. The system uses a multielectrode impedancimetric catheter to compute the instantaneous left intraventricular heart volume, through specially developed algorithms and calibration procedures, and a catheter tip micromanometer to measure the instantaneous left intraventricular pressure. With these two variables, and after a preload maneuver, the

J. C. Spinelli; M. C. Herrera



Ethical Issues in Cardiac Surgery  

PubMed Central

While ethical behavior has always been part of cardiac surgical practice, ethical deliberation has only recently become an important component of cardiac surgical practice. Issues such as informed consent, conflict of interest, and professional self-regulation, among many others, have increasingly attracted the attention of cardiac surgeons. This review covers several broad topics of interest to cardiac surgeons and cardiologists, and treats several other topics more briefly. There is much uncertainty about what the future holds for cardiac surgical practice, research, and culture, and we discuss the background of ethical issues to serve as a platform for envisioning what is to come. PMID:22642634

Kavarana, Minoo N.; Sade, Robert M.



Magnetic resonance imaging analysis of cardiac cycle events in diabetic rats: the effect of angiotensin-converting enzyme inhibition  

PubMed Central

Non-invasive magnetic resonance imaging (MRI) was used to characterize changes in left and right ventricular cardiac cycles following induction of experimental, streptozotocin (STZ)-induced, diabetes in male Wistar rats at different ages. The effects of the angiotensin-converting enzyme (ACE) inhibitor captopril upon such chronic physiological changes were then evaluated, also for the first time. Diabetes was induced at the age of 7 weeks in two experimental groups, of which one group was subsequently maintained on captopril (2 g l?1)-containing drinking water, and at 10 and 13 weeks in two further groups. The fifth group provided age-matched controls. All groups (each n = 4 animals) were scanned consistently at 16 weeks, in parallel with timings used in earlier studies that employed this experimental model. Cine magnetic resonance (MR) image acquisition provided transverse sections through both ventricles at twelve time points covering systole and most of diastole. These yielded reconstructions of cardiac anatomy used to derive critical functional indices and their dependence upon time following the triggering electrocardiographic R waves. The left and right ventricular end-diastolic (EDV), end-systolic (ESV) and stroke volumes (SV), and ejection fractions (EF) calculated from each, control and experimental, group showed matching values. This confirmed a necessary condition requiring balanced right and left ventricular outputs and further suggested that STZ-induced diabetes produced physiological changes in both ventricles. Absolute left and right ventricular SVs were significantly altered in all diabetic animals; EDVs and EFs significantly altered in animals diabetic from 7 and 10 but not 13 weeks. When normalized to body weight, left and right ventricular SVs had significantly altered in animals diabetic from 7 and 10 weeks but not 13 weeks. Normalized left ventricular EDVs were also significantly altered in animals diabetic from 7 and 10 weeks. However, normalized right ventricular EDVs were significantly altered only in animals made diabetic from 7 weeks. Diabetic hearts showed major kinetic changes in left and right ventricular contraction (ejection) and relaxation (filling). Both the initial rates of volume change (dV/dt) in both ventricles and the plots of dV/dt values through the cardiac cycle demonstrated more gradual developments of tension during systole and relaxation during diastole. Estimates of the derived left ventricular performance parameters of cardiac output, cardiac power output and stroke work in control animals were comparable with human values when normalized to both body (or cardiac) weight and heart rate. All deteriorated with diabetes. Comparisons of experimental groups diabetic from 7 weeks demonstrated that captopril treatment relieved the alterations in critical volumes, dependence of SV upon EDV, kinetics of systolic contraction and diastolic relaxation and in the derived indicators of ventricular performance. This study represents the first demonstration using non-invasive MRI of early, chronic changes in diastolic filling and systolic ejection in both the left and the right ventricles and of their amelioration by ACE inhibition following STZ-induction of diabetes in intact experimental animals. PMID:11790819

Al-Shafei, Ahmad I M; Wise, R G; Gresham, G A; Carpenter, T A; Hall, L D; Huang, Christopher L-H



Are Electronic Cardiac Devices Still Evolving?  

PubMed Central

Summary Objectives The goal of this paper is to review some important issues occurring during the past year in Implantable devices. Methods First cardiac implantable device was proposed to maintain an adequate heart rate, either because the heart’s natural pacemaker is not fast enough, or there is a block in the heart’s electrical conduction system. During the last forty years, pacemakers have evolved considerably and become programmable and allow to configure specific patient optimum pacing modes. Various technological aspects (electrodes, connectors, algorithms diagnosis, therapies, …) have been progressed and cardiac implants address several clinical applications: management of arrhythmias, cardioversion / defibrillation and cardiac resynchronization therapy. Results Observed progress was the miniaturization of device, increased longevity, coupled with efficient pacing functions, multisite pacing modes, leadless pacing and also a better recognition of supraventricular or ventricular tachycardia’s in order to deliver appropriate therapy. Subcutaneous implant, new modes of stimulation (leadless implant or ultrasound lead), quadripolar lead and new sensor or new algorithm for the hemodynamic management are introduced and briefly described. Each times, the main result occurring during the two past years are underlined and repositioned from the history, remaining limitations are also addressed. Conclusion Some important technological improvements were described. Nevertheless, news trends for the future are also considered in a specific session such as the remote follow-up of the patient or the treatment of heart failure by neuromodulation. PMID:25123732

Mabo, P.



Robust operation of double-output AC machine drive  

Microsoft Academic Search

This paper presents strategies for maintaining operation of a double-output AC machine drive in the presence of various component failures. With a short\\/open-switch fault, the drive is capable of operating the AC machine at a reduced power capability by creating an artificial neutral. The procedures of mode transition are shown to depend on the system configuration. This operating method can

Y. Wang; T. A. Lipo; D. Pan



x1 OUTPUT OUTPUT ROUTINES * 1. Output routines. This is the file that contains all the output routines fo*  

E-print Network

) and their corresponding images coordinates. With the image, * *to get the coordinates the picture must be inverted, so routines. This is the file that contains all the output routines fo* *r the pictures `X' envirom- ment. So all the functions that print the mathematical pictures and skew diagra* *ms are coded

van Leeuwen, Marc


Multi-Output Battery Cells  

E-print Network

+ + + _ _ _ Fig.2 Multi-output SC (MoSC) based power management system. Intermediate bus Battery cells LDO loads power management system. A LOW-VOLUME POWER MANAGEMENT MODULE FOR PORTABLE APPLICATIONS BASED ON A MULTI,prodic} Abstract-- This paper introduces a 2-stage power management architecture for battery powered portable

Prodiæ, Aleksandar


Data Integration using Self-Maintainable Views  

Microsoft Academic Search

.In this paper we de#ne the concept of self-maintainable views# these are views that can be maintained using only the contents ofthe view and the database modi#cations, without accessing any of theunderlying databases. We derive tight conditions under which severaltypes of select-project-join are self-maintainable upon insertions, deletionsand updates. Self-Maintainability is a desirable property for e#-ciently maintaining large views in applications

Ashish Gupta; H. V. Jagadish; Inderpal Singh Mumick



Myo-cortical crossed feedback reorganizes primate motor cortex output  

PubMed Central

The motor system is capable of adapting to changed conditions such as amputations or lesions by reorganizing cortical representations of peripheral musculature. To investigate the underlying mechanisms we induced targeted reorganization of motor output effects by establishing an artificial recurrent connection between a forelimb muscle and an unrelated site in primary motor cortex (M1) of macaques. A head-fixed computer transformed forelimb electromyographic (EMG) activity into proportional subthreshold intracortical microstimulation during hours of unrestrained volitional behavior. This conditioning paradigm stimulated the cortical site for a particular muscle in proportion to activation of another muscle and induced robust site- and input-specific reorganization of M1 output effects. Reorganization was observed within 25 minutes and could be maintained with intermittent conditioning for successive days. Control stimulation that was independent of muscle activity, termed ‘pseudoconditioning,’ failed to produce reorganization. Pre-conditioning output effects were gradually restored during volitional behaviors following the end of conditioning. The ease of changing the relationship between cortical sites and associated muscle responses suggests that under normal conditions these relations are maintained through physiological feedback loops. These findings demonstrate that motor cortex outputs may be reorganized in a targeted and sustainable manner through artificial afferent feedback triggered from controllable and readily recorded muscle activity. Such cortical reorganization has implications for therapeutic treatment of neurological injuries. PMID:23516291

Lucas, Timothy H.; Fetz, Eberhard E.



Design of a specialized computer for on-line monitoring of cardiac stroke volume  

NASA Technical Reports Server (NTRS)

The design of a specialized analog computer for on-line determination of cardiac stroke volume by means of a modified version of the pressure pulse contour method is presented. The design consists of an analog circuit for computation and a timing circuit for detecting necessary events on the pressure waveform. Readouts of arterial pressures, systolic duration, heart rate, percent change in stroke volume, and percent change in cardiac output are provided for monitoring cardiac patients. Laboratory results showed that computational accuracy was within 3 percent, while animal experiments verified the operational capability of the computer. Patient safety considerations are also discussed.

Webb, J. A., Jr.; Gebben, V. D.



[Cardiac glycosides: From ancient history through Withering's foxglove to endogeneous cardiac glycosides].  


For centuries, drugs that increase the power of contraction of the failing heart have been used for the treatment of congestive heart failure (dropsy). The cardiac effect is due to the content of cardiac glycosides. Squill or sea onion, Urginea (Scilla) maritima, a seashore plant, was known by the ancient Romans and Syrians and possibly also by the ancient Egyptians. Squills were used erratically, but some prescriptions indicate that they may have been used for the treatment of oedematous states. The toxic effect of strophanthus species was known from poisoned arrows used by the natives in Africa. Digitalis, derived form the foxglove plant, Digitalis purpurea, is mentioned in writings as early as 1250; a Welsh family, known as the Physicians of Myddvai, collected different herbs and digitalis was included in their prescriptions. However, the druge was used erratically until the 18th century, when William Withering, an English physician and botanist, published a monograph describing the clinical effects of an extract of the foxglove plant. Later, in 1785, the indication and the toxicity of digitalis were reported in his book, "An account of the Foxglove and some of its medical uses with practical remarks on dropsy, and other diseases". In Denmark, the leaves of Digitalis purpurea or Digitalis lanata were tested for cardiac glycoside activity. The standardized digitalis powder was used in tinctures, infusions, and tablets. The preparations were included in successive editions of the Danish pharmacopoeia, some of the tinctures already in 1828, i.e. before the standardization of the drug. Isolation of cardiac glycosides from digitalis, strophanthus and squill and determination of their chemical structures initiated biochemical and pharmacological studies. The scientific advances led to an understanding of cardiac muscle contractility and the Na,K pump as the cellular receptor for the inotropic action of digitalis. Examination of putative endogenous ligands to the receptor revealed some endogenous cardiac glycosides of similar or identical structures as those found in digitalis, strophanthus and squill. Increased concentrations of these glycosides are found in patients with heart failure. Further investigations are needed to determine whether the secretion of glycosides might be a physiologic response to a diminished cardiac output. PMID:15685783

Norn, Svend; Kruse, Poul R



Acoustic saturation and output regulation.  


Acoustic saturation pressures are predicted for ultrasonic beams of a range of frequencies and focal depths. Using reasonable approximations, saturation values for mechanical index (MI) and derated spatial-peak, time-average and pulse-average intensities are calculated. These are compared with thresholds set for regulatory purposes by the U. S. Food and Drug Administration (FDA), and by the International Electrotechnical Commission (IEC). It is concluded that there are many conditions for which acoustic saturation in water prevents the values of MI and regulated intensities from exceeding thresholds set by the FDA. These conditions are particularly associated with higher frequencies and deeper focal lengths. The thresholds for action set by IEC 61157 are sufficiently low that similar problems do not arise. It is concluded that present regulations are not fully effective in limiting the output from diagnostic ultrasound equipment, and that some conditions exist that are not subject to output control. PMID:10461731

Duck, F A



Microgyroscope with closed loop output  

NASA Technical Reports Server (NTRS)

A micro-gyroscope (10) having closed loop operation by a control voltage (V.sub.TY), that is demodulated by an output signal of the sense electrodes (S1, S2), providing Coriolis torque rebalance to prevent displacement of the micro-gyroscope (10) on the output axis (y-axis). The present invention provides wide-band, closed-loop operation for a micro-gyroscope (10) and allows the drive frequency to be closely tuned to a high Q sense axis resonance. A differential sense signal (S1-S2) is compensated and fed back by differentially changing the voltage on the drive electrodes to rebalance Coriolis torque. The feedback signal is demodulated in phase with the drive axis signal ( to produce a measure of the Coriolis force.

Challoner, A. Dorian (Inventor); Gutierrez, Roman C. (Inventor); Tang, Tony K. (Inventor); Cargille, Donald R. (Inventor)



UFO - The Universal FEYNRULES Output  

NASA Astrophysics Data System (ADS)

We present a new model format for automatized matrix-element generators, the so-called Universal FEYNRULES Output (UFO). The format is universal in the sense that it features compatibility with more than one single generator and is designed to be flexible, modular and agnostic of any assumption such as the number of particles or the color and Lorentz structures appearing in the interaction vertices. Unlike other model formats where text files need to be parsed, the information on the model is encoded into a PYTHON module that can easily be linked to other computer codes. We then describe an interface for the MATHEMATICA package FEYNRULES that allows for an automatic output of models in the UFO format.

Degrande, Céline; Duhr, Claude; Fuks, Benjamin; Grellscheid, David; Mattelaer, Olivier; Reiter, Thomas



Output Effects of Government Purchases  

Microsoft Academic Search

The theoretical analysis focuses on the distinction between temporary and permanent movements in government purchases. Under plausible conditions, the temporary case involves an output response that is positive, less than one-to-one with the change in government purchases, and larger than that generated by an equal-sized, but permanent, shift in purchases. The equilibrium real rate of return rises in the temporary

Robert J. Barro



Salacia oblonga root improves cardiac lipid metabolism in Zucker diabetic fatty rats: Modulation of cardiac PPAR-{alpha}-mediated transcription of fatty acid metabolic genes  

SciTech Connect

Excess cardiac triglyceride accumulation in diabetes and obesity induces lipotoxicity, which predisposes the myocytes to death. On the other hand, increased cardiac fatty acid (FA) oxidation plays a role in the development of myocardial dysfunction in diabetes. PPAR-{alpha} plays an important role in maintaining homeostasis of lipid metabolism. We have previously demonstrated that the extract from Salacia oblonga root (SOE), an Ayurvedic anti-diabetic and anti-obesity medicine, improves hyperlipidemia in Zucker diabetic fatty (ZDF) rats (a genetic model of type 2 diabetes and obesity) and possesses PPAR-{alpha} activating properties. Here we demonstrate that chronic oral administration of SOE reduces cardiac triglyceride and FA contents and decreases the Oil red O-stained area in the myocardium of ZDF rats, which parallels the effects on plasma triglyceride and FA levels. Furthermore, the treatment suppressed cardiac overexpression of both FA transporter protein-1 mRNA and protein in ZDF rats, suggesting inhibition of increased cardiac FA uptake as the basis for decreased cardiac FA levels. Additionally, the treatment also inhibited overexpression in ZDF rat heart of PPAR-{alpha} mRNA and protein and carnitine palmitoyltransferase-1, acyl-CoA oxidase and 5'-AMP-activated protein kinase mRNAs and restored the downregulated acetyl-CoA carboxylase mRNA. These results suggest that SOE inhibits cardiac FA oxidation in ZDF rats. Thus, our findings suggest that improvement by SOE of excess cardiac lipid accumulation and increased cardiac FA oxidation in diabetes and obesity occurs by reduction of cardiac FA uptake, thereby modulating cardiac PPAR-{alpha}-mediated FA metabolic gene transcription.

Huang, Tom H.-W. [Herbal Medicines Research and Education Centre, Faculty of Pharmacy, University of Sydney, NSW 2006 (Australia); Yang Qinglin [Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA 30310 (United States); Harada, Masaki [Department of Medicine and Clinical Science, Kyoto University Graduate School of Medicine, Kyoto 606-8507 (Japan); Uberai, Jasna [Herbal Medicines Research and Education Centre, Faculty of Pharmacy, University of Sydney, NSW 2006 (Australia); Radford, Jane [Faculty of Medicine, University of Sydney (Australia); Li, George Q. [Herbal Medicines Research and Education Centre, Faculty of Pharmacy, University of Sydney, NSW 2006 (Australia); Yamahara, Johji [Pharmafood Institute, Kyoto (Japan); Roufogalis, Basil D. [Herbal Medicines Research and Education Centre, Faculty of Pharmacy, University of Sydney, NSW 2006 (Australia); Li Yuhao [Herbal Medicines Research and Education Centre, Faculty of Pharmacy, University of Sydney, NSW 2006 (Australia)]. E-mail:



Cardiac arrhythmogenesis and temperature.  


Fast processes in cardiac electrophysiology are often studied at temperatures lower than physiological. Extrapolation of values is based on widely accepted Q10 (Arrhenius) model of temperature dependence (ratio of kinetic properties for a 10 degrees C change in temperature). In this study, we set out to quantify the temperature dependence of essential parameters that define spatiotemporal behavior of cardiac excitation. Additionally, we examined temperature's effects on restitution dynamics. We employed fast fluorescence imaging with voltage-and calcium-sensitive dyes in neonatal rat cardiomyocyte sheets. Conduction velocity (CV), calcium transient duration (CTD), action potential duration (APD) and wavelength (W=CV*duration) change as functions of temperature were quantified. Using 24 degrees C as a reference point, we found a strong temperature-driven increase of CV (Q10=2.3) with smaller CTD and APD changes (Q10=1.33, 1.24, respectively). The spatial equivalents of voltage and calcium duration, wavelength, were slightly less sensitive to temperature with Q10=2.05 and 1.78, respectively, due to the opposing influences of decreasing duration with increased velocity. More importantly, we found that Q10 varies as a function of diastolic interval. Our results indicate the importance of examining temperature sensitivity across several frequencies. Armed with our results, experimentalists and modelers alike have a tool for reconciling different environmental conditions. In a broader sense, these data help better understand thermal influences on arrhythmia development or suppression such as during hibernation or cardiac surgery. PMID:17946861

Shah, Ujas; Bien, Harold; Entcheva, Emilia



Sucrose non-fermenting related kinase enzyme is essential for cardiac metabolism  

PubMed Central

ABSTRACT In this study, we have identified a novel member of the AMPK family, namely Sucrose non-fermenting related kinase (Snrk), that is responsible for maintaining cardiac metabolism in mammals. SNRK is expressed in the heart, and brain, and in cell types such as endothelial cells, smooth muscle cells and cardiomyocytes (CMs). Snrk knockout (KO) mice display enlarged hearts, and die at postnatal day 0. Microarray analysis of embryonic day 17.5 Snrk hearts, and blood profile of neonates display defect in lipid metabolic pathways. SNRK knockdown CMs showed altered phospho-acetyl-coA carboxylase and phospho-AMPK levels similar to global and endothelial conditional KO mouse. Finally, adult cardiac conditional KO mouse displays severe cardiac functional defects and lethality. Our results suggest that Snrk is essential for maintaining cardiac metabolic homeostasis, and shows an autonomous role for SNRK during mammalian development. PMID:25505152

Cossette, Stephanie M.; Gastonguay, Adam J.; Bao, Xiaoping; Lerch-Gaggl, Alexandra; Zhong, Ling; Harmann, Leanne M.; Koceja, Christopher; Miao, Robert Q.; Vakeel, Padmanabhan; Chun, Changzoon; Li, Keguo; Foeckler, Jamie; Bordas, Michelle; Weiler, Hartmut; Strande, Jennifer; Palecek, Sean P.; Ramchandran, Ramani




PubMed Central

Background Pulmonary arteriovenous malformations (PAVMs) can occur after the Fontan and are believed to be associated with disproportionate pulmonary distribution of hepatic venous effluent. We studied the impact of total cavo-pulmonary connection (TCPC) geometry and the effect of increased cardiac output (CO) on distribution of inferior vena caval (IVC) return to the lungs. Methods 10 Fontan patients – 5 with extra-cardiac (EC) and 5 with intra-cardiac (IC) configurations of the TCPC previously analyzed for power loss were processed for calculating the distribution of inferior vena caval return to the lungs (2nd order accuracy). One idealized TCPC was similarly analyzed under parametric variation of IVC offset and CO flow split Results Streaming of the IVC return in the idealized TCPC model was dependent on both IVC offset magnitude and CO flow split ratio. For patient-specific TCPCs, preferential streaming of the IVC return was directly proportional to CO flow split ratio in the IC type TCPCs (p < 0.0001). Preferential streaming in EC TCPCs correlated to the IVC offset (p<0.05) and did not correlate to CO flow split. Enhanced mixing in IC is speculated to explain the contrasting results. Exercising tends to reduce streaming towards LPA in IC, while for EC, exercising tends to equalize the streaming. Conclusions EC and IC TCPCs have inherently different streaming characteristics due to contrasting mixing characteristics owing to their geometric differences. PA diameters and IVC offsets may together determine hepatic flow streaming. PMID:20621314

Dasi, Lakshmi P.; Whitehead, Kevin; Pekkan, Kerem; de Zelicourt, Diane; Sundareswaran, Kartik; Kanter, Kirk; Fogel, Mark A.; Yoganathan, Ajit P.



Cardiac index and oxygen delivery during low and high tidal volume ventilation strategies in patients with acute respiratory distress syndrome: a crossover randomized clinical trial  

PubMed Central

Introduction The beneficial effect of low tidal volume (TV) ventilation strategy on mortality in patients with acute respiratory distress syndrome (ARDS) has been attributed to the protective effect on ventilator-induced lung injury, and yet its effect on cardiovascular function might also play an important role. The aim of this study was to assess whether low TV ventilation improves cardiac output and oxygen delivery compared with high TV ventilation strategy in patients with ARDS. Methods In this crossover randomized clinical trial 16 ARDS patients were recruited in an intensive care unit at a university-affiliated hospital. Each patient was ventilated for 30 min with low (6 mL/kg) and 30 min with high (12 mL/kg) TV. The two experimental periods, applied in random order and with allocation concealment, were separated by 30 min of basal ventilation. Minute ventilation was constantly maintained by appropriate respiratory rate changes. Results Compared with high TV ventilation, low TV ventilation showed decreased pH (7.37 vs. 7.41, P = 0.001) and increased PaCO2 (49 vs. 43 mmHg; P = 0.002). Cardiac index and oxygen delivery index were increased with low compared with high TV ventilation (3.9 vs. 3.5 L.min-1.m-2, P = 0.012, and 521 vs. 463 mL.min-1.m-2, P = 0.002, respectively), while oxygen extraction ratio decreased (0.36 vs. 0.44, P = 0.027). In four patients oxygen extraction ratio was >0.5 during high TV but not during low TV strategy. The magnitude of the change in cardiac index was positively associated with PaCO2 variation (P = 0.004), while it was unrelated to the magnitude of changes in TV and airway pressure. The decrease of cardiac index was predicted by PaCO2 reduction, with and area under ROC curve of 0.72. Conclusions Our findings suggest that a low TV ventilation strategy increases cardiac index and oxygen delivery, thus supporting the hypothesis that the beneficial effect of low TV ventilation in patients with ARDS could be partially explained by hemodynamic improvement. In other words, low tidal volume ventilation could be protective also for the cardiovascular system and not only for the lung. The slight increase of PaCO2 during low TV ventilation seems to predict the increase of cardiac index. Trial registration NCT00713713 PMID:23880084



Cardiac Emergencies in Neurosurgical Patients  

PubMed Central

Perioperative safety concerns are a major area of interest in recent years. Severe cardiac perturbation such as cardiac arrest is one of the most dreaded complications in the intraoperative period; however, little is known about the management of these events in the patients undergoing elective neurosurgery. This special group needs further attention, as it is often neither feasible nor appropriate to apply conventional advanced cardiac life support algorithms in patients undergoing neurosurgery. Factors such as neurosurgical procedure and positioning can also have a significant effect on the occurrence of cardiac arrest. Therefore, the aim of this paper is to describe the various causes and management of cardiac emergencies with special reference to cardiac arrest during elective neurosurgical procedures, including discussion of position-related factors and resuscitative considerations in these situations. This will help to formulate possible guidelines for management of such events.

Petropolis, Andrea; Cappellani, Ronald B.



Cardiac tamponade in pregnancy during the treatment of severe pre-eclampsia: report of a case.  


