Echocardiographic assessment of cardiovascular physiology of preterm miniature piglets supported with a pumped artificial placenta system.

OBJECTIVES: We evaluated fetal cardiovascular physiology and mode of cardiac failure in premature miniature piglets on a pumped artificial placenta (AP) circuit. METHODS: Fetal pigs were cannulated via the umbilical vessels and transitioned to an AP circuit composed of a centrifugal pump and neonatal oxygenator and maintained in a fluid-filled biobag. Echocardiographic studies were conducted to measure ventricular function, umbilical blood flow, and fluid status. In utero scans were used as control data. RESULTS: AP fetuses (n = 13; 102±4d gestational age [term 115d]; 616 ± 139 g [g]; survival 46.4 ± 46.8 h) were tachycardic and hypertensive with initially supraphysiologic circuit flows. Increased myocardial wall thickness was observed. Signs of fetal hydrops were present in all piglets. Global longitudinal strain (GLS) measurements increased in the left ventricle (LV) after transition to the circuit. Right ventricle (RV) and LV strain rate decreased early during AP support compared with in utero measurements but recovered toward the end of the experiment. Fetuses supported for >24 h had similar RV GLS to in utero controls and significantly higher GLS compared to piglets surviving only up to 24 h. CONCLUSIONS: Fetuses on a pump-supported AP circuit experienced an increase in afterload, and redistribution of blood flow between the AP and systemic circulations, associated with elevated end-diastolic filling pressures. This resulted in heart failure and hydrops. These preterm fetuses were unable to tolerate the hemodynamic changes associated with connection to the current AP circuit. To better mimic the physiology of the native placenta and preserve normal fetal cardiovascular physiology, further optimization of the circuit will be required.

The effectiveness and types of serves used in elite women's and men's volleyball in the 2021/2022 season.

In elite volleyball, the serve takes an offensive form, aiming to directly score a point or significantly hinder the opponent from launching an attack. Which is why the research aimed to compare the type and effectiveness of the serve in the main round of Tauron and PlusLiga in the 2021/2022 season and update the current knowledge on the types of serves by function and gender. The study analysed observation consisted of 314 women's and men's matches. VolleyStation Pro v 1.29.5; Volleystation z o. o. Poland. Data from the main round matches that took place in the 2021/2022 season in the Polish elite league PlusLiga (182 men's matches) and Tauron Liga (132 women's matches) were used, and the regular season consisted of 2 rounds. The average percentage effectiveness of the serve in women was higher (E = 22%) than in men (E = 15%). In women, only 3 types were observed (JS, JF and W), as much as 86% of all the serves were JF serves. In men, as many as 5 types (JS, JF, FJS, FJF and W), of which over 67% were dynamic JS serves (jumping serve). The serve element has been modified over the years to obtain better effects conducive to winning. Ranging from increasing the speed of the serve, eliminating the serves from the spot in favor of the jump serves, to the use of serves to hide the correct hit of the ball ("Fake"-FFJ, FJS).

Kinematics of Two Special Endurance Trials: A Methodological Contribution to 400-m Performance.

This study aimed to determine changes in the kinematics of sprint steps based on progressive muscular fatigue during high-intensity 350-m and 500-m trials. Twelve elite healthy male 400-m sprinters with a minimum of six years of regular sprint training experience were recruited. They were divided into two groups for the experiment: a 350-m and a 500-m trial group. Time and kinematics of sprinting step motion for specific segments, i.e., starting to final stages of each trial, were obtained using the Opto Jump-Microgate optical measurement system. The starting phase of each sprint was defined as the section without muscular fatigue (noF), and the final phase was the sprint under muscular fatigue (onF). Each last 25 m of the 50-m evaluated section containing ten complete running steps was selected for detailed statistical analysis. Various patterns of temporal and spatial variables of sprinting efforts were observed between 350-m and 500-m trials. Each trial result was influenced by significant individual changes (p < 0.05). All variables indicated that the two distances differed significantly in terms of running kinematics. This was confirmed by significant differences in the mean step frequency (p < 0.001), which presented a difference of 11.75%, and the mean step speed (p < 0.001). As a result of these changes, a hierarchical intermittent endurance training pattern was defined. The research concluded that special endurance (intermittent sprints) based on 350 m differed significantly in kinematics from sprints over 500 m. Therefore, it should be assumed that the distance of 350 m is more similar in its kinematics to the 400-m competition. This should encourage coaches and athletes to apply a 350-m distance in training developing special endurance, especially in the pre-competitive and competitive periods.

Impact of Right Ventricular Pressure Overload on Myocardial Stiffness Assessed by Natural Wave Imaging.

BACKGROUND: Right ventricular (RV) hemodynamic performance determines the prognosis of patients with RV pressure overload. Using ultrafast ultrasound, natural wave velocity (NWV) induced by cardiac valve closure was proposed as a new surrogate to quantify myocardial stiffness. OBJECTIVES: This study aimed to assess RV NWV in rodent models and children with RV pressure overload vs control subjects and to correlate NWV with RV hemodynamic parameters. METHODS: Six-week-old rats were randomized to pulmonary artery banding (n = 6), Sugen hypoxia-induced pulmonary arterial hypertension (n = 7), or sham (n = 6) groups. They underwent natural wave imaging, echocardiography, and hemodynamic assessment at baseline and 6 weeks postoperatively. The authors analyzed NWV after tricuspid and after pulmonary valve closure (TVC and PVC, respectively). Conductance catheters were used to generate pressure-volume loops. In parallel, the authors prospectively recruited 14 children (7 RV pressure overload; 7 age-matched control subjects) and compared RV NWV with echocardiographic and invasive hemodynamic parameters. RESULTS: NWV significantly increased in RV pressure overload rat models (4.99 ± 0.27 m/s after TVC and 5.03 ± 0.32 m/s after PVC in pulmonary artery banding at 6 weeks; 4.89 ± 0.26 m/s after TVC and 4.84 ± 0.30 m/s after PVC in Sugen hypoxia at 6 weeks) compared with control subjects (2.83 ± 0.15 m/s after TVC and 2.72 ± 0.34 m/s after PVC). NWV after TVC correlated with both systolic and diastolic parameters including RV dP/dtmax (r = 0.75; P < 0.005) and RV Ees (r = 0.81; P < 0.005). NWV after PVC correlated with both diastolic and systolic parameters and notably with RV end-diastolic pressure (r = 0.65; P < 0.01). In children, NWV after both right valves closure in RV pressure overload were higher than in healthy volunteers (P < 0.01). NWV after PVC correlated with RV E/E' (r = 0.81; P = 0.008) and with RV chamber stiffness (r = 0.97; P = 0.03). CONCLUSIONS: Both RV early-systolic and early-diastolic myocardial stiffness show significant increase in response to pressure overload. Based on physiology and our observations, early-systolic myocardial stiffness may reflect contractility, whereas early-diastolic myocardial stiffness might be indicative of diastolic function.