Cardiac rhythm, rate and ventricular repolarization properties in infants at risk for sudden infant death syndrome: comparison with age- and sex-matched control infants.

Using 24-hour ambulatory electrocardiographic recordings and 120-lead body surface potential maps, prevailing cardiac rate and rhythm, incidence and frequency of dysrhythm and rate and pattern of ventricular repolarization at the body surface were compared in 17 infants at risk for sudden infant death syndrome (SIDS) and 17 age- and sex-matched control subjects. Sinus rhythm was the prevailing rhythm in both study groups and there were no intergroup differences in average overall awake or asleep sinus rates, nor in temporal variability of sinus rate. Atrial and ventricular ectopic activity were equally uncommon in both study groups. Although there were smooth and bipolar body surface distributions of ST-T and QRST time integrals in both study groups, the average rate of ventricular repolarization (QTc), measured from the 12-lead electrocardiogram, 120-lead body surface potential maps and 24-hour electrocardiography, was consistently shorter in the at-risk group than in the control group. However, temporal variability of QTc was not different between the 2 groups. Thus, significant cardiac dysrhythm and QT prolongation are not found in infants at increased risk for SIDS. Rather, there is an abbreviated ventricular repolarization interval in at-risk infants. In combination with the findings of intergroup similarity of average sinus rate and temporal variability of sinus rate and ventricular repolarization rate, the data suggest a subtle, constant difference in cardiac autonomic activity, most likely an increase in sympathetic tone, in at-risk subjects. The role of this altered cardiac autonomic activity in the causation of SIDS remains undetermined.

Regulation of adhesion molecule expression by CD8 T cells in vivo. II. Expression of L-selectin (CD62L) by memory cytolytic T cells responding to minor histocompatibility antigens.

Activation of murine T cells by Ag or mitogens results in changes in the expression of several cell-surface adhesion molecules that alter the way in which these cells migrate and localize in tissues in vivo. As naive CD8 precursor cells in lymph nodes (LN) differentiate into effector CTL in response to a skin allograft, they up-regulate their expression of Pgp-1 (CD44), VLA-4, and LFA-1 (CD11a/18), while down-regulating L-selectin (CD62L). All cytolytic activity is therefore present in this minor population of L-selectin- Pgp-1high LN T cells. We now report that, late after rejection of minor histocompatibility Ag-disparate skin grafts, the majority of memory CD8 T cells express both L-selectin and Pgp-1 and thus would be expected to migrate via the classical route of recirculation through LN. Furthermore, restimulation of these memory cells by Ag causes them to down-regulate L-selectin, so that memory-effector cells have the same L-selectin- Pgp-1high phenotype as do primary effector cells. These results are in contrast to recent reports that murine and ovine CD4 memory cells do not express L-selectin or recirculate through LN high endothelial venules. In addition, although virgin and naive CD4 cells may be divided based upon their expression of CD45RA or CD45RB, memory CD8 cells cannot be differentiated by their expression of CD45 isoforms.