We present a case of cardiac tamponade that occurred during the course of treatment for severe pre-eclampsia. A 37-year-old woman who underwent cesarean section for severe pre-eclampsia developed cardiac tamponade after delivery. While percutaneous pericardiocentesis temporarily improved her condition, pericardial effusion, dyspnea and tachycardia reappeared 5 days after delivery. A continuous drainage tube placed in the pericardial cavity for 5 days was required to maintain maternal cardiac function. Her clinical course was uneventful after continuous drainage and she was discharged 20 days after delivery. No such causes of symptomatic pericardial effusion were detected in the present case. Physicians should be aware of this complication when dyspnea is accompanied by tachycardia and enlargement of the cardiac silhouette with hypolucent lungs on chest X-ray. Immediate pericardiocentesis is also required to prevent life-threatening cardiac tamponade in such cases. PMID:24738125

Matsuki, Rikako; Nakago, Satoshi; Takaoka, Hideyuki; Oishi, Tetsuya; Kotsuji, Fumikazu



Simulation of Cardiac Action Potentials  

Microsoft Academic Search

\\u000a Simulation of cardiac action potentials offers a brief introduction to cardiac action potential modeling by examining the\\u000a history of the field and discusses experimental and modeling breakthroughs that have yielded today’s current models. The chapter\\u000a begins with an overview of the cardiac action potential and highlights the Hodgkin and Huxley formalism. The chapter then\\u000a highlights specific key models with a

Jonathan D. Moreno; Colleen E. Clancy


Health Enhancing Behavior Maintaining a Healthy Diet  

E-print Network

Health Enhancing Behavior Maintaining a Healthy Diet Weight Control #12;Maintaining a Healthy Diet at risk for Coronary artery disease, hypertension Diabetes Cancer #12;Why Maintain a Healthy Diet? Dietary cholesterol level, sudden death, salt and HTN Estimates of degree to which diet contributes to cancer exceed

Meagher, Mary


Clinical course and medical management of neonates with severe cardiac failure related to vein of Galen malformation  

PubMed Central

Background: Neonatal presentation of vein of Galen aneurysmal malformations (VGAMs) with intractable cardiac failure is considered a poor prognostic sign. Interventional neuroradiology with embolisation has been shown to control cardiac failure, but there is a perception that neurological outcome in survivors is poor. Objective: To determine if aggressive intensive care and anaesthetic management of cardiac failure before urgent embolisation can influence morbidity and mortality. Patients: Nine newborns (four boys, five girls) were diagnosed with symptomatic vein of Galen malformations in the neonatal period during the period 1996–2001. Eight developed intractable high output cardiac failure requiring initial endovascular treatment in the first week of life. Results: The immediate outcome after a series of endovascular procedures was control of cardiac failure and normal neurological function in six (66%) patients, one death from intractable cardiac failure in the neonatal period, and two late deaths with severe hypoxic-ischaemic neurological injury (33% mortality). Clinical review at 6 months to 4 years of age showed five infants with no evidence of neurological abnormality or cardiac failure and one child with mild developmental delay (11%). Conclusions: Aggressive medical treatment of cardiac failure and early neurointervention combined with modern neuroanaesthetic care results in good survival rates with low morbidity even in cases of high risk VGAM presenting in the immediate perinatal period with cardiac failure. Systemic arterial vasodilators improve outcome in neonates with cardiac failure secondary to VGAM. Excessive ß adrenergic stimulation induced by conventional inotropic agents may exacerbate systemic hypoperfusion. PMID:12193525

Frawley, G; Dargaville, P; Mitchell, P; Tress, B; Loughnan, P



Comparison of cardiac function and coronary angiography between conventional pigs and micropigs as measured by multidetector row computed tomography  

PubMed Central

Pigs are the most likely source animals for cardiac xenotransplantation. However, an appropriate method for estimating the cardiac function of micropigs had not been established. Computed tomography (CT) analysis aimed at estimating cardiac function and assessing the coronary arteries has not been carried out in micropigs. This study determined the feasibility of evaluating cardiac function in a micropig model using multidetector row computed tomography (MDCT) and compared the cardiac function values with those of conventional pigs. The mean age of the conventional pigs and micropigs was approximately 80 days and approximately 360 days, respectively. The mean body weight in the conventional pigs and micropigs was 29.70 ± 0.73 and 34.10 ± 0.98 kg, respectively. Cardiac MDCT detected ejection fractions of 52.93 ± 3.10% and 59.00 ± 5.56% and cardiac outputs of 1.46 ± 0.64 l/min and 1.21 ± 0.24 l/min in conventional pigs and micropigs, respectively. There were no significant differences in cardiac function between conventional pigs and micropigs in the reconstructed CT images. There were also no differences in the coronary angiographic images obtained by MDCT. It is expected that the results of this study will help improve understanding of cardiac function in micropigs. The data presented in this study suggest that MDCT is a feasible method for evaluating cardiac function in micropigs. PMID:18487932

Ahn, Young Keun; Ryu, Jung Min; Jeong, Hea Chang; Kim, Yun Hyeon; Jeong, Myung Ho; Lee, Min Young; Lee, Sang Hun; Park, Jae Hong; Yun, Seung Pil



Are older patients’ cardiac rehabilitation needs being met?  

PubMed Central

Aims. The primary aim of this study was to examine the needs of older people in relation to cardiac rehabilitation and to determine if these were currently being met. A secondary aim was to compare illness representations, quality of life and anxiety and depression in groups with different levels of attendance at a cardiac rehabilitation programme. Background. Coronary heart disease accounted for over seven million cardiovascular deaths globally in 2001. Associated deaths increase with age and are highest in those older than 65. Effective cardiac rehabilitation can assist independent function and maintain health but programme uptake rates are low. We have, therefore, focussed specifically on the older patient to determine reasons for the low uptake. Design. Mixed methods. Methods. A purposive sample of 31 older men and women (?65 years) completed three questionnaires to determine illness representations, quality of life and anxiety and depression. They then underwent a brief clinical assessment and participated in a face-to-face audio-taped interview. Results. Quantitative: Older adults, who did not attend a cardiac rehabilitation programme, had significantly poorer personal control and depression scores (p < 0·01) and lower quality of life scores than those who had attended. Few achieved recommended risk factor reduction targets. Qualitative: The three main themes identified as reflecting the views and experiences of and attendance at the cardiac rehabilitation programme were: ‘The sensible thing to do’, ‘Assessing the impact’ and ‘Nothing to gain’. Conclusions. Irrespective of level of attendance, cardiac rehabilitation programmes are not meeting the needs of many older people either in terms of risk factor reduction or programme uptake. More appropriate programmes are needed. Relevance to clinical practice. Cardiac rehabilitation nurses are ideally placed to identify the rehabilitation needs of older people. Identifying these from the older person’s perspective could help guide more appropriate intervention strategies. PMID:19638048

Tolmie, Elizabeth P; Lindsay, Grace M; Kelly, Tim; Tolson, Debbie; Baxter, Susan; Belcher, Philip R



Hierarchical Approaches for Systems Modeling in Cardiac Development  

PubMed Central

Ordered cardiac morphogenesis and function is essential for all vertebrate life. The heart begins as a simple contractile tube, but quickly grows and morphs into a multi-chambered pumping organ, complete with valves, while maintaining regulation of blood flow and nutrient distribution. Though not identical, cardiac morphogenesis shares many molecular and morphological processes across vertebrate species. Quantitative data across multiple time and length scales have been gathered through decades of reductionist single variable analyses. These range from detailed molecular signaling pathways at the cellular levels to cardiac function at the tissue/organ levels. However, none of these components act in true isolation from others, and each, in turn, exhibits short- and long-range effects in both time and space. With the absence of a gene, entire signaling cascades and genetic profiles may be shifted, resulting in complex feedback mechanisms. Also taking into account local microenvironmental changes throughout development, it is apparent that a systems level approach is an essential resource to accelerate information generation concerning the functional relationships across multiple length scales (molecular data vs. physiological function) and structural development. In this review, we discuss relevant in vivo and in vitro experimental approaches, compare different computational frameworks for systems modeling, and the latest information about systems modeling of cardiac development. Lastly, we conclude with some important future directions for cardiac systems modeling. PMID:23463736

Gould, Russell A.; Aboulmouna, Lina M.; Varner, Jeffrey D.; Butcher, Jonathan T.



Biventricular Pacing (Cardiac Resynchronization Therapy)  

PubMed Central

Executive Summary Issue In 2002, (before the establishment of the Ontario Health Technology Advisory Committee), the Medical Advisory Secretariat conducted a health technology policy assessment on biventricular (BiV) pacing, also called cardiac resynchronization therapy (CRT). The goal of treatment with BiV pacing is to improve cardiac output for people in heart failure (HF) with conduction defect on ECG (wide QRS interval) by synchronizing ventricular contraction. The Medical Advisory Secretariat concluded that there was evidence of short (6 months) and longer-term (12 months) effectiveness in terms of cardiac function and quality of life (QoL). More recently, a hospital submitted an application to the Ontario Health Technology Advisory Committee to review CRT, and the Medical Advisory Secretariat subsequently updated its health technology assessment. Background Chronic HF results from any structural or functional cardiac disorder that impairs the ability of the heart to act as a pump. It is estimated that 1% to 5% of the general population (all ages) in Europe have chronic HF. (1;2) About one-half of the patients with HF are women, and about 40% of men and 60% of women with this condition are aged older than 75 years. The incidence (i.e., the number of new cases in a specified period) of chronic HF is age dependent: from 1 to 5 per 1,000 people each year in the total population, to as high as 30 to 40 per 1,000 people each year in those aged 75 years and older. Hence, in an aging society, the prevalence (i.e., the number of people with a given disease or condition at any time) of HF is increasing, despite a reduction in cardiovascular mortality. A recent study revealed 28,702 patients were hospitalized for first-time HF in Ontario between April 1994 and March 1997. (3) Women comprised 51% of the cohort. Eighty-five percent were aged 65 years or older, and 58% were aged 75 years or older. Patients with chronic HF experience shortness of breath, a limited capacity for exercise, high rates of hospitalization and rehospitalization, and die prematurely. (2;4) The New York Heart Association (NYHA) has provided a commonly used functional classification for the severity of HF (2;5): Class I: No limitation of physical activity. No symptoms with ordinary exertion. Class II: Slight limitations of physical activity. Ordinary activity causes symptoms. Class III: Marked limitation of physical activity. Less than ordinary activity causes symptoms. Asymptomatic at rest. Class IV: Inability to carry out any physical activity without discomfort. Symptoms at rest. The National Heart, Lung, and Blood Institute estimates that 35% of patients with HF are in functional NYHA class I; 35% are in class II; 25%, class III; and 5%, class IV. (5) Surveys (2) suggest that from 5% to 15% of patients with HF have persistent severe symptoms, and that the remainder of patients with HF is evenly divided between those with mild and moderately severe symptoms. Overall, patients with chronic, stable HF have an annual mortality rate of about 10%. (2) One-third of patients with new-onset HF will die within 6 months of diagnosis. These patients do not survive to enter the pool of those with “chronic” HF. About 60% of patients with incident HF will die within 3 years, and there is limited evidence that the overall prognosis has improved in the last 15 years. To date, the diagnosis and management of chronic HF has concentrated on patients with the clinical syndrome of HF accompanied by severe left ventricular systolic dysfunction. Major changes in treatment have resulted from a better understanding of the pathophysiology of HF and the results of large clinical trials. Treatment for chronic HF includes lifestyle management, drugs, cardiac surgery, or implantable pacemakers and defibrillators. Despite pharmacologic advances, which include diuretics, angiotensin-converting enzyme inhibitors, beta-blockers, spironolactone, and digoxin, many patients remain symptomatic on maximally tolerated doses. The Technology Owing to the limitations of drug therap



Output-Sensitive Autocompletion Search  

E-print Network

the following autocompletion search scenario: imagine a user of a search engine typing a query; then with everyOutput-Sensitive Autocompletion Search Holger Bast Christian W. Mortensen Ingmar Weber MPI­I­2006£'8¦7PS§©sbYd H 1¨78'(1¥)§©¨y8¦(tIP1§1¨7¡#0©§©§©18¦(1¥¤y¡)Au7P1§ Xva 7P H dYFq¡¤78¦91F ¡¤( H 7¨78¦(1¥w


Silicon central pattern generators for cardiac diseases.  


Cardiac rhythm management devices provide therapies for both arrhythmias and resynchronization but not heart failure, which affects millions of patients worldwide. This paper reviews recent advances in biophysics and mathematical engineering that provide a novel technological platform for addressing heart disease and enabling beat-to-beat adaptation of cardiac pacing in response to physiological feedback. The technology consists of silicon hardware central pattern generators (hCPG) that may be trained to emulate accurately the dynamical response of biological central pattern generators (bCPG). We discuss the limitations of present CPGs and appraise the advantages of analogue over digital circuits for application in bioelectronic medicine. To test the system, we have focused on the cardio-respiratory oscillators in the medulla oblongata that modulate heart rate in phase with respiration to induce respiratory sinus arrhythmia (RSA). We describe here a novel, scalable hCPG comprising physiologically realistic (Hodgkin-Huxley type) neurones and synapses. Our hCPG comprises two neurones that antagonise each other to provide rhythmic motor drive to the vagus nerve to slow the heart. We show how recent advances in modelling allow the motor output to adapt to physiological feedback such as respiration. In rats, we report on the restoration of RSA using an hCPG that receives diaphragmatic electromyography input and use it to stimulate the vagus nerve at specific time points of the respiratory cycle to slow the heart rate. We have validated the adaptation of stimulation to alterations in respiratory rate. We demonstrate that the hCPG is tuneable in terms of the depth and timing of the RSA relative to respiratory phase. These pioneering studies will now permit an analysis of the physiological role of RSA as well as its any potential therapeutic use in cardiac disease. This article is protected by copyright. All rights reserved. PMID:25433077

Nogaret, Alain; O'Callaghan, Erin L; Paton, Julian F R; Lataro, Renata M; Salgado, Helio C; Meliza, C Daniel; Duncan, Edward; Abarbanel, Henry D I



Cardiac troponins: bench to bedside interpretation in cardiac disease.  


Cardiac troponins are the preferred biomarkers for the determination of acute myocardial necrosis. The high sensitivity of the available assays has significantly increased the detection of microscopic amounts of myocardial damage. Although compelling evidence indicates that elevated cardiac troponins are markers of poor prognosis and increased mortality, irrespective of the clinical scenario, small elevations can be seen in protean conditions and may confound the diagnosis of acute coronary syndromes. Emerging evidence suggests multiple different cellular mechanisms leading to cardiac troponin release, which challenge long held paradigms such as equivalency between troponin release into the circulation and irreversible cell death. Hence, knowledge of the physiology and pathophysiology of these cardiac biomarkers is essential for their accurate interpretation and consequent correct clinical diagnosis. Herein, the current relevant information about cardiac troponins is discussed, with special emphasis on pathophysiology and clinical correlates. PMID:23656921

Muthu, Vasundhara; Kozman, Hani; Liu, Kan; Smulyan, Harold; Villarreal, Daniel




PubMed Central

Purpose of review To review the latest development in cardiac xenotransplantation in small and large animal models and related in vitro studies. Recent findings With the recent introduction of ?1,3-galactosyltransferase gene-knockout (GT-KO) pig organs for xenotransplantation, improved cardiac graft survival has been obtained. However, this experience has demonstrated the importance of pig antigens other than Gal?1,3Gal (Gal) antigens (so-called nonGal antigens) as targets for primate anti-pig antibodies. Several in vitro studies have confirmed that, although the incidence and levels of anti-nonGal antibodies in non-human primates and humans are significantly less when compared with total anti-pig antibodies (i.e., anti-Gal + anti-nonGal), they can result in complement-mediated lysis of GT-KO pig cells. More recently, it has been demonstrated that regulatory T cells (Treg) suppress the cellular xenogeneic response, thus potentially preventing or reducing T cell-mediated rejection. The importance of thrombotic microangiopathy as a feature of the immune/inflammatory response and incompatibilities between the coagulation-anticoagulation systems of pig and primate are receiving increasing attention. Development of GT-KO pigs transgenic for one or more ‘anti-thrombotic’ genes, e.g., CD39 or tissue factor pathway inhibitor, may contribute to overcoming these problems. Summary Although GT-KO pigs have provided an advance over wild-type pigs as a source of Organs for transplantation into primates, further genetic modification of GT-KO pigs is required to overcome the remaining immune barriers before a clinical trial of cardiac xenotransplantation can be contemplated. PMID:19060538

Ekser, Burcin; Cooper, David K.C.



Current perspectives on cardiac amyloidosis  

PubMed Central

Amyloidosis represents a group of diseases in which proteins undergo misfolding to form insoluble fibrils with subsequent tissue deposition. While almost all deposited amyloid fibers share a common nonbranched morphology, the affected end organs, clinical presentation, treatment strategies, and prognosis vary greatly among this group of diseases and are largely dependent on the specific amyloid precursor protein. To date, at least 27 precursor proteins have been identified to result in either local tissue or systemic amyloidosis, with nine of them manifesting in cardiac deposition and resulting in a syndrome termed “cardiac amyloidosis” or “amyloid cardiomyopathy.” Although cardiac amyloidosis has been traditionally considered to be a rare disorder, as clinical appreciation and understanding continues to grow, so too has the prevalence, suggesting that this disease may be greatly underdiagnosed. The most common form of cardiac amyloidosis is associated with circulating amyloidogenic monoclonal immunoglobulin light chain proteins. Other major cardiac amyloidoses result from a misfolding of products of mutated or wild-type transthyretin protein. While the various cardiac amyloidoses share a common functional consequence, namely, an infiltrative cardiomyopathy with restrictive pathophysiology leading to progressive heart failure, the underlying pathophysiology and clinical syndrome varies with each precursor protein. Herein, we aim to provide an up-to-date overview of cardiac amyloidosis from nomenclature to molecular mechanisms and treatment options, with a particular focus on amyloidogenic immunoglobulin light chain protein cardiac amyloidosis. PMID:22058156

Guan, Jian; Mishra, Shikha; Falk, Rodney H.



Optogenetic Control of Cardiac Function  

Microsoft Academic Search

The cardiac pacemaker controls the rhythmicity of heart contractions and can be substituted by a battery-operated device as a last resort. We created a genetically encoded, optically controlled pacemaker by expressing halorhodopsin and channelrhodopsin in zebrafish cardiomyocytes. Using patterned illumination in a selective plane illumination microscope, we located the pacemaker and simulated tachycardia, bradycardia, atrioventricular blocks, and cardiac arrest. The

Aristides B. Arrenberg; Didier Y. R. Stainier; Herwig Baier; Jan Huisken



Systemic hypoperfusion is associated with executive dysfunction in geriatric cardiac patients  

Microsoft Academic Search

The present study examines the relationship between systemic hypoperfusion via cardiac output (CO) and neuropsychological performances emphasizing executive function in an aging cohort. Geriatric outpatients with treated, stable cardiovascular disease (CVD) and no history of neurological illness (n = 72, ages 56-85) were administered cognitive measures with an emphasis on executive functioning. Echocardiogram findings were used to stratify participants into

Angela L. Jefferson; Athena Poppas; Robert H. Paul; Ronald A. Cohen



Effect of hypokinesia on cardiac contractile function and nervous regulation of the heart  

NASA Technical Reports Server (NTRS)

Longterm hypokinesia caused cardiac deadaptation in rabbits, which resulted in the diminishing of the left ventricular rate of contraction and relaxation, joined later by decreased vascular resistance. As a results, the ejection rate as well as stroke volume and cardiac output were normal. The decrease of the relaxation speed was more obvious at a high heart rate and results in shortening of the diastolic pause and diminishing of cardiac output. Hearts of the hypokinetic animals were characterized by normal maximal pressure developed by a unit of muccardial mass aorta clamping, decreased adrenoreactivity, and increased cholinoreactivity. This complex of changes is contrary to changes observed in adaptation to exercise, but is similar to changes observed in compensatory hypertrophy of the heart.

Meyerson, F. Z.; Kapelko, V. I.; Gorina, M. S.; Shchegolkov, A. N.; Larinov, N. P.



Automatic UAV Landing with Ground Target Maintained in the Field of View  

E-print Network

Automatic UAV Landing with Ground Target Maintained in the Field of View Laurent Burlion and Henry de Plinval Abstract In this paper, a key feature for UAV visual servoing in automatic land- ing. First, a control law for UAV automatic landing is proposed. Then, the output con- straint method


The Chemotherapy of Cardiac Arrest  

PubMed Central

Direct-air ventilation, external cardiac compression, and external defibrillation are established techniques for patients who unexpectedly develop cardiac arrest. The proper use of drugs can increase the incidence of successful resuscitation. Intracardiac adrenaline (epinephrine) acts as a powerful stimulant during cardiac standstill and, in addition, converts fine ventricular fibrillation to a coarser type, more responsive to electrical defibrillation. Routine use of intravenous sodium bicarbonate is recommended to combat the severe metabolic acidosis accompanying cardiac arrest. Lidocaine is particularly useful when ventricular fibrillation or ventricular tachycardia tends to recur. Analeptics are contraindicated, since they invariably increase oxygen requirements of already hypoxic cerebral tissues. The following acrostic is a useful mnemonic for recalling the details of the management of cardiac arrest in their proper order: A (Airway), B (Breathing), C (Circulation), D (Diagnosis of underlying cause), E (Epinephrine), F (Fibrillation), G (Glucose intravenously), pH (Sodium bicarbonate), I (Intensive care). ImagesFig. 1Fig. 3Fig. 4 PMID:14216141

Minuck, Max



Challenges in Cardiac Tissue Engineering  

PubMed Central

Cardiac tissue engineering aims to create functional tissue constructs that can reestablish the structure and function of injured myocardium. Engineered constructs can also serve as high-fidelity models for studies of cardiac development and disease. In a general case, the biological potential of the cell—the actual “tissue engineer”—is mobilized by providing highly controllable three-dimensional environments that can mediate cell differentiation and functional assembly. For cardiac regeneration, some of the key requirements that need to be met are the selection of a human cell source, establishment of cardiac tissue matrix, electromechanical cell coupling, robust and stable contractile function, and functional vascularization. We review here the potential and challenges of cardiac tissue engineering for developing therapies that could prevent or reverse heart failure. PMID:19698068

Tandon, Nina; Godier, Amandine; Maidhof, Robert; Marsano, Anna; Martens, Timothy P.; Radisic, Milica



Output feedback pole-assignment procedure  

Microsoft Academic Search

A new algorithm based on pole-assignment considerations for linear time-invariant m-input p-output systems by means of static output feedback is presented for the case in which the number of inputs m and the number of outputs p are less than the order of the system n. This algorithm determines the output-feedback matrix required to assign max (p, m) - 1




[No compression of cardiac cavities in transthoracic ultrasound does not exclude cardiac tamponade.  


The clinical presentation of cardiac tamponade is difficult to distinguish from other causes of shock. Pericardial fluid is easy to visualize with cardiac ultrasound and a key sign of overt cardiac tamponade is the compression of right side cavities. We present two cases in which cardiac tamponade was present, but where compression of cardiac cavities could not be demon-strated with transthoracic cardiac ultrasound. This emphasizes that cardiac tamponade is still a clinical diagnosis. PMID:25430575

Juhl-Olsen, Peter; Frederiksen, Christina Alcaraz; Sloth, Erik



Concrete induced cardiac contusion.  


A previously fit 22 year old man was struck in the chest by a concrete block dropped through the windscreen of his car while he was driving on the motorway. He suffered extensive chest wall trauma and lung contusion, which subsequently precipitated acute respiratory distress. On admission ECG showed right bundle branch block and left axis deviation. Three days later QRS duration was normal but there was anterior ST segment elevation and subsequent T wave change. There was a large rise in creatine kinase, and echocardiography revealed septal and apical hyokinesis as well as a mobile mass attached to the left side of the interventricular septum, which had the echogenic texture of myocardium. The patient had fixed perfusion defects in the areas of hypokinesis on thallium scanning but the coronary arteries were unobstructed at angiography. He was treated with warfarin in the short term and an angiotensin converting enzyme inhibitor in the longer term and has made an asymptomatic recovery. Outpatient echocardiography two months after the injury demonstrated some recovery in overall left ventricular systolic function and no evidence of the intracardiac mass. This case illustrates some of the typical features of non-fatal cardiac contusion associated with non-penetrating cardiac trauma, and was complicated by partial thickness avulsion of a strip of the myocardium in the interventricular septum. PMID:9391297

Curzen, N; Brett, S; Fox, K



Digital plus analog output encoder  

NASA Technical Reports Server (NTRS)

The disclosed encoder is adapted to produce both digital and analog output signals corresponding to the angular position of a rotary shaft, or the position of any other movable member. The digital signals comprise a series of binary signals constituting a multidigit code word which defines the angular position of the shaft with a degree of resolution which depends upon the number of digits in the code word. The basic binary signals are produced by photocells actuated by a series of binary tracks on a code disc or member. The analog signals are in the form of a series of ramp signals which are related in length to the least significant bit of the digital code word. The analog signals are derived from sine and cosine tracks on the code disc.

Hafle, R. S. (inventor)



Basal Ganglia Outputs Map Instantaneous Position Coordinates during Behavior.  


