ABSTRACT
AIMS: QRS narrowing with initiation of biventricular pacing might be an acute electrocardiographic indicator of correction of left bundle branch block (LBBB)-induced depolarization delay and asynchrony. However, its impact on prognosis remains controversial, especially in non-LBBB patients. Our goal was to evaluate the impact of QRS narrowing on long-term mortality and morbidity in a large cohort of patients undergoing cardiac resynchronization therapy (CRT) with different pre-implantation QRS types: LBBB, non-LBBB, and permanent right ventricular pacing. METHODS AND RESULTS: This study included consecutive patients who underwent CRT device implantation. Study endpoints: death from any cause or urgent heart transplantation and death from any cause/urgent heart transplantation or hospital admission for heart failure. All pre- and post-implantation electrocardiograms were analysed using digital callipers, high-amplitude augmentation, 100 mm/s paper speed, and global QRS duration measurement method. A total of 552 CRT patients entered the survival analysis. During the 9 years observation period, 232 (42.0%) and 292 (52.9%) patients met primary and secondary endpoints, respectively. QRS narrowing predicted survival in the Kaplan-Meier analysis only in patients with LBBB. Multivariate Cox regression model showed that QRS narrowing was the major determinant of both study endpoints, with hazard ratios of 0.46 and 0.43, respectively. There was a strong relationship between mortality risk and shortening/widening of the QRS, albeit only in the LBBB group. Patients with non-LBBB morphologies had unfavourable prognosis similar to that in LBBB patients without QRS narrowing. CONCLUSION: Acute QRS narrowing in patients with LBBB might be a desirable endpoint of CRT device implantation.
Subject(s)
Bundle of His/physiopathology , Bundle-Branch Block/therapy , Cardiac Resynchronization Therapy/mortality , Action Potentials , Aged , Aged, 80 and over , Bundle-Branch Block/diagnosis , Bundle-Branch Block/mortality , Bundle-Branch Block/physiopathology , Cardiac Resynchronization Therapy/adverse effects , Electrophysiologic Techniques, Cardiac , Female , Heart Rate , Humans , Male , Middle Aged , Retrospective Studies , Risk Assessment , Risk Factors , Time Factors , Treatment Outcome , Ventricular Function, Left , Ventricular Function, RightABSTRACT
In the article a brief description of the biological basis of the regulation of human biological clocks was presented in order to introduce the role of circadian rhythms in physiology and specifically in the pharmacological translational tools based on the computational physiology models to motivate the need to provide models of circadian fluctuation in plasma cations. The main aim of the study was to develop statistical models of the circadian rhythm of potassium, sodium, and calcium concentrations in plasma. The developed ion models were further tested by assessing their influence on QT duration (cardiac endpoint) as simulated by the biophysically detailed models of human left ventricular cardiomyocyte. The main results are model equations along with an electronic supplement to the article that contains a fully functional implementation of all models.
Subject(s)
Calcium/blood , Circadian Rhythm/physiology , Electrophysiologic Techniques, Cardiac/statistics & numerical data , Potassium/blood , Sodium/blood , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Computer Simulation , Drug Chronotherapy , Electrocardiography/statistics & numerical data , Female , Humans , Male , Middle Aged , Models, Cardiovascular , Myocytes, Cardiac/physiology , Stochastic Processes , Young AdultABSTRACT
The paper presents the results of analyses of samples of manure from a pig farm located near Pila, Poland performed between June 2011 and May 2012 using a single sampling system. The statistical analyses of the average content of chemical and biological oxide demands, nitrogen, phosphorus, potassium, calcium and dry mass in the slurry in various seasons allowed us to draw conclusions concerning the changes in the chemical composition of the manure in specific seasons and to determine the correlations between the chemical parameters. The average content of N, BOD, P, and dry mass content tended to decrease systematically from the spring until the winter. The highest correlation coefficient, which indicates significant interdependency among the variables tested, was consistently found for COD and BOD, whereas the smallest correlation coefficient was found consistently for K and Ca and once for Ca and N.
Subject(s)
Fertilizers , Manure , Animals , Calcium/chemistry , Nitrogen/chemistry , Phosphorus/chemistry , Poland , Potassium/chemistry , Seasons , Sodium/chemistry , SwineABSTRACT
Asymmetric dimethylarginine (ADMA) has been recognized as a marker of cardiovascular risk. We sought to investigate whether consumption of tea, coffee, fruit or vegetables is associated with ADMA. In 148 consecutive apparently healthy subjects (104 men and 44 women aged 40 to 70), daily tea, coffee, fruit and vegetable consumption was ascertained by questionnaire. Plasma ADMA, symmetric dimethylarginine (SDMA), and l-arginine levels were measured by high-performance liquid chromatography. Median tea and coffee consumption was 2 cups/d, while vegetable and fruit intake was 152 (120-179)g/d and 120 (108-134)g/d, respectively. Median plasma ADMA, SDMA and arginine were 0.47 (0.43-0.53)µmol/L, 0.59 (0.54-0.66)µmol/L and 86 (68-101)µmol/L, respectively. ADMA correlated inversely with tea (r = -0.70, P < .0001) and vegetable consumption (r = -0.50, P < .0001) even after adjustment for age, sex, body mass index, smoking status, and potential dietary and biochemical parameters. No association between ADMA and fruit consumption was found. ADMA correlated positively with coffee intake (r = 0.37, P < .0001), although these associations were less potent after adjustment for dietary factors. Higher tea and vegetable intake is associated with lower plasma ADMA levels in healthy middle-aged subjects.
Subject(s)
Arginine/analogs & derivatives , Cardiovascular Diseases/metabolism , Feeding Behavior , Nitric Oxide Synthase/antagonists & inhibitors , Tea , Vegetables , Aged , Arginine/blood , Cardiovascular Diseases/blood , Cardiovascular Diseases/etiology , Cardiovascular Diseases/prevention & control , Chromatography, High Pressure Liquid , Coffee , Enzyme Inhibitors/blood , Female , Fruit , Humans , Linear Models , Male , Middle Aged , Multivariate Analysis , Reference Values , Risk FactorsABSTRACT
Electrical phenomena located within the plasma membrane of the mammalian cardiac cells are connected with the cells' main physiological functions--signals processing and contractility. They were extensively studied and described mathematically in so-called Hodgkin-Huxley paradigm. One of the physiological parameters, namely cell electric capacitance, has not been analyzed in-depth. The aim of the study was to validate the mechanistic model describing the capacitive properties of cells, based on a collected experimental dataset which describes the electric capacitance of human ventricular myocytes. The gathered data was further utilized for developing an empirical correlation between a healthy individual's age and cardiomyocyte electric capacitance.