The basal ganglia (BG) are implicated in many movement disorders, yet how they contribute to movement remains unclear. Using wireless in vivo recording, we measured BG output from the substantia nigra pars reticulata (SNr) in mice while monitoring their movements with video tracking. The firing rate of most nigral neurons reflected Cartesian coordinates (either x- or y-coordinates) of the animal's head position during movement. The firing rates of SNr neurons are either positively or negatively correlated with the coordinates. Using an egocentric reference frame, four types of neurons can be classified: each type increases firing during movement in a particular direction (left, right, up, down), and decreases firing during movement in the opposite direction. Given the high correlation between the firing rate and the x and y components of the position vector, the movement trajectory can be reconstructed from neural activity. Our results therefore demonstrate a quantitative and continuous relationship between BG output and behavior. Thus, a steady BG output signal from the SNr (i.e., constant firing rate) is associated with the lack of overt movement, when a stable posture is maintained by structures downstream of the BG. Any change in SNr firing rate is associated with a change in position (i.e., movement). We hypothesize that the SNr output quantitatively determines the direction, velocity, and amplitude of voluntary movements. By changing the reference signals to downstream position control systems, the BG can produce transitions in body configurations and initiate actions. PMID:25673860

Barter, Joseph W; Li, Suellen; Sukharnikova, Tatyana; Rossi, Mark A; Bartholomew, Ryan A; Yin, Henry H



Light-operated proximity detector with linear output  


A light-operated proximity detector is described in which reflected light intensity from a surface whose proximity to the detector is to be gauged is translated directly into a signal proportional to the distance of the detector from the surface. A phototransistor is used to sense the reflected light and is connected in a detector circuit which maintains the phototransistor in a saturated state. A negative feedback arrangement using an operational amplifier connected between the collector and emitter of the transistor provides an output at the output of the amplifier which is linearly proportional to the proximity of the surface to the detector containing the transistor. This direct proportional conversion is true even though the light intensity is varying with the proximity in proportion to the square of the inverse of the distance. The detector may be used for measuring the distance remotely from any target surface.

Simpson, Marc L. (Harriman, TN); McNeilly, David R. (Maryville, TN)



Dielectric elastomer transducers with enhanced force output and work density  

NASA Astrophysics Data System (ADS)

We demonstrate that the force output and work density of polydimethylsiloxane (PDMS) based dielectric elastomer transducers can be significantly enhanced by the addition of high permittivity titanium dioxide nanoparticles. The nanocomposites are capable of maintaining the actuation strain performance of the pure PDMS at relatively low electric fields while increasing the force output and work density due to mechanical reinforcement. A model relating the Maxwell stress to the measured force from the actuator was used to determine the dielectric permittivity at high electric fields thus providing results that can be directly correlated to device performance. This approach toward higher work density materials should enable smaller, lighter, and less intrusive actuator systems ideal for biomedical and robotic devices in particular.

Stoyanov, Hristiyan; Brochu, Paul; Niu, Xiaofan; Della Gaspera, Enrico; Pei, Qibing



Space maintainers in dentistry: past to present.  


Early orthodontic interventions are often initiated in the developing dentition to promote favourable developmental changes. Interceptive orthodontic can eliminate or reduce the severity of a developing malocclusion, the complexity of orthodontic treatment, overall treatment time and cost. The safest way to prevent future malocclusions from tooth loss is to place a space maintainer that is effective and durable. An appropriate use of space maintainer is advocated to hold the space until the eruption of permanent teeth. This case report describes the various changing trends in use of space maintainers: conventional band and loop, prefabricated band with custom made loop and glass fibre reinforced composite resins as space maintainers. PMID:24298544

Setia, Vikas; Pandit, Inder Kumar; Srivastava, Nikhil; Gugnani, Neeraj; Sekhon, Harveen Kaur



Designing for Maintainability and System Availability  

NASA Technical Reports Server (NTRS)

The final goal for a delivered system (whether a car, aircraft, avionics box or computer) should be its availability to operate and perform its intended function over its expected design life. Hence, in designing a system, we cannot think in terms of delivering the system and just walking away. The system supplier needs to provide support throughout the operating life of the product. Here, supportability requires an effective combination of reliability, maintainability, logistics and operations engineering (as well as safety engineering) to have a system that is available for its intended use throughout its designated mission lifetime. Maintainability is a key driving element in the effective support and upkeep of the system as well as providing the ability to modify and upgrade the system throughout its lifetime. This paper then, will concentrate on maintainability and its integration into the system engineering and design process. The topics to be covered include elements of maintainability, the total cost of ownership, how system availability, maintenance and logistics costs and spare parts cost effect the overall program costs. System analysis and maintainability will show how maintainability fits into the overall systems approach to project development. Maintainability processes and documents will focus on how maintainability is to be performed and what documents are typically generated for a large scale program. Maintainability analysis shows how trade-offs can be performed for various alternative components. The conclusions summarize the paper and are followed by specific problems for hands-on training.

Lalli, Vincent R.; Packard, Michael H.



Improving the stability of cardiac mechanical simulations.  


In the field of cardiac modelling, the mechanical action of the heart is often simulated using finite element methods. These simulations are becoming increasingly challenging as the computational domain is customized to a patient's anatomy, within which large heterogeneous tension gradients are generated via biophysical cell models which drive simulations of the cardiac pump cycle. The convergence of nonlinear solvers in simulations of large deformation mechanics depends on many factors. When extreme stress or irregular deformations are modelled, commonly used numerical methods can often fail to find a solution, which can prevent investigation of interesting parameter variations or use of models in a clinical context with high standards for robustness. This article outlines a novel numerical method that is straightforward to implement and which significantly improves the stability of these simulations. The method involves adding a compressibility penalty to the standard incompressible formulation of large deformation mechanics. We compare the method's performance when used with both a direct discretization of the equations for incompressible solid mechanics, as well as the formulation based on an isochoric/deviatoric split of the deformation gradient. The addition of this penalty decreases the tendency for solutions to deviate from the incompressibility constraint, and significantly improves the ability of the Newton solver to find a solution. Additionally our method maintains the expected order of convergence under mesh refinement, has nearly identical solutions for the pressure-volume relations, and stabilizes the solver to allow challenging simulations of both diastolic and systolic function on personalized patient geometries. PMID:25474804

Land, Sander; Niederer, Steven A; Lamata, Pablo; Smith, Nicolas P



Registration-based segmentation of murine 4D cardiac micro-CT data using symmetric normalization  

PubMed Central

Micro-CT can play an important role in preclinical studies of cardiovascular disease because of its high spatial and temporal resolution. Quantitative analysis of 4D cardiac images requires segmentation of the cardiac chambers at each time point, an extremely time consuming process if done manually. To improve throughput this study proposes a pipeline for registration-based segmentation and functional analysis of 4D cardiac micro-CT data in the mouse. Following optimization and validation using simulations, the pipeline was applied to in vivo cardiac micro-CT data corresponding to 10 cardiac phases acquired in C57BL/6 mice (n = 5). After edge-preserving smoothing with a novel adaptation of 4D bilateral filtration, one phase within each cardiac sequence was manually segmented. Deformable registration was used to propagate these labels to all other cardiac phases for segmentation. The volumes of each cardiac chamber were calculated and used to derive stroke volume, ejection fraction, cardiac output, and cardiac index. Dice coefficients and volume accuracies were used to compare manual segmentations of two additional phases with their corresponding propagated labels. Both measures were, on average, >0.90 for the left ventricle and >0.80 for the myocardium, the right ventricle, and the right atrium, consistent with trends in inter- and intra-segmenter variability. Segmentation of the left atrium was less reliable. On average, the functional metrics of interest were underestimated by 6.76% or more due to systematic label propagation errors around atrioventricular valves; however, execution of the pipeline was 80% faster than performing analogous manual segmentation of each phase. PMID:22971564

Clark, Darin; Badea, Alexandra; Liu, Yilin; Johnson, G. Allan; Badea, Cristian T.



Airway management in cardiac arrest—comparison of the laryngeal tube, tracheal intubation and bag-valve mask ventilation in emergency medical training  

Microsoft Academic Search

Tracheal intubation (ETI) is considered the method of choice for securing the airway and for providing effective ventilation during cardiac arrest. However, ETI requires skills which are difficult to maintain especially if practised infrequently. The laryngeal tube (LT) has been successfully tested and used in anaesthesia and in simulated cardiac arrest in manikins. To compare the initiation and success of

J. Kurola; H. Harve; T. Kettunen; J.-P. Laakso; J. Gorski; H. Paakkonen; T. Silfvast



X-ray source assembly having enhanced output stability, and fluid stream analysis applications thereof  


An x-ray source assembly and method of operation are provided having enhanced output stability. The assembly includes an anode having a source spot upon which electrons impinge and a control system for controlling position of the anode source spot relative to an output structure. The control system can maintain the anode source spot location relative to the output structure notwithstanding a change in one or more operating conditions of the x-ray source assembly. One aspect of the disclosed invention is most amenable to the analysis of sulfur in petroleum-based fuels.

Radley, Ian (Glenmont, NY); Bievenue, Thomas J. (Delmar, NY); Burdett, John H. (Charlton, NY); Gallagher, Brian W. (Guilderland, NY); Shakshober, Stuart M. (Hudson, NY); Chen, Zewu (Schenectady, NY); Moore, Michael D. (Alplaus, NY)



[Tolerance of +Gz accelerations in chronic compensated cardiac muscle disease].  


The functional potentialities of the cardiovascular system were investigated during an exposure of people with compensated chronic diseases of the cardiac muscle to acceleration (+Gz). The test subjects were exposed to acceleration of 3 and 5 g for 30 sec with an interval of 5 min. The parameters of hemodynamics, ECG and visual perception were recorded. The systolic blood volume, cardiac output and specific peripheral resistance were derived from the Bremser-Ranke formula. Seventy one subjects with heart diseases and 23 healthy subjects were examined. The subjects with myocardiodystrophy and myocarditic cardiosclerosis (12+/-16) showed a reduced tolerance to accelerations. During an exposure the subjects with atherosclerotic cardiosclerosis showed a higher pressure in vessels of ear conch than the healthy subjects. The myocardiodystrophic subjects frequently (20%) exhibited an inversion of electrocardiographic T2. The subjects with heart diseases (27-33%) showed extrasystolic disturbances. The results may be used in medical expertise of pilots. PMID:1214489

Suvorov, P M; Bykova, Iu I



Compensatory mechanisms for cardiac dysfunction in myocardial infarction.  


Loss of contractile myocardial tissue by myocardial infarction would result in depressed cardiac output if compensatory mechanisms would not be operative. Frank-Straub-Starling-mechanism and increased heart rate and contractility due to sympathetic stimulation are unlikely to chronically compensate for cardiac dysfunction. Structural left ventricular dilatation may be compensatory, but results in increased wall stress and, ultimately, in progressive dilatation and heart failure. In patients with myocardial infarction, we have shown left-ventricular dilatation in dependence of infarct size and time after infarction. Dilatation is compensatory first and normalizes stroke volume. However, left ventricular dilatation progresses without further hemodynamic profit and, thus, may participate in development of heart failure. PMID:1838246

Ertl, G; Gaudron, P; Eilles, C; Schorb, W; Kochsiek, K



Metoclopramide-induced cardiac arrest  

PubMed Central

The authors report a case of cardiac arrest in a patient receiving intravenous (IV) metoclopramide and review the pertinent literature. A 62-year-old morbidly obese female admitted for a gastric sleeve procedure, developed cardiac arrest within one minute of receiving metoclopramide 10 mg via slow intravenous (IV) injection. Bradycardia at 4 beats/min immediately appeared, progressing rapidly to asystole. Chest compressions restored vital function. Electrocardiogram (ECG) revealed ST depression indicative of myocardial injury. Following intubation, the patient was transferred to the intensive care unit. Various cardiac dysrrhythmias including supraventricular tachycardia (SVT) associated with hypertension and atrial fibrillation occurred. Following IV esmolol and metoprolol, the patient reverted to normal sinus rhythm. Repeat ECGs revealed ST depression resolution without pre-admission changes. Metoclopramide is a non-specific dopamine receptor antagonist. Seven cases of cardiac arrest and one of sinus arrest with metoclopramide were found in the literature. The metoclopramide prescribing information does not list precautions or adverse drug reactions (ADRs) related to cardiac arrest. The reaction is not dose related but may relate to the IV administration route. Coronary artery disease was the sole risk factor identified. According to Naranjo, the association was possible. Other reports of cardiac arrest, severe bradycardia, and SVT were reviewed. In one case, five separate IV doses of 10 mg metoclopramide were immediately followed by asystole repeatedly. The mechanism(s) underlying metoclopramide's cardiac arrest-inducing effects is unknown. Structural similarities to procainamide may play a role. In view of eight previous cases of cardiac arrest from metoclopramide having been reported, further elucidation of this ADR and patient monitoring is needed. Our report should alert clinicians to monitor patients and remain diligent in surveillance and reporting of bradydysrrhythmias and cardiac arrest in patients receiving metoclopramide. PMID:24765383

Rumore, Martha M.; Lee, Spencer Evan; Wang, Steven; Farmer, Brenna



Peripartum cardiac failure  

PubMed Central

Peripartum cardiac failure (PPCF) is common in Zaria, in northern Nigeria, but has not been described elsewhere in Nigeria except in Ibadan. The geographic origin of a series of 224 patients with PPCF was studied in Zaria, and a survey of the syndrome as seen in hospitals and by physicians in the northern states of Nigeria was carried out; information was also gathered from medical and nursing students from various tribal groups in the same area. It was found that PPCF is only common in the areas of Hausa majority, mostly around Zaria and Malumfashi, where the postpartum practices of taking hot baths, lying on a hot bed, and taking large amounts of kanwa (a lake-salt rich in sodium) are pursued with great vigour. These customs may impose a critical load on a vulnerable myocardium, and it seems that tribe and tradition could well explain the high incidence of PPCF around Zaria. PMID:4549486

Davidson, N. McD.; Trevitt, Lorna; Parry, E. H. O.



Metrics for assessing a software system's maintainability  

Microsoft Academic Search

It is noted that the factors of software that determine or influence maintainability can be organized into a hierarchical structure of measurable attributes. For each of these attributes the authors show a metric definition consistent with the published definitions of the software characteristic being measured. The result is a tree structure of maintainability metrics which can be used for purposes

Paul Oman; Jack Hagemeister



Constructing and testing software maintainability assessment models  

Microsoft Academic Search

Software metrics are used to quantitatively characterize the essential features of software. The paper investigates the use of metrics in assessing software maintainability by presenting and comparing seven software maintainability assessment models. Eight software systems were used for initial construction and calibrating the automated assessment models, and an additional six software systems were used for testing the results. A comparison

Fang Zhuo; Bruce Lowther; Paul Oman; Jack Hagemeister



Cell Reports AKAP-Anchored PKA Maintains  

E-print Network

Cell Reports Article AKAP-Anchored PKA Maintains Neuronal L-type Calcium Channel Activity and NFAT to the channel by A-kinase anchoring protein 79/150 (AKAP79/150). AKAP79/150 anchoring of CaN also promotes LTCC report here that the basal activity of AKAP79/150-anchored PKA maintains neuronal LTCC coupling to Ca

Scott, John D.


Determining system maintainability as a probability  

Microsoft Academic Search

Maintainability has often been defined in principle as the probability that a system or component can be repaired in a specific time given that it is in a failed state, but presented in practice in terms of mean-time-to-repair. In this paper, formulas are developed for maintainability as a probability, analogous to those for reliability and availability. This formulation is expressed

R. E. Wright; C. L. Atwood



Cardiac action potential imaging  

NASA Astrophysics Data System (ADS)

Action potentials in cardiac myocytes have durations in the order of magnitude of 100 milliseconds. In biomedical investigations the documentation of the occurrence of action potentials is often not sufficient, but a recording of the shape of an action potential allows a functional estimation of several molecular players. Therefore a temporal resolution of around 500 images per second is compulsory. In the past such measurements have been performed with photometric approaches limiting the measurement to one cell at a time. In contrast, imaging allows reading out several cells at a time with additional spatial information. Recent developments in camera technologies allow the acquisition with the required speed and sensitivity. We performed action potential imaging on isolated adult cardiomyocytes of guinea pigs utilizing the fluorescent membrane potential sensor di-8-ANEPPS and latest electron-multiplication CCD as well as scientific CMOS cameras of several manufacturers. Furthermore, we characterized the signal to noise ratio of action potential signals of varying sets of cameras, dye concentrations and objective lenses. We ensured that di-8-ANEPPS itself did not alter action potentials by avoiding concentrations above 5 ?M. Based on these results we can conclude that imaging is a reliable method to read out action potentials. Compared to conventional current-clamp experiments, this optical approach allows a much higher throughput and due to its contact free concept leaving the cell to a much higher degree undisturbed. Action potential imaging based on isolated adult cardiomyocytes can be utilized in pharmacological cardiac safety screens bearing numerous advantages over approaches based on heterologous expression of hERG channels in cell lines.

Tian, Qinghai; Lipp, Peter; Kaestner, Lars



Normal cardiac function in mice with supraphysiological cardiac creatine levels  

PubMed Central

Creatine and phosphocreatine levels are decreased in heart failure, and reductions in myocellular phosphocreatine levels predict the severity of the disease and portend adverse outcomes. Previous studies of transgenic mouse models with increased creatine content higher than two times baseline showed the development of heart failure and shortened lifespan. Given phosphocreatine's role in buffering ATP content, we tested the hypothesis whether elevated cardiac creatine content would alter cardiac function under normal physiological conditions. Here, we report the creation of transgenic mice that overexpress the human creatine transporter (CrT) in cardiac muscle under the control of the ?-myosin heavy chain promoter. Cardiac transgene expression was quantified by qRT-PCR, and human CrT protein expression was documented on Western blots and immunohistochemistry using a specific anti-CrT antibody. High-energy phosphate metabolites and cardiac function were measured in transgenic animals and compared with age-matched, wild-type controls. Adult transgenic animals showed increases of 5.7- and 4.7-fold in the content of creatine and free ADP, respectively. Phosphocreatine and ATP levels were two times as high in young transgenic animals but declined to control levels by the time the animals reached 8 wk of age. Transgenic mice appeared to be healthy and had normal life spans. Cardiac morphometry, conscious echocardiography, and pressure-volume loop studies demonstrated mild hypertrophy but normal function. Based on our characterization of the human CrT protein expression, creatine and phosphocreatine content, and cardiac morphometry and function, these transgenic mice provide an in vivo model for examining the therapeutic value of elevated creatine content for cardiac pathologies. PMID:24271489

Hernandez, Alejandro; Nienaber, Jeffrey; Mishra, Rajashree; Pinilla, Miguel; Burchette, James; Mao, Lan; Rockman, Howard A.; Jacobs, Danny O.



Cardiac catheterization is underutilized after in-hospital cardiac arrest  

PubMed Central

Background Indications for immediate cardiac catheterization in cardiac arrest survivors without ST elevation myocardial infarction (STEMI) are uncertain as electrocardiographic and clinical criteria may be challenging to interpret in this population. We sought to evaluate rates of early catheterization after in-hospital ventricular fibrillation (VF) arrest and the association with survival. Methods Using a billing database we retrospectively identified cases with an ICD-9 code of cardiac arrest (427.5) or VF (427.41). Discharge summaries were reviewed to identify in-hospital VF arrests. Rates of catheterization on the day of arrest were determined by identifying billing charges. Unadjusted analyses were performed using chi square, and adjusted analyses were performed using logistic regression. Results 110 in-hospital VF arrest survivors were included in the analysis. Cardiac catheterization was performed immediately or within one day of arrest in 27% (30/110) of patients and of these patients, 57% (17/30) successfully received percutaneous coronary intervention. Of those who received cardiac catheterization the indication for the procedure was STEMI or new left bundle branch block (LBBB) in 43% (13/30). Therefore, in the absence of standard ECG data suggesting acute myocardial infarction, 57% (17/30) received angiography. Patients receiving cardiac catheterization were more likely to survive than those who did not receive catheterization (80% vs. 54%, p<.05). Conclusion In patients receiving cardiac catheterization, more than half received this procedure for indications other than STEMI or new LBBB. Cardiac catheterization was associated with improved survival. Future recommendations need to be established to guide clinicians on which arrest survivors might benefit from immediate catheterization. PMID:18951683

Merchant, Raina M.; Abella, Benjamin S.; Khan, Monica; Huang, Kuang-Ning; Beiser, David B.; Neumar, Robert W.; Carr, Brendan G.; Becker, Lance B.; Vanden Hoek, Terry L.



Normal cardiac function in mice with supraphysiological cardiac creatine levels.  


Creatine and phosphocreatine levels are decreased in heart failure, and reductions in myocellular phosphocreatine levels predict the severity of the disease and portend adverse outcomes. Previous studies of transgenic mouse models with increased creatine content higher than two times baseline showed the development of heart failure and shortened lifespan. Given phosphocreatine's role in buffering ATP content, we tested the hypothesis whether elevated cardiac creatine content would alter cardiac function under normal physiological conditions. Here, we report the creation of transgenic mice that overexpress the human creatine transporter (CrT) in cardiac muscle under the control of the ?-myosin heavy chain promoter. Cardiac transgene expression was quantified by qRT-PCR, and human CrT protein expression was documented on Western blots and immunohistochemistry using a specific anti-CrT antibody. High-energy phosphate metabolites and cardiac function were measured in transgenic animals and compared with age-matched, wild-type controls. Adult transgenic animals showed increases of 5.7- and 4.7-fold in the content of creatine and free ADP, respectively. Phosphocreatine and ATP levels were two times as high in young transgenic animals but declined to control levels by the time the animals reached 8 wk of age. Transgenic mice appeared to be healthy and had normal life spans. Cardiac morphometry, conscious echocardiography, and pressure-volume loop studies demonstrated mild hypertrophy but normal function. Based on our characterization of the human CrT protein expression, creatine and phosphocreatine content, and cardiac morphometry and function, these transgenic mice provide an in vivo model for examining the therapeutic value of elevated creatine content for cardiac pathologies. PMID:24271489

Santacruz, Lucia; Hernandez, Alejandro; Nienaber, Jeffrey; Mishra, Rajashree; Pinilla, Miguel; Burchette, James; Mao, Lan; Rockman, Howard A; Jacobs, Danny O



Assessment of Diastolic Function by Cardiac MRI  

Microsoft Academic Search

Cardiac magnetic resonance imaging (MRI) techniques continue to change rapidly, and cardiac MRI is developing as an alternative\\u000a noninvasive technique having the unique potential of three-dimensional function analysis with great accuracy and reproducibility.\\u000a Advances in rapid cardiac MRI technology are making real-time imaging possible at approaching echocardiographic frame rates.\\u000a Together with the increasing availability of cardiac MRI machines, cardiac MRI

Bernard P. Paelinck; Hildo J. Lamb


Fibroblasts in post-infarction inflammation and cardiac repair.  


Fibroblasts are the predominant cell type in the cardiac interstitium. As the main matrix-producing cells in the adult mammalian heart, fibroblasts maintain the integrity of the extracellular matrix network, thus preserving geometry and function. Following myocardial infarction fibroblasts undergo dynamic phenotypic alterations and direct the reparative response. Due to their strategic location, cardiac fibroblasts serve as sentinel cells that sense injury and activate the inflammasome secreting cytokines and chemokines. During the proliferative phase of healing, infarct fibroblasts undergo myofibroblast transdifferentiation forming stress fibers and expressing contractile proteins (such as ?-smooth muscle actin). Mechanical stress, transforming growth factor (TGF)-?/Smad3 signaling and alterations in the composition of the extracellular matrix induce acquisition of the myofibroblast phenotype. In the highly cellular and growth factor-rich environment of the infarct, activated myofibroblasts produce matrix proteins, proteases and their inhibitors regulating matrix metabolism. As the infarct matures, "stress-shielding" of myofibroblasts by the cross-linked matrix and growth factor withdrawal may induce quiescence and ultimately cause apoptotic death. Because of their critical role in post-infarction cardiac remodeling, fibroblasts are promising therapeutic targets following myocardial infarction. However, the complexity of fibroblast functions and the pathophysiologic heterogeneity of post-infarction remodeling in the clinical context discourage oversimplified approaches in clinical translation. This article is part of a Special Issue entitled: Cardiomyocyte Biology: Cardiac Pathways of Differentiation, Metabolism and Contraction. PMID:22982064

Chen, Wei; Frangogiannis, Nikolaos G



PREVIMER : Meteorological inputs and outputs  

NASA Astrophysics Data System (ADS)

PREVIMER is a pre-operational system aiming to provide a wide range of users, from private individuals to professionals, with short-term forecasts about the coastal environment along the French coastlines bordering the English Channel, the Atlantic Ocean, and the Mediterranean Sea. Observation data and digital modelling tools first provide 48-hour (probably 96-hour by summer 2009) forecasts of sea states, currents, sea water levels and temperatures. The follow-up of an increasing number of biological parameters will, in time, complete this overview of coastal environment. Working in partnership with the French Naval Hydrographic and Oceanographic Service (Service Hydrographique et Océanographique de la Marine, SHOM), the French National Weather Service (Météo-France), the French public science and technology research institute (Institut de Recherche pour le Développement, IRD), the European Institute of Marine Studies (Institut Universitaire Européen de la Mer, IUEM) and many others, IFREMER (the French public institute fo marine research) is supplying the technologies needed to ensure this pertinent information, available daily on Internet at, and stored at the Operational Coastal Oceanographic Data Centre. Since 2006, PREVIMER publishes the results of demonstrators assigned to limited geographic areas and to specific applications. This system remains experimental. The following topics are covered : Hydrodynamic circulation, sea states, follow-up of passive tracers, conservative or non-conservative (specifically of microbiological origin), biogeochemical state, primary production. Lastly, PREVIMER provides researchers and R&D departments with modelling tools and access to the database, in which the observation data and the modelling results are stored, to undertake environmental studies on new sites. The communication will focus on meteorological inputs to and outputs from PREVIMER. It will draw the lessons from almost 3 years during which the system has been operational almost everyday and propose perspectives in terms of technical improvements and possible business models.

Ravenel, H.; Lecornu, F.; Kerléguer, L.



Image guidance in cardiac electrophysiology  

E-print Network

Cardiac arrhythmias are characterized by a disruption or abnormal conduction of electrical signals within the heart. Treatment of arrhythmias has dramatically evolved over the past half-century, and today, minimally-invasive ...

Malchano, Zachary John



Pulmonary Hypertension in Cardiac Surgery  

PubMed Central

Pulmonary hypertension is an important prognostic factor in cardiac surgery associated with increased morbidity and mortality. With the aging population and the associated increase severity of illness, the prevalence of pulmonary hypertension in cardiac surgical patients will increase. In this review, the definition of pulmonary hypertension, the mechanisms and its relationship to right ventricular dysfunction will be presented. Finally, pharmacological and non-pharmacological therapeutic and preventive approaches will be presented. PMID:21286273

Denault, André; Deschamps, Alain; Tardif, Jean-Claude; Lambert, Jean; Perrault, Louis



Can cardiac surgery cause hypopituitarism?  

Microsoft Academic Search

Apoplexy of pituitary adenomas with subsequent hypopituitarism is a rare but well recognized complication following cardiac\\u000a surgery. The nature of cardiac on-pump surgery provides a risk of damage to the pituitary because the vascular supply of the\\u000a pituitary is not included in the cerebral autoregulation. Thus, pituitary tissue may exhibit an increased susceptibility to\\u000a hypoperfusion, ischemia or intraoperative embolism. After

Flverly Francis; Ines Burger; Eva Maria Poll; Andrea Reineke; Christian J. Strasburger; Guido Dohmen; Joachim M. Gilsbach; Ilonka Kreitschmann-Andermahr


Cardiac manifestations in systemic sclerosis  

PubMed Central

Primary cardiac involvement, which develops as a direct consequence of systemic sclerosis (SSc), may manifest as myocardial damage, fibrosis of the conduction system, pericardial and, less frequently, as valvular disease. In addition, cardiac complications in SSc may develop as a secondary phenomenon due to pulmonary arterial hypertension and kidney pathology. The prevalence of primary cardiac involvement in SSc is variable and difficult to determine because of the diversity of cardiac manifestations, the presence of subclinical periods, the type of diagnostic tools applied, and the diversity of patient populations. When clinically manifested, cardiac involvement is thought to be an important prognostic factor. Profound microvascular disease is a pathognomonic feature of SSc, as both vasospasm and structural alterations are present. Such alterations are thought to predict macrovascular atherosclerosis over time. There are contradictory reports regarding the prevalence of atherosclerosis in SSc. According to some authors, the prevalence of atherosclerosis of the large epicardial coronary arteries is similar to that of the general population, in contrast with other rheumatic diseases such as rheumatoid arthritis and systemic lupus erythematosus. However, the level of inflammation in SSc is inferior. Thus, the atherosclerotic process may not be as aggressive and not easily detectable in smaller studies. Echocardiography (especially tissue Doppler imaging), single-photon emission computed tomography, magnetic resonance imaging and cardiac computed tomography are sensitive techniques for earlier detection of both structural and functional scleroderma-related cardiac pathologies. Screening for subclinical cardiac involvement via modern, sensitive tools provides an opportunity for early diagnosis and treatment, which is of crucial importance for a positive outcome. PMID:25276300

Lambova, Sevdalina



Sudden cardiac death in Athletes  

Microsoft Academic Search

The impact of sudden cardiac death (SCD) in athletes has been highlighted by increasing media coverage, as well as medical\\u000a and lay awareness of the entities associated with SCD. Common etiologies include cardiac abnormalities such as hypertrophic\\u000a cardiomyopathy (HCM), arrhythmogenic right ventricular dysplasia\\/cardiomyopathy (ARVD), and coronary artery anomalies, each\\u000a with varying geographic incidence. New recommendations regarding noninvasive preparticipation screening have

Olaf Hedrich; Mark Estes; Mark S. Link



Drosophila Models of Cardiac Disease  

PubMed Central

The fruit fly Drosophila melanogaster has emerged as a useful model for cardiac diseases, both developmental abnormalities and adult functional impairment. Using the tools of both classical and molecular genetics, the study of the developing fly heart has been instrumental in identifying the major signaling events of cardiac field formation, cardiomyocyte specification, and the formation of the functioning heart tube. The larval stage of fly cardiac development has become an important model system for testing isolated preparations of living hearts for the effects of biological and pharmacological compounds on cardiac activity. Meanwhile, the recent development of effective techniques to study adult cardiac performance in the fly has opened new uses for the Drosophila model system. The fly system is now being used to study long-term alterations in adult performance caused by factors such as diet, exercise, and normal aging. The fly is a unique and valuable system for the study of such complex, long-term interactions, as it is the only invertebrate genetic model system with a working heart developmentally homologous to the vertebrate heart. Thus, the fly model combines the advantages of invertebrate genetics (such as large populations, facile molecular genetic techniques, and short lifespan) with physiological measurement techniques that allow meaningful comparisons with data from vertebrate model systems. As such, the fly model is well situated to make important contributions to the understanding of complicated interactions between environmental factors and genetics in the long-term regulation of cardiac performance. PMID:21377627

Piazza, Nicole; Wessells, R.J.



Output Control Using Feedforward And Cascade Controllers  

NASA Technical Reports Server (NTRS)

Report presents theoretical study of open-loop control elements in single-input, single-output linear system. Focus on output-control (servomechanism) problem, in which objective is to find control scheme that causes output to track certain command inputs and to reject certain disturbance inputs in steady state. Report closes with brief discussion of characteristics and relative merits of feedforward, cascade, and feedback controllers and combinations thereof.

Seraji, Homayoun



The cardiac output response and the oxygen cost of increased work of breathing  

E-print Network

in Table 3. A significant difference was found in the MANOVA analysis Table 3. Results of hyperventilation VF VT FB PMI Work Vo2 RM QRM Effic HR SV 22. 0 1. 07 22. 1 -11. 7 2. 89 ? - ? 66. 2 78. 8 0. 9 0. 03 0. 3 0. 4 0. 25 - - ? 5. 4 9. 0 44. 5 2. 03..., and conditioned with a DC amplifier (Grass Instruments 7 P122D). Inspiratory and expiratory volumes were / stoppeo v' sark o( f /aaf') e)' ~ SRI$%I I R~HRRPI I ? ot sark sr) )n v ~ arkerp( 1 ) Veal ksf' l ) 1 ) pelts V(1 i 0 00000 s 25 0000 s 5 00 s...

Krause, Kevin Michael



The measurement of cardiac output and related cardiovascular parameters in the Javelina (Tayassu tajacu)  

E-print Network

Cardiovascular Recordings Obtained from the Javelina. 30 CHAPTER I INTRODUCTION There is a continuing search in the scientific community for new animal species to serve as models for study of the normal functions and disease processes of the human body.... The mean, standard de~iation (S. D. ) and standard error of the mean (S. E. ) were determined for each cardiovascular parameter measured. S'Khohn-Hite Band Pass Filter, Model 330N, Cambridge, Mass. 18 CHAPTER IV RESULTS The 5 javelinas made...

Schilling, Paul Wesley



Continuous thermodilution cardiac output: clinical validation against a reference technique of known accuracy  

Microsoft Academic Search

Objective: To evaluate the accuracy and precision of continuous thermodilution (CCO) by using a validated bolus thermodilution (BCO)\\u000a reference technique as criterion standard. Design: Under circulatory steady state conditions, a CCO system (Vigilance, software versions 4.35 and 4.39) was validated with\\u000a regard to CCO as well as iced and room temperature BCO. Setting: Intensive care unit at a university hospital.

E. R. Schmid; D. Schmidlin; M. Tornic; B. Seifert




EPA Science Inventory

The hepatotoxicity of carbon tetrachloride and chloroform in rats is increased when exposure occurs during the dark part of the lighting cycle when rats are more active. ats are used as surrogates for humans in toxicology, but have opposite activity patterns, with humans being ac...


Changes in cardiac output and tibial artery flow during and after progressive LBNP  

NASA Technical Reports Server (NTRS)

A 3.0 MHz Pulsed Doppler velocity meter (PD) was used to determine blood velocities in the ascending aorta from the suprasternal notch before, during and after progressive 5 min stages of lower body negative pressure (LBNP) in 7 subjects. Changes in stroke volume were calculated from the systolic velocity integrals. A unique 20 MHz PD was used to estimate bloodflow in the posterior tibial artery. With -20 torr mean stroke volume fell 11% and then continued to decline by 48% before LBNP was terminated. Mean tibial flow fell progressively with LBNP stress, due to an increase in reverse flow component and a reduction in peak forward flow and diameter. Stroke volume increased and heart rate fell dramatically during the first 15 sec of recovery. The LBNP was terminated early in 2 subjects because of vasovagal symptons (V). During V the stroke volume rose 86% which more than compensated for the drop in heart rate. This implies that V is accompanied by a paradoxical increase in venous return and that the reduction in HR is the primary cardiovascular event. During the first 15 sec of recovery these 2 subjects had a distinctive marked rise to heart rate reminiscent of the Bainbridge reflex.



Pulmonary tissue volume, cardiac output, and diffusing capacity in sustained microgravity  

NASA Technical Reports Server (NTRS)

In microgravity (microG) humans have marked changes in body fluids, with a combination of an overall fluid loss and a redistribution of fluids in the cranial direction. We investigated whether interstitial pulmonary edema develops as a result of a headward fluid shift or whether pulmonary tissue fluid volume is reduced as a result of the overall loss of body fluid. We measured pulmonary tissue volume (Vti), capillary blood flow, and diffusing capacity in four subjects before, during, and after 10 days of exposure to microG during spaceflight. Measurements were made by rebreathing a gas mixture containing small amounts of acetylene, carbon monoxide, and argon. Measurements made early in flight in two subjects showed no change in Vti despite large increases in stroke volume (40%) and diffusing capacity (13%) consistent with increased pulmonary capillary blood volume. Late in-flight measurements in four subjects showed a 25% reduction in Vti compared with preflight controls (P < 0.001). There was a concomittant reduction in stroke volume, to the extent that it was no longer significantly different from preflight control. Diffusing capacity remained elevated (11%; P < 0.05) late in flight. These findings suggest that, despite increased pulmonary perfusion and pulmonary capillary blood volume, interstitial pulmonary edema does not result from exposure to microG.

Verbanck, S.; Larsson, H.; Linnarsson, D.; Prisk, G. K.; West, J. B.; Paiva, M.



Fick's Principle and the Estimation of Cardiac Output and Pressure Resistance Relationships Gen Bio 2  

E-print Network

and expired gases) = 0.25 L O2 min-1 Heart rate = 60 beats / min 1? In the right atrium? ­ applied anatomy 2. Find this person's right circulation of the same things used in question 4 ­ and a good lesson in the anatomy

Prestwich, Ken


Measurement of exercise cardiac output by thoracic impedance in healthy children  

Microsoft Academic Search

The purpose of this study was to track changes in stroke volume during exercise by impedance cardiography in order to validate the method, and to obtain such data in a large number of healthy children for reference purposes. One hundred and fifteen healthy children (aged 7–19 years) performed progressive exercise to voluntary exhaustion with work increments every minute on a cycle

Paul T. Pianosi



Cointegration of output, capital, labor, and energy  

NASA Astrophysics Data System (ADS)

Cointegration analysis is applied to the linear combinations of the time series of (the logarithms of) output, capital, labor, and energy for Germany, Japan, and the USA since 1960. The computed cointegration vectors represent the output elasticities of the aggregate energy-dependent Cobb-Douglas function. The output elasticities give the economic weights of the production factors capital, labor, and energy. We find that they are for labor much smaller and for energy much larger than the cost shares of these factors. In standard economic theory output elasticities equal cost shares. Our heterodox findings support results obtained with LINEX production functions.

Stresing, R.; Lindenberger, D.; Kã¼mmel, R.



Maintaining Financial Stability in a Global Economy  

NSDL National Science Digital Library

The Federal Reserve Bank of Kansas City has made available the papers presented at the "Maintaining Financial Stability in a Global Economy" symposium. The aim of the symposium is to explore "options for public authorities in adapting policies to keep financial systems safe and efficient, and to discuss response mechanisms to financial crises." The papers presented here look at the causes of financial instability, why policymakers should be concerned about financial instability, lessons from recent financial crises, and policies for maintaining financial stability.



Maintaining competency for float nursing staff.  


Orienting staff to multiple areas is challenging, as is maintaining multiple competencies, which might be used infrequently. Creating a strategy to regularly assess needed competencies to maintain a highly skilled pool of nurses, prepared to float to multiple areas, is critical to supporting flexible staffing. A plan for how to achieve this complex analysis is described and can be translated to other complex environments. PMID:25036084

Overman, Kimberly; Hauver, Jeni; McKay, Jennifer; Aucoin, Julia



Clinical Trial of Induced Hypothermia in Comatose Survivors of Out-of-Hospital Cardiac Arrest  

Microsoft Academic Search

Study objective: To examine the effects of moderate hypothermia (33° C), induced by surface cooling in the ED and maintained for 12 hours in the ICU, on patients with anoxic brain injury after out-of-hospital cardiac arrest. Methods: We conducted the study in a teaching hospital in Melbourne, Victoria, Australia. Participants were 22 adults who remained unconscious after return of spontaneous

Stephen A Bernard; Bruce Mac C Jones; Malcolm K Horne




EPA Science Inventory

The contribution of small mammals to nitrogen cycling is poorly understood, but it could have reverberations back to the producer community by maintaining or perhaps magnifying nitrogen availability. Our objective was to model nitrogen outputs (deposition of feces and urine) of ...


Cardiac achalasia in childhood  

PubMed Central

Cardiac achalasia is a disorder not unknown in the paediatric age-group and may occur even in the neonatal period. This disorder should, therefore, be considered in all cases presenting with persistent vomiting, as well as in those with chronic respiratory disease in whom more common causes have been excluded. It is almost universally accepted that the disorder results from a disturbed function of ganglion cells in the distal oesophagus, as the disease has been reproduced in laboratory animals by denervation of the distal oesophagus. The exact pathogenesis of this degenerative change is not well understood. However, in at least some of the cases congenital absence of the ganglion cells may be responsible for this functional disturbance. This is inferred from the fact that the disease may be found in association with Hirschsprung disease, in which there is a congenital absence of ganglion cells in the terminal colon. Moreover, the occurrence of the disease in the neonatal period itself favours a congenital lesion. Surgery was preferred to other forms of treatment in the paediatric age-group in view of the reported equivocal response to mechanical dilatation and pre-disposition of children to respiratory complications. The results of surgery were satisfactory. ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 5Fig. 6Fig. 7Fig. 8 PMID:5790932

Singh, Harjit; Sethi, R. S.; Gupta, H. L.; Khetarpal, S. K.



Perlecan Maintains the Integrity of Cartilage and Some Basement Membranes  

PubMed Central

Perlecan is a heparan sulfate proteoglycan that is expressed in all basement membranes (BMs), in cartilage, and several other mesenchymal tissues during development. Perlecan binds growth factors and interacts with various extracellular matrix proteins and cell adhesion molecules. Homozygous mice with a null mutation in the perlecan gene exhibit normal formation of BMs. However, BMs deteriorate in regions with increased mechanical stress such as the contracting myocardium and the expanding brain vesicles showing that perlecan is crucial for maintaining BM integrity. As a consequence, small clefts are formed in the cardiac muscle leading to blood leakage into the pericardial cavity and an arrest of heart function. The defects in the BM separating the brain from the adjacent mesenchyme caused invasion of brain tissue into the overlaying ectoderm leading to abnormal expansion of neuroepithelium, neuronal ectopias, and exencephaly. Finally, homozygotes developed a severe defect in cartilage, a tissue that lacks BMs. The chondrodysplasia is characterized by a reduction of the fibrillar collagen network, shortened collagen fibers, and elevated expression of cartilage extracellular matrix genes, suggesting that perlecan protects cartilage extracellular matrix from degradation. PMID:10579729

Costell, Mercedes; Gustafsson, Erika; Aszódi, Attila; Mörgelin, Matthias; Bloch, Wilhelm; Hunziker, Ernst; Addicks, Klaus; Timpl, Rupert; Fässler, Reinhard



Three-phase uninterruptible power supply maintaining reserve energy sources in idling condition with unbalanced loads  

SciTech Connect

A control arrangement for a three-phase, uninterruptible power supply generates timing signals to drive the static switches of inverters located in each phase. This control arrangement precisely controls the phase differences of the inverter signals with relation to each other so that while the overall three-phase power supplied by the inverters is nulled, power circulation through the inverters compensates for unbalanced output loads thereby maintaining balanced phase angles between the output voltage and a balanced input impedance at the input of the power supply.

Boettcher, C.W.; Hamilton, B.H.; Zweig, W.L.



Influence of inorganic phosphate and energy state on force in skinned cardiac muscle from freshwater turtle and rainbow trout  

Microsoft Academic Search

Inorganic phosphate, which increases in the hypoxic cardiac cell, depresses force development. The cardiac muscle of freshwater\\u000a turtle maintains a remarkably high contractility during hypoxia; this may involve a low sensitivity to phosphate. Therefore,\\u000a freshwater turtle and rainbow trout were compared with regard to Ca2+-activated force in skinned atrial trabeculae in a bath containing 3?mM ATP buffered by 15?mM creatine

M. A. Jensen; H. Gesser



Post-hypothermic cardiac left ventricular systolic dysfunction after rewarming in an intact pig model  

PubMed Central

Introduction We developed a minimally invasive, closed chest pig model with the main aim to describe hemodynamic function during surface cooling, steady state severe hypothermia (one hour at 25°C) and surface rewarming. Methods Twelve anesthetized juvenile pigs were acutely catheterized for measurement of left ventricular (LV) pressure-volume loops (conductance catheter), cardiac output (Swan-Ganz), and for vena cava inferior occlusion. Eight animals were surface cooled to 25°C, while four animals were kept as normothermic time-matched controls. Results During progressive cooling and steady state severe hypothermia (25°C) cardiac output (CO), stroke volume (SV), mean arterial pressure (MAP), maximal deceleration of pressure in the cardiac cycle (dP/dtmin), indexes of LV contractility (preload recruitable stroke work, PRSW, and maximal acceleration of pressure in the cardiac cycle, dP/dtmax) and LV end diastolic and systolic volumes (EDV and ESV) were significantly reduced. Systemic vascular resistance (SVR), isovolumetric relaxation time (Tau), and oxygen content in arterial and mixed venous blood increased significantly. LV end diastolic pressure (EDP) remained constant. After rewarming all the above mentioned hemodynamic variables that were depressed during 25°C remained reduced, except for CO that returned to pre-hypothermic values due to an increase in heart rate. Likewise, SVR and EDP were significantly reduced after rewarming, while Tau, EDV, ESV and blood oxygen content normalized. Serum levels of cardiac troponin T (TnT) and tumor necrosis factor-alpha (TNF-?) were significantly increased. Conclusions Progressive cooling to 25°C followed by rewarming resulted in a reduced systolic, but not diastolic left ventricular function. The post-hypothermic increase in heart rate and the reduced systemic vascular resistance are interpreted as adaptive measures by the organism to compensate for a hypothermia-induced mild left ventricular cardiac failure. A post-hypothermic increase in TnT indicates that hypothermia/rewarming may cause degradation of cardiac tissue. There were no signs of inadequate global oxygenation throughout the experiments. PMID:21092272



HYPOTHALAMIC DYSFUNCTION—A Review of Experimental and Clinical Observations of Cardiac and Renal Aspects  

PubMed Central

The nuclear cell masses of the hypothalamus act as autonomic regulators for visceromotor function. Through the correlation of impulses arising in or about the hypothalamus with the changes in cellular chemistry, there is provided, by mediation of the endocrines, a balanced control of water metabolism, renal function and cardiac action. Derangement of hypothalamic regulation causes specific clinical syndromes described by the general term “diencephalohypophyseal dystrophy.” Cardiac abnormalities attributable to hypothalamic dysfunction include alterations in rate and various arrhythmias. Alteration in renal function includes hematuria, polyuria or relative anuria, and specific effects on electrolyte and nitrogen output. PMID:13009469

Weinberg, S. J.



Multiwavelength Switching of Raman Fiber Ring Laser Incorporating Composite Polarization-Maintaining Fiber Lyot-Sagnac Filter  

Microsoft Academic Search

A multiwavelength switching laser is demonstrated by a precise and fast tuning of a composite Lyot-Sagnac comb filter based on multisegment polarization-maintaining fibers. Broadband multiwavelength output is generated by cascaded Raman Stokes waves between 1.12 and 1.58 µm in a fiber-ring cavity with a wave-division-multiplexed coupler. Theoretical and experimental analysis of stable multiwavelength output operation for various Raman gain fibers

Chang-Seok Kim; Jin U. Kang



Gradient matrices for output feedback systems  

Microsoft Academic Search

Gradient matrices are formulated for the linear multivariable system with output feedback. The incremental motion of the poles and zeros and the coefficients of the numerator and denominator transfer function polynomials is determined as a function of the elements of an output feedback gain matrix. Also considered is the incremental movement of zeros and the coefficients of the numerator transfer




Reinvestigating the Noticing Function of Output  

ERIC Educational Resources Information Center

A conceptual replication of Izumi and Bigelow's research, this study used multiple measures to investigate second language (L2) learners' processes in output-input-output sequences. Specifically, it examined whether producing the target language impacts learners' attention to L2 structures in subsequent input. Thirty learners of English as a…

Uggen, Maren S.



VF CWEB OUTPUT 1 The Voting Farm  

E-print Network

VF CWEB OUTPUT 1 The Voting Farm A Distributed Class for Software Voting V1.5 by Vincenzo De Florio Katholieke Universiteit Leuven Departement Elektrotechniek Afdeling ESAT/ACCA #12;2 CWEB OUTPUT VF 1. VotingFarm module connected to one user module and to a farm of fellow voters arranged into a cliqu´e. User Module


Molecular candidates for cardiac stretch-activated ion channels  

PubMed Central

The heart is a mechanically-active organ that dynamically senses its own mechanical environment. This environment is constantly changing, on a beat-by-beat basis, with additional modulation by respiratory activity and changes in posture or physical activity, and further overlaid with more slowly occurring physiological (e.g. pregnancy, endurance training) or pathological challenges (e.g. pressure or volume overload). Far from being a simple pump, the heart detects changes in mechanical demand and adjusts its performance accordingly, both via heart rate and stroke volume alteration. Many of the underlying regulatory processes are encoded intracardially, and are thus maintained even in heart transplant recipients. Over the last three decades, molecular substrates of cardiac mechanosensitivity have gained increasing recognition in the scientific and clinical communities. Nonetheless, the processes underlying this phenomenon are still poorly understood. Stretch-activated ion channels (SAC) have been identified as one contributor to mechanosensitive autoregulation of the heartbeat. They also appear to play important roles in the development of cardiac pathologies – most notably stretch-induced arrhythmias. As recently discovered, some established cardiac drugs act, in part at least, via mechanotransduction pathways suggesting SAC as potential therapeutic targets. Clearly, identification of the molecular substrate of cardiac SAC is of clinical importance and a number of candidate proteins have been identified. At the same time, experimental studies have revealed variable–and at times contrasting–results regarding their function. Further complication arises from the fact that many ion channels that are not classically defined as SAC, including voltage and ligand-gated ion channels, can respond to mechanical stimulation. Here, we summarise what is known about the molecular substrate of the main candidates for cardiac SAC, before identifying potential further developments in this area of translational research. PMID:25405172

Reed, Alistair; Kohl, Peter; Peyronnet, Rémi



47 CFR 2.1046 - Measurements required: RF power output.  

Code of Federal Regulations, 2010 CFR

...false Measurements required: RF power output. 2.1046 Section...GENERAL RULES AND REGULATIONS Equipment Authorization Procedures Certification...1046 Measurements required: RF power output. (a) For...output shall be measured at the RF output terminals when...



47 CFR 2.1046 - Measurements required: RF power output.  

Code of Federal Regulations, 2011 CFR

...false Measurements required: RF power output. 2.1046 Section...GENERAL RULES AND REGULATIONS Equipment Authorization Procedures Certification...1046 Measurements required: RF power output. (a) For...output shall be measured at the RF output terminals when...



Calcium Signaling in Cardiac Myocytes  

PubMed Central

Calcium (Ca2+) is a critical regulator of cardiac myocyte function. Principally, Ca2+ is the link between the electrical signals that pervade the heart and contraction of the myocytes to propel blood. In addition, Ca2+ controls numerous other myocyte activities, including gene transcription. Cardiac Ca2+ signaling essentially relies on a few critical molecular players—ryanodine receptors, voltage-operated Ca2+ channels, and Ca2+ pumps/transporters. These moieties are responsible for generating Ca2+ signals upon cellular depolarization, recovery of Ca2+ signals following cellular contraction, and setting basal conditions. Whereas these are the central players underlying cardiac Ca2+ fluxes, networks of signaling mechanisms and accessory proteins impart complex regulation on cardiac Ca2+ signals. Subtle changes in components of the cardiac Ca2+ signaling machinery, albeit through mutation, disease, or chronic alteration of hemodynamic demand, can have profound consequences for the function and phenotype of myocytes. Here, we discuss mechanisms underlying Ca2+ signaling in ventricular and atrial myocytes. In particular, we describe the roles and regulation of key participants involved in Ca2+ signal generation and reversal. PMID:21875987

Fearnley, Claire J.; Roderick, H. Llewelyn; Bootman, Martin D.



Global output feedback tracking for nonlinear systems in generalized output-feedback canonical form  

Microsoft Academic Search

A global output feedback dynamic compensator is proposed for stabilization and tracking of a class of systems that are globally diffeomorphic into systems which are in generalized output-feedback canonical form. This form includes as special cases the standard output-feedback canonical form and various other forms considered previously in the literature. Output-dependent nonlinearities are allowed to enter both additively and multiplicatively.

P. Krishnamurthy; F. Khorrami; Z. P. Jiang



Stoichiometric analysis of self-maintaining metabolisms.  


This paper presents an extension of stoichiometric analysis in systems where the catalytic compounds (enzymes) are also intermediates of the metabolic network (dual property), so they are produced and degraded by the reaction network itself. To take this property into account, we introduce the definition of enzyme-maintaining mode, a set of reactions that produces its own catalyst and can operate at stationary state. Moreover, an enzyme-maintaining mode is defined as elementary with respect to a given reaction if the removal of any of the remaining reactions causes the cessation of any steady state flux through this reference reaction. These concepts are applied to determine the network structure of a simple self-maintaining system. PMID:18222485

Montero, Francisco; Nuño, Juan Carlos; Meléndez-Hevia, Enrique; Olasagasti, Felix; Vázquez, Sara; Morán, Federico



Cardiac alterations induced by a fish-catching diving competition.  


Cardiac changes induced by repeated breath-hold diving were investigated after a fish-catching diving competition. Eleven healthy subjects carried out repeated breath-hold dives at a mean maximal depth of 20 ± 2.7 msw (66 ± 9 fsw) during 5 h. One hour after the competition, the body mass loss was -1.7 ± 0.5 kg. Most of the breath-hold divers suffered from cold and although the core temperature remained normal, a decrease in cutaneous temperature was recorded in the extremities. Systolic blood pressure was reduced in both upper and lower limbs. Heart rate was unchanged, but left ventricular (LV) stroke volume was reduced leading to a decrease in cardiac output (-20%). Left atrial and LV diameters were significantly decreased. LV filling was assessed on a trans-mitral profile. An increase in the contribution of the atrial contraction to LV filling was observed. Right cavity diameters were increased. The cardiac autonomic alterations were in favor of sympathetic hyperactivity. After a fish-catching diving competition in cold water, alterations suggesting dehydration, contraction in plasma volume and sympathetic hyperactivity were observed. Furthermore, enlargements of right cavities were in favor of right ventricular strains. Repeated apnea and swimming in cold water may account for these alterations. PMID:20738824

Gargne, O; Joulia, F; Golé, Y; Coulange, M; Bessereau, J; Fontanari, P; Desruelle, A-V; Gavarry, O; Boussuges, A



Automated Methods to Maintain Aircraft Separation  

NASA Technical Reports Server (NTRS)

The air traffic control system in the United States has a great track-record for safety. As more aircraft enter the system at a given time, the situation becomes more complex though. Researchers at NASA are attempting to leverage advances in many fields including optimization, data mining, and numerical modeling of systems to improve the air-transportation system maintaining safety while increasing throughput and reducing delays. This talk will give a brief overview of the research at NASA towards modernizing the air-transportation system. It will then focus on the specific area of automation tools for maintaining physical separation between aircraft known as Separation Assurance.

Lauderdale, Todd



Exceptional CO? tolerance in white sturgeon (Acipenser transmontanus) is associated with protection of maximum cardiac performance during hypercapnia in situ.  


White sturgeon rank among the most CO?-tolerant fish species examined to date. We investigated whether this exceptional CO? tolerance extended to the heart, an organ generally viewed as acidosis intolerant. Maximum cardiac output (Q(max)) and maximum cardiac power output (PO(max)) were assessed using a working, perfused, in situ heart preparation. Exposure to a Pco? of 3 kPa for 20 min had no significant effect on maximum cardiac performance, while exposure to 6-kPa Pco? reduced heart rate, Q(max), PO(max), and rate of ventricular force generation (F(O)) by 23%, 28%, 26%, and 18%, respectively; however, full recovery was observed in all these parameters upon return to control conditions. These modest impairments during exposure to 6-kPa Pco? were associated with partially compensated intracellular ventricular acidosis. Maximum adrenergic stimulation (500 nmol L?¹ adrenaline) during 6-kPa Pco? protected maximum cardiac performance via increased inotropy (force of contraction) without affecting heart rate. Exposure to higher CO? levels associated with morbidity in vivo (i.e., 8-kPa Pco?) induced arrhythmia and a reduction in stroke volume during power assessment. Clearly, white sturgeon hearts are able to increase cardiac performance during severe hypercapnia that is lethal to other fishes. Future work focusing on atypical aspects of sturgeon cardiac function, including the lack of chronotropic response to adrenergic stimulation during hypercapnia, is warranted. PMID:21527814

Baker, Daniel W; Hanson, Linda M; Farrell, Anthony P; Brauner, Colin J



Simulation evaluation of quantitative myocardial perfusion assessment from cardiac CT  

NASA Astrophysics Data System (ADS)

Contrast enhancement on cardiac CT provides valuable information about myocardial perfusion and methods have been proposed to assess perfusion with static and dynamic acquisitions. There is a lack of knowledge and consensus on the appropriate approach to ensure 1) sufficient diagnostic accuracy for clinical decisions and 2) low radiation doses for patient safety. This work developed a thorough dynamic CT simulation and several accepted blood flow estimation techniques to evaluate the performance of perfusion assessment across a range of acquisition and estimation scenarios. Cardiac CT acquisitions were simulated for a range of flow states (Flow = 0.5, 1, 2, 3 ml/g/min, cardiac output = 3,5,8 L/min). CT acquisitions were simulated with a validated CT simulator incorporating polyenergetic data acquisition and realistic x-ray flux levels for dynamic acquisitions with a range of scenarios including 1, 2, 3 sec sampling for 30 sec with 25, 70, 140 mAs. Images were generated using conventional image reconstruction with additional image-based beam hardening correction to account for iodine content. Time attenuation curves were extracted for multiple regions around the myocardium and used to estimate flow. In total, 2,700 independent realizations of dynamic sequences were generated and multiple MBF estimation methods were applied to each of these. Evaluation of quantitative kinetic modeling yielded blood flow estimates with an root mean square error (RMSE) of ~0.6 ml/g/min averaged across multiple scenarios. Semi-quantitative modeling and qualitative static imaging resulted in significantly more error (RMSE = ~1.2 and ~1.2 ml/min/g respectively). For quantitative methods, dose reduction through reduced temporal sampling or reduced tube current had comparable impact on the MBF estimate fidelity. On average, half dose acquisitions increased the RMSE of estimates by only 18% suggesting that substantial dose reductions can be employed in the context of quantitative myocardial blood flow estimation. In conclusion, quantitative model-based dynamic cardiac CT perfusion assessment is capable of accurately estimating MBF across a range of cardiac outputs and tissue perfusion states, outperforms comparable static perfusion estimates, and is relatively robust to noise and temporal subsampling.

Bindschadler, Michael; Modgil, Dimple; Branch, Kelley R.; La Riviere, Patrick J.; Alessio, Adam M.



An integrated platform for image-guided cardiac resynchronization therapy  

NASA Astrophysics Data System (ADS)

Cardiac resynchronization therapy (CRT) is an effective procedure for patients with heart failure but 30% of patients do not respond. This may be due to sub-optimal placement of the left ventricular (LV) lead. It is hypothesized that the use of cardiac anatomy, myocardial scar distribution and dyssynchrony information, derived from cardiac magnetic resonance imaging (MRI), may improve outcome by guiding the physician for optimal LV lead positioning. Whole heart MR data can be processed to yield detailed anatomical models including the coronary veins. Cine MR data can be used to measure the motion of the LV to determine which regions are late-activating. Finally, delayed Gadolinium enhancement imaging can be used to detect regions of scarring. This paper presents a complete platform for the guidance of CRT using pre-procedural MR data combined with live x-ray fluoroscopy. The platform was used for 21 patients undergoing CRT in a standard catheterization laboratory. The patients underwent cardiac MRI prior to their procedure. For each patient, a MRI-derived cardiac model, showing the LV lead targets, was registered to x-ray fluoroscopy using multiple views of a catheter looped in the right atrium. Registration was maintained throughout the procedure by a combination of C-arm/x-ray table tracking and respiratory motion compensation. Validation of the registration between the three-dimensional (3D) roadmap and the 2D x-ray images was performed using balloon occlusion coronary venograms. A 2D registration error of 1.2 ± 0.7 mm was achieved. In addition, a novel navigation technique was developed, called Cardiac Unfold, where an entire cardiac chamber is unfolded from 3D to 2D along with all relevant anatomical and functional information and coupled to real-time device detection. This allowed more intuitive navigation as the entire 3D scene was displayed simultaneously on a 2D plot. The accuracy of the unfold navigation was assessed off-line using 13 patient data sets by computing the registration error of the LV pacing lead electrodes which was found to be 2.2 ± 0.9 mm. Furthermore, the use of Unfold Navigation was demonstrated in real-time for four clinical cases.

Ma, Ying Liang; Shetty, Anoop K.; Duckett, Simon; Etyngier, Patrick; Gijsbers, Geert; Bullens, Roland; Schaeffter, Tobias; Razavi, Reza; Rinaldi, Christopher A.; Rhode, Kawal S.



Mechanical Regulation of Cardiac Development  

NASA Astrophysics Data System (ADS)

Mechanical forces are an essential contributor to and unavoidable component of cardiac formation, both inducing and orchestrating local and global molecular and cellular changes. Experimental animal studies have contributed substantially to understanding the mechanobiology of heart development. More recent integration of high-resolution imaging modalities with computational modeling has greatly improved our quantitative understanding of hemodynamic flow in heart development. Merging these latest experimental technologies with molecular and genetic signaling analysis will accelerate our understanding of the relationships integrating mechanical and biological signaling for proper cardiac formation. These advances will likely be essential for clinically translatable guidance for targeted interventions to rescue malforming hearts and/or reconfigure malformed circulations for optimal performance. This review summarizes our current understanding on the levels of mechanical signaling in the heart and their roles in orchestrating cardiac development.

Lindsey, Stephanie; Butcher, Jonathan; Yalcin, Huseyin



High Energy Output Marx Generator Design  

SciTech Connect

High Energy Output Marx Generator Design a design of a six stage Marx generator that has a unipolar pulse waveform of 200 kA in a 50×500 microsecond waveform is presented. The difficulties encountered in designing the components to withstand the temperatures and pressures generated during the output pulse are discussed. The unique methods and materials used to successfully overcome these problems are given. The steps necessary to increase the current output of this Marx generator design to the meg-ampere region or higher are specified.

Monty Lehmann



d-Propranolol protects against oxidative stress and progressive cardiac dysfunction in iron overloaded rats  

PubMed Central

d-Propranolol (d-Pro: 2–8 mg·(kg body mass)?1·day?1) protected against cardiac dysfunction and oxidative stress during 3–5 weeks of iron overload (2 mg Fe–dextran·(g body mass)?1·week?1) in Sprague–Dawley rats. At 3 weeks, hearts were perfused in working mode to obtain baseline function; red blood cell glutathione, plasma 8-isoprostane, neutrophil basal superoxide production, lysosomal-derived plasma N-acetyl-?-galactosaminidase (NAGA) activity, ventricular iron content, and cardiac iron deposition were assessed. Hearts from the Fe-treated group of rats exhibited lower cardiac work (26%) and output (CO, 24%); end-diastolic pressure rose 1.8-fold. Further, glutathione levels increased 2-fold, isoprostane levels increased 2.5-fold, neutrophil superoxide increased 3-fold, NAGA increased 4-fold, ventricular Fe increased 4.9-fold; and substantial atrial and ventricular Fe-deposition occurred. d-Pro (8 mg) restored heart function to the control levels, protected against oxidative stress, and decreased cardiac Fe levels. After 5 weeks of Fe treatment, echocardiography revealed that the following were depressed: percent fractional shortening (%FS, 31% lower); left ventricular (LV) ejection fraction (LVEF, 17%), CO (25%); and aortic pressure maximum (Pmax, 24%). Mitral valve E/A declined by 18%, indicating diastolic dysfunction. Cardiac CD11b+ infiltrates were elevated. Low d-Pro (2 mg) provided modest protection, whereas 4–8 mg greatly improved LVEF (54%–75%), %FS (51%–81%), CO (43%–78%), Pmax (56%–100%), and E/A >100%; 8 mg decreased cardiac inflammation. Since d-Pro is an antioxidant and reduces cardiac Fe uptake as well as inflammation, these properties may preserve cardiac function during Fe overload. PMID:22913465

Kramer, Jay H.; Spurney, Christopher F.; Iantorno, Micaela; Tziros, Constantine; Chmielinska, Joanna J.; Mak, I. Tong; Weglicki, William B.



Nomenclature for congenital and paediatric cardiac disease: historical perspectives and The International Pediatric and Congenital Cardiac Code.  


Clinicians working in the field of congenital and paediatric cardiology have long felt the need for a common diagnostic and therapeutic nomenclature and coding system with which to classify patients of all ages with congenital and acquired cardiac disease. A cohesive and comprehensive system of nomenclature, suitable for setting a global standard for multicentric analysis of outcomes and stratification of risk, has only recently emerged, namely, The International Paediatric and Congenital Cardiac Code. This review, will give an historical perspective on the development of systems of nomenclature in general, and specifically with respect to the diagnosis and treatment of patients with paediatric and congenital cardiac disease. Finally, current and future efforts to merge such systems into the paperless environment of the electronic health or patient record on a global scale are briefly explored. On October 6, 2000, The International Nomenclature Committee for Pediatric and Congenital Heart Disease was established. In January, 2005, the International Nomenclature Committee was constituted in Canada as The International Society for Nomenclature of Paediatric and Congenital Heart Disease. This International Society now has three working groups. The Nomenclature Working Group developed The International Paediatric and Congenital Cardiac Code and will continue to maintain, expand, update, and preserve this International Code. It will also provide ready access to the International Code for the global paediatric and congenital cardiology and cardiac surgery communities, related disciplines, the healthcare industry, and governmental agencies, both electronically and in published form. The Definitions Working Group will write definitions for the terms in the International Paediatric and Congenital Cardiac Code, building on the previously published definitions from the Nomenclature Working Group. The Archiving Working Group, also known as The Congenital Heart Archiving Research Team, will link images and videos to the International Paediatric and Congenital Cardiac Code. The images and videos will be acquired from cardiac morphologic specimens and imaging modalities such as echocardiography, angiography, computerized axial tomography and magnetic resonance imaging, as well as intraoperative images and videos. Efforts are ongoing to expand the usage of The International Paediatric and Congenital Cardiac Code to other areas of global healthcare. Collaborative efforts are underway involving the leadership of The International Nomenclature Committee for Pediatric and Congenital Heart Disease and the representatives of the steering group responsible for the creation of the 11th revision of the International Classification of Diseases, administered by the World Health Organisation. Similar collaborative efforts are underway involving the leadership of The International Nomenclature Committee for Pediatric and Congenital Heart Disease and the International Health Terminology Standards Development Organisation, who are the owners of the Systematized Nomenclature of Medicine or "SNOMED". The International Paediatric and Congenital Cardiac Code was created by specialists in the field to name and classify paediatric and congenital cardiac disease and its treatment. It is a comprehensive code that can be freely downloaded from the internet ( and is already in use worldwide, particularly for international comparisons of outcomes. The goal of this effort is to create strategies for stratification of risk and to improve healthcare for the individual patient. The collaboration with the World Heath Organization, the International Health Terminology Standards Development Organisation, and the healthcare industry, will lead to further enhancement of the International Code, and to its more universal use. PMID:19063777

Franklin, Rodney C G; Jacobs, Jeffrey Phillip; Krogmann, Otto N; Béland, Marie J; Aiello, Vera D; Colan, Steven D; Elliott, Martin J; William Gaynor, J; Kurosawa, Hiromi; Maruszewski, Bohdan; Stellin, Giovanni; Tchervenkov, Christo I; Walters Iii, Henry L; Weinberg, Paul; Anderson, Robert H



Alertness maintaining tasks (AMTs) while driving  

Microsoft Academic Search

We evaluated the effectiveness of alertness maintaining tasks (AMTs) on driver performance, subjective feelings, and psychophysiological state in monotonous simulated driving in two experiments. In the first experiment, 12 professional truck drivers participated in five sessions of simulated driving: driving only, driving with one of three AMTs (counterbalanced), and driving while listening to music. AMTs were not equally effective in

Tal Oron-Gilad; Adi Ronen; David Shinar



How oversight improves member-maintained communities  

Microsoft Academic Search

Online communities need regular maintenance activities such as moderation and data input, tasks that typically fall to community owners. Communities that allow all members to participate in maintenance tasks have the potential to be more robust and valuable. A key challenge in creating member-maintained communities is building interfaces, algorithms, and social structures that encourage people to provide high-quality contributions. We

Dan Cosley; Dan Frankowski; Sara B. Kiesler; Loren G. Terveen; John Riedl



Web Maintainers Forum 29 August 2013  

E-print Network

1 Web Maintainers Forum 29 August 2013 Agenda Welcome and introduction Web team Update My Baker, WCMS Project Manager) Questions Web team update Web team site rebranded When was the last time you visited the web team site: August? June or July? 2013? 2012? Never

Hickman, Mark


Maintaining Academic Integrity in Online Education  

Microsoft Academic Search

Online education has come under a great deal of scrutiny over the issue of academic integrity. It is assumed that cheating and plagiarism are a greater problem online than in a traditional class. In reality, maintaining academic integrity is equally a challenge in both delivery modes. However, by the very nature of online education, a case can be made that

Michael Heberling


Original article Preconditioning treatment maintains taste characteristic  

E-print Network

fruits immediately after harvest and prior to cold storage at 20 °C for 24­48 h in special chambers aimed fruit during this 40-day cold- storage period. Preconditioned and control fruit were also segregated maintained their sensory characteristics longer than control fruit during this 40-day cold-storage period

Crisosto, Carlos H.


Synaptic AMPA receptor exchange maintains bidirectional plasticity.  


Activity-dependent synaptic delivery of GluR1-, GluR2L-, and GluR4-containing AMPA receptors (-Rs) and removal of GluR2-containing AMPA-Rs mediate synaptic potentiation and depression, respectively. The obvious puzzle is how synapses maintain the capacity for bidirectional plasticity if different AMPA-Rs are utilized for potentiation and depression. Here, we show that synaptic AMPA-R exchange is essential for maintaining the capacity for bidirectional plasticity. The exchange process consists of activity-independent synaptic removal of GluR1-, GluR2L-, or GluR4-containing AMPA-Rs and refilling with GluR2-containing AMPA-Rs at hippocampal and cortical synapses in vitro and in intact brains. In GluR1 and GluR2 knockout mice, initiation or completion of synaptic AMPA-R exchange is compromised, respectively. The complementary AMPA-R removal and refilling events in the exchange process ultimately maintain synaptic strength unchanged, but their long rate time constants ( approximately 15-18 hr) render transmission temporarily depressed in the middle of the exchange. These results suggest that the previously hypothesized "slot" proteins, rather than AMPA-Rs, code and maintain transmission efficacy at central synapses. PMID:16600857

McCormack, Stefanie G; Stornetta, Ruth L; Zhu, J Julius



Obtaining, Maintaining, and Advancing Your Fitness Certification  

ERIC Educational Resources Information Center

Public awareness of health, fitness, and exercise has increased and the fitness industry has expanded in recent years. Yet, ironically, the health of our nation continues to deteriorate. Now more than ever there is the need for qualified fitness professionals to help individuals to improve or maintain health and fitness. Since fitness…

Pierce, Patricia; Herman, Susan



Maintaining Biconnected Components of Dynamic Planar Graphs  

Microsoft Academic Search

We present algorithms for maintaining the biconnected components of a planar graph undergoing repeated dynamic modifications, such as insertions and deletions of edges and vertices. We show how to test at any time whether two vertices belong to the same biconnected component, and how to insert and delete an edge in O(n 2=3 ) time in the worst case, where

Zvi Galil; Giuseppe F. Italiano



WEB Maintainers Meetup Web Branding Committee  

E-print Network

WEB Maintainers Meetup UF/IFAS DEPARTMENT #12; Web Branding Committee Introduction and TERMINALFOUR (T4) recap Preparation Page layouts Questions #12;WEB BRANDING COMMITTEE what we heard #12;Some) is the new UF Web Content Management System (WCMS) chosen for the next five years. T4 allows non

Florida, University of



E-print Network

health. Prepare for your health needs in advance by following these easy tips. Store enough food for yourMAINTAIN YOUR HEALTH DURING A DISASTER Food and Water Emergency situations can take a toll on your Commissioners Courts of Texas Cooperating Keep Your Health in Mind Avoid Illness Wash hands frequently


Maintaining Information Awareness in a Dynamic Environment  

E-print Network

Mechanism A Thesis Presented to The Academic Faculty by D. Scott McCrickard In Partial Ful llment 2000 Copyright c 2000 by D. Scott McCrickard #12;Maintaining Information Awareness in a Dynamic to keep a positive attitude while doing so. Special thanks to Joan Morton for constantly coming to my

McCrickard, Scott


Halema'uma'u Maintains Basic Geometry  

USGS Multimedia Gallery

The lava lake at Halema'uma'u has maintained the same basic geometry since February of this year. This thermal image was taken during a helicopter overflight, and shows the lava surface deep within the vent cavity. The lava surface is kidney-shaped and approximately 60 x 90 meters in size, and situa...


Maintaining and Repairing. CAP Job Function.  

ERIC Educational Resources Information Center

This Job Function Booklet (Maintaining and Repairing) is one of the 14 components (see note) of the Career Alert Planning (CAP) program, a set of individualized materials designed to help participants find out about themselves and about the kind of work for which they are suited. In this program, participants become acquainted with occupations…

Ohio State Univ., Columbus. National Center for Research in Vocational Education.


Health Literacy Predicts Cardiac Knowledge Gains in Cardiac Rehabilitation Participants  

ERIC Educational Resources Information Center

Objective: Health literacy is increasingly recognised as a potentially important patient characteristic related to patient education efforts. We evaluated whether health literacy would predict gains in knowledge after completion of patient education in cardiac rehabilitation. Method: This was a re-post observational analysis study design based on…

Mattson, Colleen C.; Rawson, Katherine; Hughes, Joel W.; Waechter, Donna; Rosneck, James




Microsoft Academic Search

Acute renal failure (ARF) following cardiac surgery occurs in 1 to 10% of patients. Patients who develop ARF have higher rates of mortality. This study was undertaken to estimate the role of perioperative variables in predicting of post cardiac surgery ARF. We studied a cohort of 398 adult patients who underwent cardiac surgery at our institution from February 2004 to

N. Safai; M. R. Ardalan; J. Etemadi


Arginylation regulates myofibrils to maintain heart function and prevent dilated cardiomyopathy  

PubMed Central

Protein arginylation mediated by arginyltransferase (ATE1) is essential for heart formation during embryogenesis, however its cell-autonomous role in cardiomyocytes and the differentiated heart muscle has never been investigated. To address this question, we generated cardiac muscle-specific Ate1 knockout mice, in which Ate1 deletion was driven by ?-myosin heavy chain promoter (?MHC-Ate1 mouse). These mice were initially viable, but developed severe cardiac contractility defects, dilated cardiomyopathy, and thrombosis over time, resulting in high rates of lethality after 6 months of age. These symptoms were accompanied by severe ultrastructural defects in cardiac myofibrils, seen in the newborns and far preceding the onset of cardiomyopathy, suggesting that these defects were primary and likely underlay the development of the future heart defects. Several major sarcomeric proteins were arginylated in vivo. Moreover, Ate1 deletion in the hearts resulted in a significant reduction of active and passive myofibril forces, suggesting that arginylation is critical for both myofibril structural integrity and contractility. Thus, arginylation is essential for maintaining the heart function by regulation of the major myofibril proteins and myofibril forces, and its absence in the heart muscle leads to progressive heart failure through cardiomyocyte-specific defects. PMID:22626847

Kurosaka, Satoshi; Leu, N. Adrian; Pavlov, Ivan; Han, Xuemei; Ribeiro, Paula Aver Bretanha; Xu, Tao; Bunte, Ralph; Saha, Sougata; Wang, Junling; Cornachione, Anabelle; Mai, Wilfried; Yates, John R; Rassier, Dilson E.; Kashina, Anna



Output control using feedforward and cascade controllers  

NASA Technical Reports Server (NTRS)

An open-loop solution to the output control problem in SISO (single-input, single-output) systems by means of feedforward and cascade controllers is investigated. A simple characterization of feedforward controllers, which achieve steady-state disturbance rejection, is given in a transfer-function setting. Cascade controllers which cause steady-state command tracking are characterized. Disturbance decoupling and command matching controllers are identified. Conditions for existence of feedforward and cascade controllers are given. For unstable systems, it is shown that a stabilizing feedback controller can be used without affecting the feedforward and cascade controllers used for output control; hence, the three controllers can be designed independently. Output control by a combination of feedforward and feedback is discussed.

Seraji, H.



Modified univibrator compensates for output timing errors  

NASA Technical Reports Server (NTRS)

One-stage, delay compensation amplifier, added to conventional univibrator circuitry time-synchronizes the trailing edge of the output pulse with the origin of the input pulse. The trailing edge is independent of the amplitude of the input pulse.

Strauss, M. G.



Back pain, leg swelling and a cardiac arrest: an interesting case of endocarditis.  


A 66-year-old woman with a history of tissue aortic valve replacement and chronic back pain presented to the emergency department with a suspected right leg deep vein thrombosis. A recent outpatient MRI had revealed discitis. A ventricular fibrillation cardiac arrest occurred in the emergency department. Cardiac output was restored on the fifth defibrillation. A transthoracic echocardiogram showed large aortic valve vegetations. Clinical impression was of infective endocarditis with cardiac arrest secondary to coronary artery embolisation. Peripheral blood cultures grew Cardiobacterium hominis, and appropriate intravenous antibiotic therapy was administered. The infected prosthetic valve was excised. The patient experienced postoperative complete heart block and a right hemisphere cerebrovascular accident, however she is now recovering well. This case describes an unusual case of infective endocarditis secondary to C. hominis, with disc, leg, coronary artery and brain septic embolisation. Infective endocarditis is an important differential diagnosis in multisystem presentations. PMID:24859548

Donovan, Joseph; Hatcher, James; Riddell, Anna; Tiberi, Simon



High renal regional oxygen saturation in femoral arteriovenous fistula after neonatal cardiac surgery.  


The use of an indwelling arterial catheter is standard practice in the postoperative monitoring of paediatric cardiac surgery patients. Arteriovenous fistula related to this procedure can be difficult to diagnose. Regional haemoglobin oxygen saturation (rSO2) using near-infrared spectroscopy and central venous oxygen saturation (ScvO2) are monitored to follow the balance between oxygen consumption and delivery. Low values of these parameters are a sign of low cardiac output. High rSO2 and high ScvO2 are less frequently described. We report the discovery of an iatrogenic arteriovenous fistula in a neonate after cardiac surgery who had unexpectedly high values of renal rSO2 and femoral ScvO2. High renal rSO2 after femoral instrumentation should alert the physician to the possibility of arteriovenous fistula. PMID:25678609

Tremblay-Roy, Jean-Sébastien; Harrington, Karen; Vobecky, Suzanne; Emeriaud, Guillaume



Effect of Obesity on Cardiac Function in Children and Adolescents: A Review  

PubMed Central

Increases in cardiac mass, ventricular dimensions, and stroke volume are typically observed in obese adults, accompanied by evidence of diminished ventricular systolic and diastolic function. Given sufficient severity and duration of excessive body fat, signs of overt congestive heart failure may ensue (cardiomyopathy of obesity). This review of cardiac findings in obese children and adolescents indicates similar anatomic features as well as early subclinical findings of ventricular dysfunction. However, cardiac functional reserve (cardiovascular fitness) appears to be preserved even in those with morbid levels of obesity. Key pointsExcessive body fat increases the work output of the heart.Longstanding increases in heart work result in abnormalities of heart function.Early findings of such changes can be observed in adolescents with severe obesity. PMID:24149418

Rowland, Thomas W.



The effects of peptide histidine isoleucine and neuropeptide Y on mucus volume output from the ferret trachea.  

PubMed Central

1. The effects of peptide histidine isoleucine (PHI) and neuropeptide Y (NPY) were examined on the mucus volume output produced by methacholine and phenylephrine in the ferret whole trachea in vitro. 2. Sustained application of methacholine (5 microM) or phenylephrine (20 microM) produced a maintained volume output of mucus from the trachea. Both these agonists also increased the output of lysozyme (a marker for serous cell secretion). 3. PHI inhibited the maintained mucus volume output produced by methacholine but had no effect on that due to phenylephrine. The output of lysozyme produced by methacholine or phenylephrine was not significantly changed by PHI. 4. NPY enhanced the volume output of mucus produced by methacholine or phenylephrine; however, the rate of output of lysozyme in mucus produced by both agonists was reduced by NPY. 5. We suggest that PHI has no effect on serous cell secretion but inhibits secretion from another source, possibly mucous cells. NPY inhibits serous cell secretion but has a stronger stimulant action on secretion from another source, again possibly mucous cells. 6. PHI and NPY may be important physiological modulators of mucus volume output in the ferret trachea. PMID:3219475

Webber, S. E.



MiR-133 promotes cardiac reprogramming by directly repressing Snai1 and silencing fibroblast signatures.  


Fibroblasts can be directly reprogrammed into cardiomyocyte-like cells (iCMs) by overexpression of cardiac transcription factors or microRNAs. However, induction of functional cardiomyocytes is inefficient, and molecular mechanisms of direct reprogramming remain undefined. Here, we demonstrate that addition of miR-133a (miR-133) to Gata4, Mef2c, and Tbx5 (GMT) or GMT plus Mesp1 and Myocd improved cardiac reprogramming from mouse or human fibroblasts by directly repressing Snai1, a master regulator of epithelial-to-mesenchymal transition. MiR-133 overexpression with GMT generated sevenfold more beating iCMs from mouse embryonic fibroblasts and shortened the duration to induce beating cells from 30 to 10 days, compared to GMT alone. Snai1 knockdown suppressed fibroblast genes, upregulated cardiac gene expression, and induced more contracting iCMs with GMT transduction, recapitulating the effects of miR-133 overexpression. In contrast, overexpression of Snai1 in GMT/miR-133-transduced cells maintained fibroblast signatures and inhibited generation of beating iCMs. MiR-133-mediated Snai1 repression was also critical for cardiac reprogramming in adult mouse and human cardiac fibroblasts. Thus, silencing fibroblast signatures, mediated by miR-133/Snai1, is a key molecular roadblock during cardiac reprogramming. PMID:24920580

Muraoka, Naoto; Yamakawa, Hiroyuki; Miyamoto, Kazutaka; Sadahiro, Taketaro; Umei, Tomohiko; Isomi, Mari; Nakashima, Hanae; Akiyama, Mizuha; Wada, Rie; Inagawa, Kohei; Nishiyama, Takahiko; Kaneda, Ruri; Fukuda, Toru; Takeda, Shu; Tohyama, Shugo; Hashimoto, Hisayuki; Kawamura, Yoshifumi; Goshima, Naoki; Aeba, Ryo; Yamagishi, Hiroyuki; Fukuda, Keiichi; Ieda, Masaki



Surface emitting lasers with combined output  

NASA Technical Reports Server (NTRS)

Surface emitting lasers are laterally aligned and coupled together and also have their light output signals combined. This results in greater phase and frequency coherency and narrower and reduced amplitude sidelobes. Preferably, not more than two lasers are longitudinally aligned along the same axis for still greater coherency compared with adding the light output signals of more than two longitudinally aligned lasers. The lasers can be of the DH-LOC type or of the QW type.

Carlin, Donald B. (Inventor)



Periodic output feedback stabilization of neutral systems  

Microsoft Academic Search

A new feedback control technique called periodic output feedback is investigated in the context of infinite-dimensional linear systems modeled by neutral functional differential equations. In this method, discrete output samples are multiplied by a periodic gain function to generate a continuous feedback control. This work focuses on stabilization of neutral systems with delayed control modeled in the state space W2(1)

Tzyh-Jong Tarn; Tongzeng Yang; Xiaoming Zeng; Chuanfan Guo



Anomalous light output from lightning dart leaders  

NASA Technical Reports Server (NTRS)

About 5 percent of the multiple-stroke cloud-to-ground lightning discharges recorded at the NASA Kennedy Space Center during the summer of 1981 contained dart leaders that produced an unusually large light output. An analysis of these cases indicates that the average peak light output per unit length in the leader may be comparable to or even exceed that of the return stroke that follows.

Guo, C.; Krider, E. P.



Unstable resonator with reduced output coupling.  


The properties of a laser beam coupled out of a standard unstable laser resonator are heavily dependent on the chosen resonator magnification. A higher magnification results in a higher output coupling and a better beam quality. But in some configurations, an unstable resonator with a low output coupling in combination with a good beam quality is desirable. In order to reduce the output coupling for a particular resonator, magnification fractions of the outcoupled radiation are reflected back into the cavity. In the confocal case, the output mirror consists of a spherical inner section with a high reflectivity and a flat outer section with a partial reflectivity coating. With the application of the unstable resonator with reduced output coupling (URROC), magnification and output coupling can be adjusted independently from each other and it is possible to get a good beam quality and a high power extraction for lasers with a large low gain medium. The feasibility of this resonator design is examined numerically and experimentally with the help of a chemical oxygen iodine laser. PMID:22722301

Pargmann, Carsten; Hall, Thomas; Duschek, Frank; Grünewald, Karin Maria; Handke, Jürgen



Anesthetic management of antiphospholipid syndrome patients who underwent cardiac surgery: three cases report  

PubMed Central

Antiphospholipid syndrome (APS) is a rare disease in which patients display prolonged coagulation test results in vitro, but usually develop thrombotic symptoms in vivo. Patients with APS are at increased risk of valvular heart disease or coronary vascular disease, conditions that often necessitate cardiac surgery via bypass. The management of anticoagulation during cardiopulmonary bypass (CPB) is particularly challenging in these patients because of the unique features of APS. Patients with APS are constantly at risk of arterial and venous thrombotic events. Therefore it is very important to maintain proper anticoagulation perioperatively, especially during CPB. In this paper, we present three successful cases of APS patients who underwent cardiac surgery with CPB. PMID:24624277

Cho, Hyunwook; Hong, Deok Man; Kim, Hyun Joo; Min, Jeong Jin



Short-duration spaceflight impairs human carotid baroreceptor-cardiac reflex responses  

NASA Astrophysics Data System (ADS)

The effect of a spaceflight on the vagally mediated baroreceptor-cardiac reflex responses of humans were investigated by measuring the responses (provoked by neck pressure changes) in supine position and the heart rate and blood pressure in the supine and standing positions in 16 astronauts before and after 4- to 5-day long Space Shuttle missions. The results showed that exposures to spaceflight resulted in reduced baseline levels of the vagal-cardiac outflow and the vagally mediated responses to changes of the arterial baroreceptor input and that these changes contribute to postflight reductions of astronauts' ability to maintain standing arterial pressures.

Fritsch, Janice M.; Charles, John B.; Bennett, Barbara S.; Jones, Michele M.; Eckberg, Dwain L.



Influence of genetic background on ex vivo and in vivo cardiac function in several commonly used inbred mouse strains  

PubMed Central

Inbred mouse strains play a critical role in biomedical research. Genetic homogeneity within inbred strains and their general amenability to genetic manipulation have made them an ideal resource for dissecting the physiological function(s) of individual genes. However, the inbreeding that makes inbred mice so useful also results in genetic divergence between them. This genetic divergence is often unaccounted for but may be a confounding factor when comparing studies that have utilized distinct inbred strains. Here, we compared the cardiac function of C57BL/6J mice to seven other commonly used inbred mouse strains: FVB/NJ, DBA/2J, C3H/HeJ, BALB/cJ, 129X1/SvJ, C57BL/10SnJ, and 129S1/SvImJ. The assays used to compare cardiac function were the ex vivo isolated Langendorff heart preparation and in vivo real-time hemodynamic analysis using conductance micromanometry. We report significant strain-dependent differences in cardiac function between C57BL/6J and other commonly used inbred strains. C57BL/6J maintained better cardiac function than most inbred strains after ex vivo ischemia, particularly compared with 129S1/SvImJ, 129X1/SvJ, and C57BL/10SnJ strains. However, during in vivo acute hypoxia 129X1/SvJ and 129S1/SvImJ maintained relatively normal cardiac function, whereas C57BL/6J animals showed dramatic cardiac decompensation. Additionally, C3H/HeJ showed rapid and marked cardiac decompensation in response to esmolol infusion compared with effects of other strains. These findings demonstrate the complex effects of genetic divergence between inbred strains on cardiac function. These results may help inform analysis of gene ablation or transgenic studies and further demonstrate specific quantitative traits that could be useful in discovery of genetic modifiers relevant to cardiac health and disease. PMID:20627938

Barnabei, Matthew S.; Palpant, Nathan J.



Phenomics of Cardiac Chloride Channels  

PubMed Central

Forward genetic studies have identified several chloride (Cl?) channel genes, including CFTR, ClC-2, ClC-3, CLCA, Bestrophin, and Ano1, in the heart. Recent reverse genetic studies using gene targeting and transgenic techniques to delineate the functional role of cardiac Cl? channels have shown that Cl? channels may contribute to cardiac arrhythmogenesis, myocardial hypertrophy and heart failure, and cardioprotection against ischemia reperfusion. The study of physiological or pathophysiological phenotypes of cardiac Cl? channels, however, is complicated by the compensatory changes in the animals in response to the targeted genetic manipulation. Alternatively, tissue-specific conditional or inducible knockout or knockin animal models may be more valuable in the phenotypic studies of specific Cl? channels by limiting the effect of compensation on the phenotype. The integrated function of Cl? channels may involve multiprotein complexes of the Cl? channel subproteome. Similar phenotypes can be attained from alternative protein pathways within cellular networks, which are influenced by genetic and environmental factors. The phenomics approach, which characterizes phenotypes as a whole phenome and systematically studies the molecular changes that give rise to particular phenotypes achieved by modifying the genotype under the scope of genome/proteome/phenome, may provide more complete understanding of the integrated function of each cardiac Cl? channel in the context of health and disease. PMID:23720326

Duan, Dayue Darrel



Sudden Cardiac Death in Athletes  

Microsoft Academic Search

Sudden cardiac death in athletes, although relatively uncommon, is a well-recognized condition generally associated with some congenital abnormalities. It, however, continues to be of vast interest to the public as athletes are seen as a distinct group of individuals who are especially able to tolerate more intense physical activities than the general population. Obviously, intense activities predispose susceptible athletes to

Peem Lorvidhaya; Shoei K. Stephen Huang



Cardiac involvement in primary myopathies.  


Simultaneous or temporarily staggered affection of both the skeletal as well as the cardiac muscle (cardiac involvement, CI) is a frequent finding in primary myopathies (MPs). CI leads to impulse generation defects, impulse conduction defects, thickened myocardium, left ventriculalr hypertrabeculation, dilatation of the cardiac cavities, secondary valve insufficiency, reduction of coronary vasodilative reserve, intracardial thrombus formation, and heart failure with systolic and diastolic dysfunction. CI has been found in Duchenne muscular dystrophy (MD), Becker MD, Emery-Dreifuss MD, facioscapulohumeral MD, sarcoglycanopathies, myotubular congenital MD, myotonic dystrophies type 1 and 2, proximal myotonic myopathy, myoadenylate deaminase deficiency, glycogenosis type II, III, IV, VII and IX, carnitine deficiency, mitochondriopathy, desmin MP, nemaline MP, central core disease, multicore MP, congenital fiber-type disproportion MP, Barth syndrome, McLeod syndrome and Bethlem MP. Patients with any of the above-mentioned myopathies should be cardiologically investigated as soon as their diagnosis is established, since sufficient cardiac therapy improves CI in MPs and since management of these patients is influenced by the degree of CI. PMID:11111138

Finsterer, J; Stöllberger, C



Device Assists Cardiac Chest Compression  

NASA Technical Reports Server (NTRS)

Portable device facilitates effective and prolonged cardiac resuscitation by chest compression. Developed originally for use in absence of gravitation, also useful in terrestrial environments and situations (confined spaces, water rescue, medical transport) not conducive to standard manual cardiopulmonary resuscitation (CPR) techniques.

Eichstadt, Frank T.



Bifurcation theory and cardiac arrhythmias  

PubMed Central

In this paper we review two types of dynamic behaviors defined by the bifurcation theory that are found to be particularly useful in describing two forms of cardiac electrical instabilities that are of considerable importance in cardiac arrhythmogenesis. The first is action potential duration (APD) alternans with an underlying dynamics consistent with the period doubling bifurcation theory. This form of electrical instability could lead to spatially discordant APD alternans leading to wavebreak and reentrant form of tachyarrhythmias. Factors that modulate the APD alternans are discussed. The second form of bifurcation of importance to cardiac arrhythmogenesis is the Hopf-homoclinic bifurcation that adequately describes the dynamics of the onset of early afterdepolarization (EAD)-mediated triggered activity (Hopf) that may cause ventricular tachycardia and ventricular fibrillation (VT/VF respectively). The self-termination of the triggered activity is compatible with the homoclinic bifurcation. Ionic and intracellular calcium dynamics underlying these dynamics are discussed using available experimental and simulation data. The dynamic analysis provides novel insights into the mechanisms of VT/VF, a major cause of sudden cardiac death in the US. PMID:23459417

Karagueuzian, Hrayr S; Stepanyan, Hayk; Mandel, William J



Retinal output changes qualitatively with every change in ambient illuminance.  


The collective activity pattern of retinal ganglion cells, the retinal code, underlies higher visual processing. How does the ambient illuminance of the visual scene influence this retinal output? We recorded from isolated mouse and pig retina and from mouse dorsal lateral geniculate nucleus in vivo at up to seven ambient light levels covering the scotopic to photopic regimes. Across each luminance transition, most ganglion cells exhibited qualitative response changes, whereas they maintained stable responses within each luminance. We commonly observed the appearance and disappearance of ON responses in OFF cells and vice versa. Such qualitative response changes occurred for a variety of stimuli, including full-field and localized contrast steps and naturalistic movies. Our results suggest that the retinal code is not fixed but varies with every change of ambient luminance. This finding raises questions about signal processing within the retina and has implications for visual processing in higher brain areas. PMID:25485757

Tikidji-Hamburyan, Alexandra; Reinhard, Katja; Seitter, Hartwig; Hovhannisyan, Anahit; Procyk, Christopher A; Allen, Annette E; Schenk, Martin; Lucas, Robert J; Münch, Thomas A



Parvalbumin-expressing interneurons linearly control olfactory bulb output  

PubMed Central

SUMMARY In the olfactory bulb, odor representations by principal mitral cells are modulated by local inhibitory circuits. While dendrodendritic synapses between mitral and granule cells are typically thought to be a major source of this modulation, the contributions of other inhibitory neurons remain unclear. Here we demonstrate the functional properties of olfactory bulb parvalbumin-expressing interneurons (PV cells) and identify their important role in odor coding. Using paired recordings, we find that PV cells form reciprocal connections with the majority of nearby mitral cells, in contrast to the sparse connectivity between mitral and granule cells. In vivo calcium imaging in awake mice reveals that PV cells are broadly tuned to odors. Furthermore, selective PV cell inactivation enhances mitral cell responses in a linear fashion while maintaining mitral cell odor preferences. Thus, dense connections between mitral and PV cells underlie an inhibitory circuit poised to modulate the gain of olfactory bulb output. PMID:24239124

Kato, Hiroyuki K.; Gillet, Shea N.; Peters, Andrew J.; Isaacson, Jeffry S.; Komiyama, Takaki



Bioactive scaffolds for engineering vascularized cardiac tissues  

PubMed Central

Functional vascularization is a key requirement for the development and function of most tissues, and most critically cardiac muscle. Rapid and irreversible loss of cardiomyocytes during cardiac infarction directly results from the lack of blood supply. Contractile cardiac grafts, engineered using cardiovascular cells in conjunction with biomaterial scaffolds, are an actively studied method for cardiac repair. In this article, we focus on biomaterial scaffolds designed to mediate the development and maturation of vascular networks, by immobilized growth factors. The interactive effects of multiple vasculogenic factors are discussed in the context of cardiac tissue engineering. PMID:20857391

Chiu, Loraine; Radisic, Milica; Vunjak-Novakovic, Gordana



Cardiac Myocytes and Local Signaling In Nano-Domains  

PubMed Central

It is well known that calcium-induced calcium-release in cardiac myocytes takes place in spatially restricted regions known as dyads, where discrete patches of junctional sarcoplasmic reticulum tightly associate with the t-tubule membrane. The dimensions of a dyad are so small that it contains only a few Ca2+ ions at any given time. Ca2+ signaling in the dyad is therefore noisy, and dominated by the Brownian motion of Ca2+ ions in a potential field. Remarkably, from this complexity emerges the integrated behavior of the myocyte in which, under normal conditions, precise control of Ca2+ release and muscle contraction is maintained over the life of the cell. This is but one example of how signal processing within the cardiac myocyte and other cells often occurs in small “nano-domains” where proteins and protein-complexes interact at spatial dimensions on the order of ~ 1 – 10 nanometers and at time scales on the order of nanoseconds to perform the functions of the cell. In this article, we will review several examples of local signaling in nano-domains, how it contributes to the integrative behavior of the cardiac myocyte, and present computational methods for modeling signal processing within these domains across differing spatio-temporal scales. PMID:21718716

Winslow, Raimond L.; Greenstein, Joseph L.



Power system Automatic Voltage Regulator design based on Static Output Feedback PID using iterative linear matrix inequality  

Microsoft Academic Search

This paper describes the design and simulation of a static output feedback (SOF) PID automatic voltage regulator (AVR) for a synchronous-machine infinite-bus power system. The design of the regulator guarantees the stability of the closed loop system and ensures the output voltage is maintained within an acceptable threshold. In addition, it damps out local-mode oscillations of the synchronous generator to

A. M. Abdel Ghany



Maintaining Abstinence in College: Temptations and Tactics  

Microsoft Academic Search

\\u000a As the previous chapter notes, the Collegiate Recovery Community (CRC) at Texas Tech University maintains an impressive relapse\\u000a rate of only 4.4% per semester, which means that more than 95% of the community members continue their successful recovery\\u000a each semester. Although one of bedrock beliefs of the Center for Study of Addiction and Recovery is that young men and women

Richard P. Wiebe; H. Harrington Cleveland; Lukas R. Dean


Alertness maintaining tasks (AMTs) while driving.  


We evaluated the effectiveness of alertness maintaining tasks (AMTs) on driver performance, subjective feelings, and psychophysiological state in monotonous simulated driving in two experiments. In the first experiment, 12 professional truck drivers participated in five sessions of simulated driving: driving only, driving with one of three AMTs (counterbalanced), and driving while listening to music. AMTs were not equally effective in maintaining alertness. The trivia AMT prevented driving performance deterioration, and increased alertness (measured by standardized HRV). The choice reaction time AMT was least demanding but also increased subjective sleepiness and reduced arousal (measured by alpha/beta ratio). The working memory AMT caused a significant decrement in driving speed, increased subjective fatigue, and was regarded by the participants as detrimental to driving. Trivia was preferred by the majority of the drivers over the other two AMTs. Experiment 2 further examined the utility of the trivia AMT. When the drivers engaged in the trivia AMT they maintained better driving performance and perceived the driving duration as shorter than the control condition. The two experiments demonstrated that AMTs can have a positive effect on alertness. The effect is localized in the sense that it does not persist beyond the period of the AMT activation. PMID:18460351

Oron-Gilad, Tal; Ronen, Adi; Shinar, David



Interventions to Maintain Mobility: What Works?  

PubMed Central

Mobility, in broad terms, includes everything from the ability to move within your immediate environment (e.g., get out of bed) to the ability to drive across the country. Mobility is essential to maintaining independence and wellbeing, particularly for older adults. This is highlighted by the large number of interventions developed for older adults with the goal of maintaining such mobility. The current paper reviews the state of the science with respect to mobility interventions. Inclusion criteria for the review were: (1) articles must have been peer-reviewed; (2) interventions were evaluated in a randomized controlled trial (RCT); (3) studies included a mobility outcome such as lifespace, driving, or walking ability, (4) studies included a sample of healthy community-dwelling older adults (e.g., not investigations of disease conditions); and (5) studies reported enough empirical data and detail such that results could potentially be replicated. Three main types of interventions were identified: cognitive training, educational interventions, and exercise interventions. A detailed summary and evaluation of each type of intervention, and the current evidence regarding its effectiveness in maintaining mobility, are discussed. Several interventions show clear evidence of effectiveness, and thus are prime areas for translation of results to the older population. Needs and issues for future intervention research are also detailed. PMID:23083492

Ross, Lesley A.; Schmidt, Erica L.; Ball, Karlene



Cardiac lipid content is unresponsive to a physical activity training intervention in type 2 diabetic patients, despite improved ejection fraction  

PubMed Central

Background Increased cardiac lipid content has been associated with diabetic cardiomyopathy. We recently showed that cardiac lipid content is reduced after 12 weeks of physical activity training in healthy overweight subjects. The beneficial effect of exercise training on cardiovascular risk is well established and the decrease in cardiac lipid content with exercise training in healthy overweight subjects was accompanied by improved ejection fraction. It is yet unclear whether diabetic patients respond similarly to physical activity training and whether a lowered lipid content in the heart is necessary for improvements in cardiac function. Here, we investigated whether exercise training is able to lower cardiac lipid content and improve cardiac function in type 2 diabetic patients. Methods Eleven overweight-to-obese male patients with type 2 diabetes mellitus (age: 58.4 ± 0.9 years, BMI: 29.9 ± 0.01 kg/m2) followed a 12-week training program (combination endurance/strength training, three sessions/week). Before and after training, maximal whole body oxygen uptake (VO2max) and insulin sensitivity (by hyperinsulinemic, euglycemic clamp) was determined. Systolic function was determined under resting conditions by CINE-MRI and cardiac lipid content in the septum of the heart by Proton Magnetic Resonance Spectroscopy. Results VO2max increased (from 27.1 ± 1.5 to 30.1 ± 1.6 ml/min/kg, p = 0.001) and insulin sensitivity improved upon training (insulin stimulated glucose disposal (delta Rd of glucose) improved from 5.8 ± 1.9 to 10.3 ± 2.0 ?mol/kg/min, p = 0.02. Left-ventricular ejection fraction improved after training (from 50.5 ± 2.0 to 55.6 ± 1.5%, p = 0.01) as well as cardiac index and cardiac output. Unexpectedly, cardiac lipid content in the septum remained unchanged (from 0.80 ± 0.22% to 0.95 ± 0.21%, p = 0.15). Conclusions Twelve weeks of progressive endurance/strength training was effective in improving VO2max, insulin sensitivity and cardiac function in patients with type 2 diabetes mellitus. However, cardiac lipid content remained unchanged. These data suggest that a decrease in cardiac lipid content in type 2 diabetic patients is not a prerequisite for improvements in cardiac function. Trial registration ISRCTN: ISRCTN43780395 PMID:21615922



Investigation of Space Interferometer Control Using Imaging Sensor Output Feedback  

NASA Technical Reports Server (NTRS)

Numerous space interferometry missions are planned for the next decade to verify different enabling technologies towards very-long-baseline interferometry to achieve high-resolution imaging and high-precision measurements. These objectives will require coordinated formations of spacecraft separately carrying optical elements comprising the interferometer. High-precision sensing and control of the spacecraft and the interferometer-component payloads are necessary to deliver sub-wavelength accuracy to achieve the scientific objectives. For these missions, the primary scientific product of interferometer measurements may be the only source of data available at the precision required to maintain the spacecraft and interferometer-component formation. A concept is studied for detecting the interferometer's optical configuration errors based on information extracted from the interferometer sensor output. It enables precision control of the optical components, and, in cases of space interferometers requiring formation flight of spacecraft that comprise the elements of a distributed instrument, it enables the control of the formation-flying vehicles because independent navigation or ranging sensors cannot deliver the high-precision metrology over the entire required geometry. Since the concept can act on the quality of the interferometer output directly, it can detect errors outside the capability of traditional metrology instruments, and provide the means needed to augment the traditional instrumentation to enable enhanced performance. Specific analyses performed in this study include the application of signal-processing and image-processing techniques to solve the problems of interferometer aperture baseline control, interferometer pointing, and orientation of multiple interferometer aperture pairs.

Leitner, Jesse A.; Cheng, Victor H. L.



Investigation of Space Interferometer Control Using Imaging Sensor Output Feedback  

NASA Technical Reports Server (NTRS)

Numerous space interferometry missions are planned for the next decade to verify different enabling technologies towards very-long-baseline interferometry to achieve high-resolution imaging and high-precision measurements. These objectives will require coordinated formations of spacecraft separately carrying optical elements comprising the interferometer. High-precision sensing and control of the spacecraft and the interferometer-component payloads are necessary to deliver sub-wavelength accuracy to achieve the scientific objectives. For these missions, the primary scientific product of interferometer measurements may be the only source of data available at the precision required to maintain the spacecraft and interferometer-component formation. A concept is studied for detecting the interferometer's optical configuration errors based on information extracted from the interferometer sensor output. It enables precision control of the optical components, and, in cases of space interferometers requiring formation flight of spacecraft that comprise the elements of a distributed instrument, it enables the control of the formation flying vehicles because independent navigation or ranging sensors cannot deliver the high-precision metrology over the entire required geometry. Since the concept can act on the quality of the interferometer output directly, it can detect errors outside the capability of traditional metrology instruments, and provide the means needed to augment the traditional instrumentation to enable enhanced performance. Specific analyses performed in this study include the application of signal-processing and image-processing techniques to solve the problems of interferometer aperture baseline control, interferometer pointing, and orientation of multiple interferometer aperture pairs.

Cheng, Victore H. L.; Leitner, Jesse A.



Reliability and Maintainability model (RAM) user and maintenance manual. Part 2  

NASA Technical Reports Server (NTRS)

This report documents the procedures for utilizing and maintaining the Reliability and Maintainability Model (RAM) developed by the University of Dayton for the NASA Langley Research Center (LaRC). The RAM model predicts reliability and maintainability (R&M) parameters for conceptual space vehicles using parametric relationships between vehicle design and performance characteristics and subsystem mean time between maintenance actions (MTBM) and manhours per maintenance action (MH/MA). These parametric relationships were developed using aircraft R&M data from over thirty different military aircraft of all types. This report describes the general methodology used within the model, the execution and computational sequence, the input screens and data, the output displays and reports, and study analyses and procedures. A source listing is provided.

Ebeling, Charles E.



Adaptive output feedback control of nonlinear systems represented by input-output models  

Microsoft Academic Search

We consider a single-input-single-output nonlinear system which can be represented globally by an input-output model. The system is input-output linearizable by feedback and is required to satisfy a minimum phase condition. The nonlinearities are not required to satisfy any global growth condition. The model depends linearly on unknown parameters which belong to a known compact convex set. We design a

Hassan K. Khalil



A memory-mapped output interface: Omega navigation output data from the JOLT (TM) microcomputer  

NASA Technical Reports Server (NTRS)

A hardware interface which allows both digital and analog data output from the JOLT microcomputer is described in the context of a software-based Omega Navigation receiver. The interface hardware described is designed for output of six (or eight with simple extensions) bits of binary output in response to a memory store command from the microcomputer. The interface was produced in breadboard form and is operational as an evaluation aid for the software Omega receiver.

Lilley, R. W.



Ultrasound image guidance of cardiac interventions  

NASA Astrophysics Data System (ADS)

Surgical procedures often have the unfortunate side-effect of causing the patient significant trauma while accessing the target site. Indeed, in some cases the trauma inflicted on the patient during access to the target greatly exceeds that caused by performing the therapy. Heart disease has traditionally been treated surgically using open chest techniques with the patient being placed "on pump" - i.e. their circulation being maintained by a cardio-pulmonary bypass or "heart-lung" machine. Recently, techniques have been developed for performing minimally invasive interventions on the heart, obviating the formerly invasive procedures. These new approaches rely on pre-operative images, combined with real-time images acquired during the procedure. Our approach is to register intra-operative images to the patient, and use a navigation system that combines intra-operative ultrasound with virtual models of instrumentation that has been introduced into the chamber through the heart wall. This paper illustrates the problems associated with traditional ultrasound guidance, and reviews the state of the art in real-time 3D cardiac ultrasound technology. In addition, it discusses the implementation of an image-guided intervention platform that integrates real-time ultrasound with a virtual reality environment, bringing together the pre-operative anatomy derived from MRI or CT, representations of tracked instrumentation inside the heart chamber, and the intra-operatively acquired ultrasound images.

Peters, Terry M.; Pace, Danielle F.; Lang, Pencilla; Guiraudon, Gérard M.; Jones, Douglas L.; Linte, Cristian A.



Magnetostrictive torque sensor and its output characteristics  

NASA Astrophysics Data System (ADS)

A magnetostrictive torque sensor which can be installed in an automobile transmission to measure torque has been developed. The sensor shaft consists of two grooved sections. An ac bridge circuit formed by two coils surrounding the grooved sections and two fixed resistors is used to detect torque. The shaft material is a newly developed Cr-Mo steel. The sensitivity of the sensor is stable over a wide temperature range. However, the zero point of the sensor output drifted as much as 10% of the full scale of the sensor when the temperature was uniformly raised by 50 °C. To solve the temperature drift problem, the output characteristics of the bridge circuit were examined. It was found that the output signal (sinusoidal wave) from an initially balanced bridge consisted of torque and temperature components. Each component showed a constant phase angle. The torque phase angle was a fixed value whereas that of the temperature was controllable. A method was devised for separating the temperature phase angle from the torque one by about 90° and then eliminating the temperature component from the output signal. The resulting temperature drift of the sensor was less than 1% of the full measurement scale per 50 °C. This paper describes the shaft material, magnetostrictive properties of the shaft, torque and temperature dependence of coil impedances and output characteristics of the bridge circuit.

Shimada, Munekatsu



Temperature acclimation modifies Na+ current in fish cardiac myocytes.  


The present study was designed to test the hypothesis that temperature acclimation modifies sarcolemmal Na+ current (INa) of the fish cardiac myocytes differently depending on the animal's lifestyle in the cold. Two eurythermal fish species with different physiological strategies for surviving in the cold, a cold-dormant crucian carp (Carassius carassius L.) and a cold-active rainbow trout (Oncorhynchus mykiss), were used in acclimation experiments. The INa of carp and trout were also compared with INa of a cold stenothermal burbot (Lota lota). In accordance with the hypothesis, cold-acclimation decreased the density of INa in crucian carp and increased it in rainbow trout, suggesting depression of impulse conduction in cold-acclimated carp and positive compensation of impulse propagation in cold-acclimated trout. The steady-state activation curve of trout INa was shifted by 6 mV to more negative voltages by cold acclimation, which probably lowers the stimulus threshold for action potentials and further improves cardiac excitability in the cold. In burbot myocytes, the INa density was high and the position of the steady-state activation curve on the voltage axis was even more negative than in trout or carp myocytes, suggesting that the burbot INa is adapted to maintain high excitability and conductivity in the cold. The INa of the burbot heart differed from those of carp and trout in causing four times larger charge influx per excitation, which suggests that INa may also have a significant role in cardiac excitation-contraction coupling of the burbot heart. In summary, INa of fish cardiac myocytes shows thermal plasticity that is different in several respects in cold-dormant and cold-active species and thus has a physiologically meaningful role in supporting the variable life styles and habitat conditions of each species. PMID:15235011

Haverinen, Jaakko; Vornanen, Matti



Stimulating Cardiac Muscle by Light: Cardiac Optogenetics by Cell Delivery  

PubMed Central

Background After the recent cloning of light-sensitive ion channels and their expression in mammalian cells, a new field, optogenetics, emerged in neuroscience, allowing for precise perturbations of neural circuits by light. However, functionality of optogenetic tools has not been fully explored outside neuroscience; and a non-viral, non-embryogenesis based strategy for optogenetics has not been shown before. Methods and Results We demonstrate the utility of optogenetics to cardiac muscle by a tandem cell unit (TCU) strategy, where non-excitable cells carry exogenous light-sensitive ion channels, and when electrically coupled to cardiomyocytes, produce optically-excitable heart tissue. A stable channelrhodopsin2 (ChR2) expressing cell line was developed, characterized and used as a cell delivery system. The TCU strategy was validated in vitro in cell pairs with adult canine myocytes (for a wide range of coupling strengths) and in cardiac syncytium with neonatal rat cardiomyocytes. For the first time, we combined optical excitation and optical imaging to capture light-triggered muscle contractions and high-resolution propagation maps of light-triggered electrical waves, found to be quantitatively indistinguishable from electrically-triggered waves. Conclusions Our results demonstrate feasibility to control excitation and contraction in cardiac muscle by light using the TCU approach. Optical pacing in this case uses less energy, offers superior spatiotemporal control, remote access and can serve not only as an elegant tool in arrhythmia research, but may form the basis for a new generation of light-driven cardiac pacemakers and muscle actuators. The TCU strategy is extendable to (non-viral) stem cell therapy and is directly relevant to in vivo applications. PMID:21828312

Jia, Zhiheng; Valiunas, Virginijus; Lu, Zongju; Bien, Harold; Liu, Huilin; Wang, Hong-Zhang; Rosati, Barbara; Brink, Peter R.; Cohen, Ira S.; Entcheva, Emilia



Cardiac myocyte dysfunction induced by streptolysin o is membrane pore and calcium dependent.  


Septic cardiomyopathy is a severe complication among some patients who develop group A streptococcal toxic shock syndrome. Despite the importance of cardiac dysfunction in determining prognosis, very little is known about mechanisms that reduce cardiac output in association with streptococcal infection. Here, we investigated the effects of streptococcal extracellular toxins on mechanical contractility of electrically paced primary murine cardiomyocytes. Our data demonstrate that streptolysin O (SLO) is the major streptococcal toxin responsible for cardiomyocyte contractile dysfunction. Streptolysin O dose-dependently affected cardiac myocyte function in discrete stages. Exposure to SLO caused a failure of cardiac cells to respond to electrical pacing, followed by spontaneous dysregulated contractions and augmented strength of contraction. Central to these SLO-mediated effects is a marked influx of calcium into the cytosol through SLO-mediated pores in the cytoplasmic membrane. Such calcium mobilization in response to SLO correlated temporally with hypercontractility and unpaced contractions. During continued exposure to SLO, cardiomyocytes exhibited periods of reversion to normal electrical pacing suggestive of membrane lesion repair and restoration of calcium handling. Together, these observations are consistent with the clinical observation that septic cardiomyopathy is a reversible condition in patients who survive streptococcal toxic shock syndrome. These data provide strong evidence that streptococcal exotoxins, specifically SLO, can directly impact cardiac mechanical function. PMID:25243426

Bolz, Devin D; Li, Zhi; McIndoo, Eric R; Tweten, Rodney K; Bryant, Amy E; Stevens, Dennis L



Effects of interleukin 2 on cardiac function in the isolated rat heart.  

PubMed Central

Adoptive immunotherapy with IL 2 is associated with severe cardiovascular toxicities including peripheral and pulmonary edema, hypotension decreased systemic vascular resistance, increased heart rate, and an increased cardiac index. The purpose of this investigation was to determine whether IL 2 alone or in combination with lymphokine-activated killer cells (LAK) cells depress cardiac function using the isolated, perfused, working rat heart preparation. Male Sprague-Dawley rats (250-350 g) were anesthetized and the hearts were removed and placed on the perfusion apparatus. Hearts were perfused with oxygenated Krebs-Henseleit buffer (KHB), or oxygenated KHB containing IL 2 alone, IL 2-Media (cell culture media supplemented with 1,500 U IL 2/ml), LYMPH (cell culture media from cultured mononuclear cells from healthy volunteers), or LAK (cell culture media from cultured lymphocytes harvested from patients receiving IL 2/LAK in the presence of 1,500 U/ml IL 2). The cells were removed before perfusion (n = 9). Cardiac output and coronary flow were measured at 20-min intervals with preload constant (afterload varied or afterload constant (preload varied). The results indicate a significant depression in cardiac function in hearts treated with LAK. This depression was evident at 20 min and was more pronounced at 60 min. Washout of the KHB plus LAK reversed this depression. Thus, IL 2-stimulated/cultured human mononuclear cells produce a soluble factor that produces a reversible severe depression of cardiac function. PMID:2394834

Sobotka, P A; McMannis, J; Fisher, R I; Stein, D G; Thomas, J X



Web-Based Environment for Maintaining Legacy Software  

NASA Technical Reports Server (NTRS)

Advanced Tool Integration Environment (ATIE) is the name of both a software system and a Web-based environment created by the system for maintaining an archive of legacy software and expertise involved in developing the legacy software. ATIE can also be used in modifying legacy software and developing new software. The information that can be encapsulated in ATIE includes experts documentation, input and output data of tests cases, source code, and compilation scripts. All of this information is available within a common environment and retained in a database for ease of access and recovery by use of powerful search engines. ATIE also accommodates the embedment of supporting software that users require for their work, and even enables access to supporting commercial-off-the-shelf (COTS) software within the flow of the experts work. The flow of work can be captured by saving the sequence of computer programs that the expert uses. A user gains access to ATIE via a Web browser. A modern Web-based graphical user interface promotes efficiency in the retrieval, execution, and modification of legacy code. Thus, ATIE saves time and money in the support of new and pre-existing programs.

Tigges, Michael; Thompson, Nelson; Orr, Mark; Fox, Richard



33 CFR 150.555 - How must cranes be maintained?  

Code of Federal Regulations, 2010 CFR

...2010-07-01 2010-07-01 false How must cranes be maintained? 150.555 Section 150.555...Miscellaneous Operations § 150.555 How must cranes be maintained? Cranes must be operated, maintained, and tested in...



50-GHz, ultrastable, polarization-maintaining semiconductor fiber ring laser  

E-print Network

50-GHz, ultrastable, polarization-maintaining semiconductor fiber ring laser Antonios stable, all-polarization-maintaining fiber semiconductor ring laser source. It uses a semiconductor: fiber lasers; gain modulation; semiconductor optical amplifier; polarization-maintaining ring laser

Vlachos, Kyriakos G.


LASERS AND PHYSICAL PROCESSES IN THEM: Stabilization of the output power of an LGI-101 copper vapor laser  

NASA Astrophysics Data System (ADS)

A study was made of the influence of the pulse repetition frequency on the output and pump parameters of an LGI-101 copper vapor laser. It was found that the pump and output powers could be stabilized by variation of the pulse repetition frequency. A stabilization unit capable of maintaining the output power constant to within ± 5%, for changes in the line voltage of ± 20 V, was constructed. In the absence of this unit similar changes in the line voltage quenched the lasing action.

Bykanov, A. N.; Lesno?, M. A.



Output radiation from a degenerate parametric oscillator  

E-print Network

We study the squeezing as well as the statistical properties of the output radiation from a degenerate parametric oscillator coupled to a squeezed vacuum reservoir employing the stochastic differential equations associated with the normal ordering. It is found that the degree of squeezing of the output radiation is less than the corresponding cavity radiation. However, for output radiation the correlation of the quadrature operators evaluated at different times also exhibits squeezing, which is the reason for quenching of the overall noise in one of the quadrature components of the squeezing spectrum even when the oscillator is coupled to a vacuum reservoir. Moreover, coupling the oscillator to the squeezed vacuum reservoir enhances the squeezing exponentially and it also increases the mean photon number.

Sintayehu Tesfa



Plasticity of the prolactin (PRL) axis: mechanisms underlying regulation of output in female mice.  


The output of prolactin (PRL) is highly dynamic with dramatic changes in its secretion from the anterior pituitary gland depending on prevailing physiological status. In adult female mice, there are three distinct phases of output and each of these is related to the functions of PRL at specific stages of reproduction. Recent studies of the changes in the regulation of PRL during its period of maximum output, lactation, have shown alterations at both the level of the anterior pituitary and hypothalamus. The PRL-secreting cells of the anterior pituitary are organised into a homotypic network in virgin animals, facilitating coordinated bouts of activity between interconnected PRL cells. During lactation, coordinated activity increases due to the changes in structural connectivity, and this drives large elevations in PRL secretion. Surprisingly, these changes in connectivity are maintained after weaning, despite reversion of PRL output to that of virgin animals, and result in an augmented output of hormone during a second lactation. At the level of the hypothalamus, tuberoinfundibular dopamine (TIDA) neurons, the major inhibitors of PRL secretion, have unexpectedly been shown to remain responsive to PRL during lactation. However, there is an uncoupling between TIDA neuron firing and dopamine secretion, with a potential switch to enkephalin release. Such a process may reinforce hormone secretion through dual disinhibition and stimulation of PRL cell activity. Thus, integration of signalling along the hypothalamo-pituitary axis is responsible for increased secretory output of PRL cells during lactation, as well as allowing the system to anticipate future demands. PMID:25472537

Le Tissier, P R; Hodson, D J; Martin, A O; Romanò, N; Mollard, P



Isolation of functional cardiac immune cells.  


Cardiac immune cells are gaining interest for the roles they play in the pathological remodeling in many cardiac diseases. These immune cells, which include mast cells, T-cells and macrophages; store and release a variety of biologically active mediators including cytokines and proteases such as tryptase. These mediators have been shown to be key players in extracellular matrix metabolism by activating matrix metalloproteinases or causing collagen accumulation by modulating the cardiac fibroblasts' function. However, available techniques for isolating cardiac immune cells have been problematic because they use bacterial collagenase to digest the myocardial tissue. This technique causes activation of the immune cells and thus a loss of function. For example, cardiac mast cells become significantly less responsive to compounds that cause degranulation. Therefore, we developed a technique that allows for the isolation of functional cardiac immune cells which would lead to a better understanding of the role of these cells in cardiac disease. This method requires a familiarity with the anatomical location of the rat's xiphoid process, axilla and falciform ligament, and pericardium of the heart. These landmarks are important to increase success of the procedure and to ensure a higher yield of cardiac immune cells. These isolated cardiac immune cells can then be used for characterization of functionality, phenotype, maturity, and co-culture experiments with other cardiac cells to gain a better understanding of their interactions. PMID:22158428

McLarty, Jennifer L; Meléndez, Giselle C; Spencer, William J; Levick, Scott P; Brower, Gregory L; Janicki, Joseph S



Noncoherent Combination Of Optical-Heterodyne Outputs  

NASA Technical Reports Server (NTRS)

In proposed scheme for reception of amplitude- or frequency-modulated signals transmitted optically through atmosphere, main receiver aperture divided into subapertures equipped with receivers, and outputs of receivers combined noncoherently. Multiple subaperture receivers used instead of attempting to focus all light from single large aperture onto one receiver. Outputs of receivers combined after demodulation. System will not perform as well as fully coherent system, but surpasses single-large-aperture system in presence of atmospheric turbulence. Offers superior performance in presence of distorted wavefront and/or imperfect receiver optics.

Chen, Chien-Chung; Lesh, James R.



Cardiac rehabilitation in the elderly.  


Coronary heart disease (CHD) is the leading cause of death worldwide. Advanced age is associated with a higher prevalence of CHD as well as increased morbidity and mortality. One key vulnerability relates to the fact that older individuals are generally among the least fit, least active cohort and at increased risk of complications after an acute cardiac event and/or major surgery. There is ample evidence to demonstrate the beneficial effects of exercised-based cardiac rehabilitation (CR) programs on improving functional capacity and other indices of cardiovascular (CV) health. Although the predominant number of studies is in middle-aged patients, there is an escalating amount of new information that establishes the cardioprotective role of CR and, in particular, structured exercise therapy (ET) among the elderly. The present review summarizes the current data available regarding CR and ET and its salutary impact on today's growing population of older adults with CHD. PMID:25216614

Menezes, Arthur R; Lavie, Carl J; Forman, Daniel E; Arena, Ross; Milani, Richard V; Franklin, Barry A



New horizons in cardiac imaging  

SciTech Connect

The emphasis in cardiac diagnosis in recent years has been on noninvasive imaging techniques that enable anatomic diagnosis and physiologic assessment of the severity of disease. Echocardiography and radionuclide imaging were early noninvasive techniques that are now central to cardiovascular diagnosis. During the past few years, three new imaging modalities have been introduced: magnetic resonance (MR), ultrafast computed tomography (cine CT), and positron emission tomography (PET). These new techniques enable the following to be done noninvasively: depiction of internal cardiac anatomy, characterization of myocardial tissue, quantitation of blood flow, estimation and perhaps quantitation of regional myocardial perfusion, quantitation of regional myocardial contraction, and in vivo sampling of myocardial metabolism. Some of the capabilities of the new imaging modalities will be reviewed, and the likely role for each in the clinical and investigative study of cardiovascular disease will be proposed.

Higgins, C.B.



Calcium signaling in cardiac mitochondria  

PubMed Central

Mitochondrial Ca signaling contributes to the regulation of cellular energy metabolism, and mitochondria participate in cardiac excitation-contraction coupling (ECC) through their ability to store Ca, shape the cytosolic Ca signals and generate ATP required for contraction. The mitochondrial inner membrane is equipped with an elaborate system of channels and transporters for Ca uptake and extrusion that allows for the decoding of cytosolic Ca signals, and the storage of Ca in the mitochondrial matrix compartment. Controversy, however remains whether the fast cytosolic Ca transients underlying ECC in the beating heart are transmitted rapidly into the matrix compartment or slowly integrated by the mitochondrial Ca transport machinery. This review summarizes established and novel findings on cardiac mitochondrial Ca transport and buffering, and discusses the evidence either supporting or arguing against the idea that Ca can be taken up rapidly by mitochondria during ECC. PMID:23306007

Dedkova, Elena N.; Blatter, Lothar A.



Monitoring chaos of cardiac rhythms  

SciTech Connect

Chaos theory provides a new paradigm in monitoring complexity changes in heart rate variability. Even in cases where the spectral analysis only shows broad band characteristics estimations of dimensional complexity parameters can show quantitative changes in the degree of chaos present in the interbeat interval dynamics. We introduce the concept of dimensional complexity as dynamical monitoring parameter and discuss its properties in connection with control data and data taken during cardiac arrest. Whereas dimensional complexity provides a quantitative indicator of overall chaotic behavior, recurrence plots allow direct visualization of recurrences in arbitrary high dimensional pattern-space. In combination these two methods from non-linear dynamics exemplify a new approach in the problem of heart rate monitoring and identification of precursors of cardiac arrest. Finally we mention a new method of chaotic control, by which selective and highly effective perturbations of nonlinear dynamical systems could be used for improved pacing patterns. 11 refs., 6 figs.

Mayer-Kress, G.



[Cardiac magnetic resonance imaging (MRI)].  


TECHNOLOGICAL PROGRESS: Although cardiac magnetic resonance imaging (MRI) is now recognised as the imaging method of choice for the morphological study of the heart, recent technological progress have widened its indications to functional analysis of the heart rate, perfusion and contractility. FUNCTIONAL ASSESSMENT: The possibility of conducting pharmacological stress tests enhances the functional exploration of cardiac perfusion and contractility. The rapid sequences in apnea, tissue marking and injection of contrast products are all elements that help to refine the study of the locoregional consequences of an ischemia: does the myocardial tissue contract normally? Is it sufficiently perfused? Is it still viable? THE BENEFITS OF A NON-INVASIVE TECHNIQUE: The MRI offers clinicians a non-invasive and non-radiating imaging technique that is the perfect supplement to echocardiography. A reliable angio-coronary LRI technique would, for the first time, permit exploration of the coronary vascularisation, tissue perfusion and resulting contractility. PMID:15387389

Vignaux, Olivier



Echocardiographic evaluation of cardiac dyssynchrony  

PubMed Central

First described a decade ago, cardiac resynchronization therapy (CRT) has recently become a proven therapeutic strategy for refractory heart failure. Large clinical trials have shown a reduction in both morbidity and mortality in patients treated with CRT. Initial patient selection has relied mainly on electrocardiographic criteria, which allows identification of only 70% of responders. Accordingly, echocardiographic criteria were developed to identify mechanical dyssynchrony in an effort to improve patient selection. Multiple echocardiographic criteria have since been proposed, with no consensus as to which parameter better predicts CRT response. Although comparison studies using different criteria are underway, current evaluation of dyssynchrony should probably use an integrated multiparameter approach. The objective of the present article was to review the role of echocardiography in the evaluation of cardiac dyssynchrony in clinical practice. PMID:17380225

Serri, Karim; Lafitte, Stéphane; Amyot, Robert; Sauvé, Claude; Roudaut, Raymond



Injection of cardiac stem cells prolongs the survival of cardiac allograft rats.  


: Cardiac c-kit+ cells isolated from cardiac explant-derived cells modestly improve cardiac functions after myocardial infarction; however, their full potential has not yet been realized. The present study was undertaken to determine the isolation and culture of c-kit+ cardiac stem cells (CSCs), and the roles of myocardial injection of CSCs on the survival of rat cardiac allograft. Recipient Sprague-Dawley rats were transplanted with hearts from Wistar rats. In the in vitro experiment, c-kit+ cells were isolated from mouse heart fragment culture by magnetic cell sorting. CSCs expressed of cardiomyocyte specific protein cardiac troponin I, ? smooth muscle actin and von Willebrand factor in conditioned culture. CSC injection increased graft survival of cardiac allograft rats. The effects of CSCs on increase in graft survival of cardiac allograft rats were blocked by stromal-derived factor-1 (SDF-1) knockdown. The expression of SDF-1 was increased after CSC injection into the cardiac of cardiac allograft rats. These results indicate that CSC injection into the cardiac prolongs graft survival of cardiac allograft rats. SDF-1 plays an important role in the effects of CSCs on the graft survival of cardiac allograft rats. PMID:25275340

Rong, Xiao-Song; Li, Ming-Qiu; Xu, Yong; Hua, Xiao-Qin; Jiao, Guo-Qing; Wei, Liu-Yan



Cardiac Rehabilitation in the Elderly  

Microsoft Academic Search

\\u000a Rehabilitation following coronary heart events and procedures results in reduced mortality, improved risk factor profiles,\\u000a and improved quality of life. The American College of Cardiology and the American Heart Association have published specific\\u000a guidelines regarding the components of cardiac rehabilitation, which include nutritional counseling, weight management, blood\\u000a pressure management, lipid management, diabetes management, tobacco cessation, psychosocial management, physical activity\\u000a counseling,

Carl I. Gonzales; Lois A. Killewich


Infection control in cardiac surgery.  


This report relates the results of a multifaceted, 4 year program directed toward reduction of infection in patients undergoing cardiac operations and extracorporeal circulation in a large teaching hospital. Retrospective analysis of all superficial and deep wound infections and prosthetic valve infections for the period of 1966 to 1970 and a prospective study of the period of 1970 to 1974 were made. The multifaceted program begun in 1970 consisted of (1) renovation of a cardiac operating room with incorporation of a high flow, vertical unidirectional ventilation system, (2) change in the gown and draping material for improvement of barriers to bacteriologic shedding, (3) frequent steam sterilization of prosthetic valves, (4) routine use of an antistaphylococcal agent in patients receiving valve replacement, and (5) an unannounced bacteriologic monitoring program of the cardiac operating room personnel. Studies of airborne particulates and bacteria and adequacy of skin preparation and hair removal also were conducted. The studies showed that (1) a high-flow HEPA filtered vertical ventilation system and altered operating room clothing reduced the concentration of airborne particles and the concentration of bacteria at the wound by a factor of 10 compared to conventional operating rooms, (2) the incidence of markedly contaminated scrubbed and unscrubbed hands decreased, (3) shedders and carriers were identified, and (4) current patient skin preparation and hair removal practices were satisfactory. The results of the program were a reduction of the deep wound infection rate from 2.9 to 0.6 percent (p less than 0.01) and a concomitant total wound infection decrease from 6.6 to 3.3 percent. Prosthetic valve infection rates decreased fourfold, from 5.6 to 1.4 percent. It is concluded that careful attention to possible endogenous sources of infection from the patient and a multifaceted program directed to exogenous sources of infection can lower infection rates in cardiac surgical patients. PMID:1246694

Clark, R E; Amos, W C; Higgins, V; Bemberg, K F; Weldon, C S



Inverse relationship between long chain n-3 fatty acids and risk of sudden cardiac death in patients starting hemodialysis  

PubMed Central

Experimental and clinical evidence suggests that long chain n-3 fatty acids may protect against sudden cardiac death, the leading cause of mortality in hemodialysis patients. Here we investigated whether long chain n-3 fatty acids have a protective relationship with sudden cardiac death in 100 patients who died of sudden cardiac death during the first year of starting hemodialysis and 300 patients who survived. Individuals were selected from a nationally representative cohort of over 1000 U.S. hemodialysis units in 2004–2005. The odds of sudden cardiac death were calculated by quartile of long chain n-3 fatty acids levels over the first year. There was a significant inverse relationship between long chain n-3 fatty acids and the risk of sudden cardiac death even after adjusting for relevant co-morbid conditions, biochemical values, and dietary fats. The odds of sudden cardiac death at 1 year for the second, third, and fourth quartile groups of long chain n-3 fatty acids were 0.37, 0.22, and 0.20, respectively, compared to the lowest quartile. This significant inverse relationship was maintained even during the highest-risk first few months on hemodialysis. Thus, long chain n-3 fatty acids are strongly and independently associated with a lower risk of sudden cardiac death in hemodialysis patients throughout the first year of hemodialysis. PMID:23389417

Friedman, Allon N.; Yu, Zhangsheng; Tabbey, Rebeka; Denski, Cheryl; Tamez, Hector; Wenger, Julia; Thadhani, Ravi; Li, Yong; Watkins, Bruce



Exact emulation of an output queueing switch by a combined input output queueing switch  

Microsoft Academic Search

Combined input-output queueing switches (CIOQ) have better scaling properties than output queueing (OQ) switches. However, a CIOQ switch may have lower switch throughput and, more importantly, it is difficult to control delay in a CIOQ switch due to the existence of multiple queueing points. In this paper, we study the following problem: can a CIOQ switch be designed to behave

Ion Stoica; Hui Zhang



Role of training in maintaining equipment qualification  

SciTech Connect

During the last decade, US nuclear utilities have expended over half a billion dollars in establishing equipment qualification (EQ); i.e., demonstrating that all safety-related equipment can perform its function during design basis accidents and earthquakes, even if degraded by years of aging during plant operation. Focus is now on maintaining EQ-preserving the qualified configuration of installed equipment, performing special EQ maintenance (including replacement of parts, sometimes with dedicated commercial grade items), and preserving an auditable trail of EQ documentation. Because of the high turnover rate in personnel involved in EQ, utilities are examining their EQ staffing and training needs to guard against a possible gradual erosion of expertise in and attention to EQ. This paper gives a brief overview of EQ, establishes the need for comprehensive training on maintaining EQ, and presents the EQ knowledge requirements for four sectors of personnel (maintenance, engineering, QA, and management). Finally, the essential elements of training course materials to meet these needs are identified.

Sliter, G. (Electric Power Research Inst., Palo Alto, CA (United States)); Kasturi, S. (MOS, Melville, NY (United States))



Cardiac involvement in Wegener's granulomatosis.  

PubMed Central

Wegener's granulomatosis is a systemic inflammatory disorder of unknown aetiology. The protean clinical presentations depend on the organ(s) involved and the degree of progression from a local to a systemic arteritis. The development of serological tests (antieutrophil cytoplasmic antibodies) allows easier diagnosis of a disease whose incidence is increasing. This is particularly helpful where the presentation is not classic--for example "overlap syndromes"--or where the disease presents early in a more localised form. This is true of cardiac involvement, which is traditionally believed to be rare, but may not be as uncommon as has hitherto been thought (< or = 44%). This involvement may be subclinical or the principal source of symptoms either in the form of localised disease or as part of a systemic illness. Pericarditis, arteritis, myocarditis, valvulitis, and arrhythmias are all recognised. Wegener's granulomatosis should therefore be considered in the differential diagnosis of any non-specific illness with cardiac involvement. This includes culture negative endocarditis, because Wegener's granulomatosis can produce systemic upset with mass lesions and vasculitis. Echocardiography and particularly transoesophageal echocardiography can easily identify and delineate cardiac and proximal aortic involvement and may also be used to assess response to treatment. Images PMID:7696016

Goodfield, N. E.; Bhandari, S.; Plant, W. D.; Morley-Davies, A.; Sutherland, G. R.



Cardiac function in experimental uremia.  


In acutely uremic animals, the contractile force of the heart is consistently increased; such an increase can be dissociated from changes of afterload or catecholaminergic drive. It is associated with diminished sarcolemmal Na,K-ATPase activity in the heart which, in turn, may be related to increased levels of endogenous digitalis-like substances (endigens) that have been postulated to represent a natriuretic factor. In patients with chronic uremia, myocardial contractility is usually normal, but occasionally there may be heart failure unrelated to pre-existing hypertension, coronary heart disease, anemia, fluid overload, or other recognizable factors. So far, the experimental basis for this clinical observation is uncertain. Possible causes for the clinical syndrome include an excess of parathyroid hormone or cardiodepressor substances. There is experimental evidence of impaired cardiac response to beta adrenergic agonists, e.g., decreased isoproterenol-dependent calcium uptake, diminished inotropic and chronotropic responses. In acutely uremic rats, cardiac cyclic AMP levels are high but can be reversed by beta blockers. Heart calcium content is variable and heart weight is constantly increased in acutely uremic rats, despite decreased skeletal muscle mass. The change in heart weight is not related to anemia, to an excess of parathyroid hormone, or to sympathetic activity; its cause remains unknown. Experimental studies to date have shown a variety of abnormalities, but do not provide a uniform concept of the mechanisms or an explanation for the cardiac dysfunction so often observed in patients with uremia. PMID:6368951

Kreusser, W; Mann, J; Rambausek, M; Klooker, P; Mehls, O; Ritz, E



Cardiac molecular-acclimation mechanisms in response to swimming-induced exercise in Atlantic salmon.  


Cardiac muscle is a principal target organ for exercise-induced acclimation mechanisms in fish and mammals, given that sustained aerobic exercise training improves cardiac output. Yet, the molecular mechanisms underlying such cardiac acclimation have been scarcely investigated in teleosts. Consequently, we studied mechanisms related to cardiac growth, contractility, vascularization, energy metabolism and myokine production in Atlantic salmon pre-smolts resulting from 10 weeks exercise-training at three different swimming intensities: 0.32 (control), 0.65 (medium intensity) and 1.31 (high intensity) body lengths s(-1). Cardiac responses were characterized using growth, immunofluorescence and qPCR analysis of a large number of target genes encoding proteins with significant and well-characterized function. The overall stimulatory effect of exercise on cardiac muscle was dependent on training intensity, with changes elicited by high intensity training being of greater magnitude than either medium intensity or control. Higher protein levels of PCNA were indicative of cardiac growth being driven by cardiomyocyte hyperplasia, while elevated cardiac mRNA levels of MEF2C, GATA4 and ACTA1 suggested cardiomyocyte hypertrophy. In addition, up-regulation of EC coupling-related genes suggested that exercised hearts may have improved contractile function, while higher mRNA levels of EPO and VEGF were suggestive of a more efficient oxygen supply network. Furthermore, higher mRNA levels of PPAR?, PGC1? and CPT1 all suggested a higher capacity for lipid oxidation, which along with a significant enlargement of mitochondrial size in cardiac myocytes of the compact layer of fish exercised at high intensity, suggested an enhanced energetic support system. Training also elevated transcription of a set of myokines and other gene products related to the inflammatory process, such as TNF?, NF?B, COX2, IL1RA and TNF decoy receptor. This study provides the first characterization of the underlying molecular acclimation mechanisms in the heart of exercise-trained fish, which resemble those reported for mammalian physiological cardiac growth. PMID:23372811

Castro, Vicente; Grisdale-Helland, Barbara; Helland, Ståle J; Torgersen, Jacob; Kristensen, Torstein; Claireaux, Guy; Farrell, Anthony P; Takle, Harald



Cardiac Molecular-Acclimation Mechanisms in Response to Swimming-Induced Exercise in Atlantic Salmon  

PubMed Central

Cardiac muscle is a principal target organ for exercise-induced acclimation mechanisms in fish and mammals, given that sustained aerobic exercise training improves cardiac output. Yet, the molecular mechanisms underlying such cardiac acclimation have been scarcely investigated in teleosts. Consequently, we studied mechanisms related to cardiac growth, contractility, vascularization, energy metabolism and myokine production in Atlantic salmon pre-smolts resulting from 10 weeks exercise-training at three different swimming intensities: 0.32 (control), 0.65 (medium intensity) and 1.31 (high intensity) body lengths s?1. Cardiac responses were characterized using growth, immunofluorescence and qPCR analysis of a large number of target genes encoding proteins with significant and well-characterized function. The overall stimulatory effect of exercise on cardiac muscle was dependent on training intensity, with changes elicited by high intensity training being of greater magnitude than either medium intensity or control. Higher protein levels of PCNA were indicative of cardiac growth being driven by cardiomyocyte hyperplasia, while elevated cardiac mRNA levels of MEF2C, GATA4 and ACTA1 suggested cardiomyocyte hypertrophy. In addition, up-regulation of EC coupling-related genes suggested that exercised hearts may have improved contractile function, while higher mRNA levels of EPO and VEGF were suggestive of a more efficient oxygen supply network. Furthermore, higher mRNA levels of PPAR?, PGC1? and CPT1 all suggested a higher capacity for lipid oxidation, which along with a significant enlargement of mitochondrial size in cardiac myocytes of the compact layer of fish exercised at high intensity, suggested an enhanced energetic support system. Training also elevated transcription of a set of myokines and other gene products related to the inflammatory process, such as TNF?, NF?B, COX2, IL1RA and TNF decoy receptor. This study provides the first characterization of the underlying molecular acclimation mechanisms in the heart of exercise-trained fish, which resemble those reported for mammalian physiological cardiac growth. PMID:23372811

Castro, Vicente; Grisdale-Helland, Barbara; Helland, Ståle J.; Torgersen, Jacob; Kristensen, Torstein; Claireaux, Guy; Farrell, Anthony P.; Takle, Harald



A rail-to-rail input\\/output CMOS power amplifier  

Microsoft Academic Search

A rail-to-rail amplifier that maintains a high common-mode rejection ratio (CMRR) over the whole common-mode range and has a low harmonic distortion despite the use of relatively small output devices is discussed. The circuit, which measures only 0.3 mm2 in a 3-?m technology, has a quiescent current consumption of 600 ?A and a CMRR larger than 55 dB. It handles

M. D. Pardoen; M. G. Degrauwe



Priority queue schedulers with approximate sorting in output-buffered switches  

Microsoft Academic Search

All recently proposed packet-scheduling algorithms for output-buffered switches that support quality-of-service (QoS) transmit packets in some priority order, e.g., according to deadlines, virtual finishing times, eligibility times, or other time stamps that are associated with a packet. Since maintaining a sorted priority queue introduces significant overhead, much emphasis on QoS scheduler design is put on methods to simplify the task

Jorg Liebeherr; Dallas E. Wrege



Distributed formation output regulation of switching heterogeneous multi-agent systems  

Microsoft Academic Search

In this article, the distributed formation output regulation problem of linear heterogeneous multi-agent systems with uncertainty under switching topology is considered. It is a generalised framework for multi-agent coordination problems, which contains or concerns a variety of important multi-agent problems in a quite unified way. Its background includes active leader following formation for the agents to maintain desired relative distances

Xiaoli Wang



Multidimensional Health Locus of Control and Causal Attributions as Predictors of Health and Risk Factor Status after Cardiac Rehabilitation.  

ERIC Educational Resources Information Center

Compliance with many health-promoting regimens is often poor, even among individuals with known chronic disease. Lifestyle changes recommended by cardiac rehabilitation educators are often not adopted or not maintained by clients having suffered myocardial infarction and/or coronary graft bypass surgery. Subjects were graduates (N=117) of a Phase…

Birkimer, John C.; And Others


Arterial Baroreflex Control of Cardiac Vagal Outflow in Older Individuals Can Be Enhanced by Aerobic Exercise Training  

Microsoft Academic Search

Maintained cardiac vagal function is critical to cardiovascular health in human aging. Aerobic exercise training has been considered an attractive intervention to increase cardiovagal baroreflex function; however, the data are equivocal. Moreover, if regular exercise does reverse the age-related decline in cardiovagal baroreflex function, it is unknown how this might be achieved. Therefore, we assessed the effects of a 6-month

Gaelle Deley; Glen Picard; J. Andrew Taylor



42 CFR 410.49 - Cardiac rehabilitation program and intensive cardiac rehabilitation program: Conditions of coverage.  

Code of Federal Regulations, 2011 CFR

... (v) Percutaneous transluminal coronary angioplasty (PTCA) or coronary stenting; (vi) A heart or heart-lung transplant. (vii) For cardiac rehabilitation only, other cardiac conditions as specified through a national coverage...



42 CFR 410.49 - Cardiac rehabilitation program and intensive cardiac rehabilitation program: Conditions of coverage.  

Code of Federal Regulations, 2014 CFR

... (v) Percutaneous transluminal coronary angioplasty (PTCA) or coronary stenting; (vi) A heart or heart-lung transplant. (vii) For cardiac rehabilitation only, other cardiac conditions as specified through a national coverage...



42 CFR 410.49 - Cardiac rehabilitation program and intensive cardiac rehabilitation program: Conditions of coverage.  

Code of Federal Regulations, 2013 CFR

... (v) Percutaneous transluminal coronary angioplasty (PTCA) or coronary stenting; (vi) A heart or heart-lung transplant. (vii) For cardiac rehabilitation only, other cardiac conditions as specified through a national coverage...



Cardiac mechanics: Physiological, clinical, and mathematical considerations  

NASA Technical Reports Server (NTRS)

Recent studies concerning the basic physiological and biochemical principles underlying cardiac muscle contraction, methods for the assessment of cardiac function in the clinical situation, and mathematical approaches to cardiac mechanics are presented. Some of the topics covered include: cardiac ultrastructure and function in the normal and failing heart, myocardial energetics, clinical applications of angiocardiography, use of echocardiography for evaluating cardiac performance, systolic time intervals in the noninvasive assessment of left ventricular performance in man, evaluation of passive elastic stiffness for the left ventricle and isolated heart muscle, a conceptual model of myocardial infarction and cardiogenic shock, application of Huxley's sliding-filament theory to the mechanics of normal and hypertrophied cardiac muscle, and a rheological modeling of the intact left ventricle. Individual items are announced in this issue.

Mirsky, I. (editor); Ghista, D. N.; Sandler, H.



Mitochondria in cardiac hypertrophy and heart failure  

PubMed Central

Heart failure (HF) frequently is the unfavorable outcome of pathological heart hypertrophy. In contrast to physiological cardiac hypertrophy, which occurs in response to exercise and leads to full adaptation of contractility to the increased wall stress, pathological hypertrophy occurs in response to volume or pressure overload, ultimately leading to contractile dysfunction and HF. Because cardiac hypertrophy impairs the relationship between ATP demand and production, mitochondrial bioenergetics must keep up with the cardiac hypertrophic phenotype. We review data regarding the mitochondrial proteomic and energetic remodeling in cardiac hypertrophy, as well as the temporal and causal relationship between mitochondrial failure to match the increased energy demand and progression to cardiac decompensation. We suggest that the maladaptive effect of sustained neuroendocrine signals on mitochondria leads to bioenergetic fading which contributes to the progression from cardiac hypertrophy to failure. PMID:22982369

Rosca, Mariana G.; Tandler, Bernard; Hoppel, Charles L.



Porous radiant burners having increased radiant output  


Means and methods for enhancing the output of radiant energy from a porous radiant burner by minimizing the scattering and increasing the adsorption, and thus emission of such energy by the use of randomly dispersed ceramic fibers of sub-micron diameter in the fabrication of ceramic fiber matrix burners and for use therein.

Tong, Timothy W. (Tempe, AZ); Sathe, Sanjeev B. (Tempe, AZ); Peck, Robert E. (Tempe, AZ)



Contemporary Mathematics Nonlinear Input-Output Equilibrium  

E-print Network

and study Nonlinear Input-Output Equilibrium (NIOE). The main difference between NIOE and the classical of productive sectors of an economy. Since WW2 the IO model has been widely used for analysis of economic. The applications of IO range from a branch of a single economy to the World economy. The main contributor to IO

Polyak, Roman A.


Towards structured output prediction of enzyme function  

PubMed Central

Background In this paper we describe work in progress in developing kernel methods for enzyme function prediction. Our focus is in developing so called structured output prediction methods, where the enzymatic reaction is the combinatorial target object for prediction. We compared two structured output prediction methods, the Hierarchical Max-Margin Markov algorithm (HM3) and the Maximum Margin Regression algorithm (MMR) in hierarchical classification of enzyme function. As sequence features we use various string kernels and the GTG feature set derived from the global alignment trace graph of protein sequences. Results In our experiments, in predicting enzyme EC classification we obtain over 85% accuracy (predicting the four digit EC code) and over 91% microlabel F1 score (predicting individual EC digits). In predicting the Gold Standard enzyme families, we obtain over 79% accuracy (predicting family correctly) and over 89% microlabel F1 score (predicting superfamilies and families). In the latter case, structured output methods are significantly more accurate than nearest neighbor classifier. A polynomial kernel over the GTG feature set turned out to be a prerequisite for accurate function prediction. Combining GTG with string kernels boosted accuracy slightly in the case of EC class prediction. Conclusion Structured output prediction with GTG features is shown to be computationally feasible and to have accuracy on par with state-of-the-art approaches in enzyme function prediction. PMID:19091049

Astikainen, Katja; Holm, Liisa; Pitkänen, Esa; Szedmak, Sandor; Rousu, Juho



Input-output, expandable-parity network  

NASA Technical Reports Server (NTRS)

Large-scale integrated circuit generates and checks parity of four eight-bit registers. In addition, circuit will indicate by output signal whether parity error exists. Circuit can also generate or check parity of words up to 32 bits. This is done by making appropriate internal wiring connections on the large-scale integrated chip.

Mckevitt, J. F., III



BIBO Output Feedback Stabilization With Saturated Control  

Microsoft Academic Search

For the problem of stabilization of mildly nonlinear systems with saturatedcontrol, a simple and computationally attractive method of designing astabilizing gain scheduled output feedback is proposed. The resultingcontroller is characterized by an efficient use of the actuator capacity("agressive" control), and is supplied with rigorously proven input\\/outputperformance bounds. In particular, for the case of stabilization of a lineartime invariant system without

A. Megretski