ST-segment elevation predicts the occurrence of malignant ventricular arrhythmia events in patients with acute ST-segment elevation myocardial infarction.

BACKGROUND: ST-segment elevation (STE) represents a repolarization dispersion marker underlying arrhythmogenesis in ST-segment elevation myocardial infarction (STEMI); however, its value for predicting malignant ventricular arrhythmia events (MVAEs) remains uncertain. METHODS: In total, 285 patients with STEMI and those with or without MVAEs who presented within 6 h of symptom onset were enrolled. The relationships between STE and clinical characteristics of MVAEs (defined as ventricular tachycardia or ventricular fibrillation) were analyzed using t-test, chi-square test, binary multivariate logistic regression, and receiver operating characteristic curve analysis. RESULTS: Patients with STEMI and MVAEs had a shorter time from symptom onset to balloon time (p = 0.0285) and greater STE (p < 0.01) than those without MVAEs. The symptom-to-balloon time, age, and STE were associated with MVAEs after stepwise regression analysis in all cases. Only STE was significantly associated with the occurrence of MVAEs (all, p < 0.01). The area under the curve (AUC) of STE for predicting MVAEs was 0.905, and the cut-off value was 4.5 mV. When only infarct-related arteries were included in the analysis, the AUC of the left anterior descending artery was 0.925 with a cut-off value of 4.5 mV, that of the right coronary artery was 0.915 with a cut-off value of 4.5 mV, and that of the left circumflex artery was 0.929 with a cut-off value of 4.0 mV. CONCLUSIONS: In patients with STEMI presenting within 6 h of symptom onset, age, symptom-to-balloon time, and STE were the main predictors for MVAEs. However, among these, STE was the strongest predictor for MVAEs and was an index for repolarization dispersion of cardiomyocytes in infarcted and non-infarcted areas.

Bond Behavior of Plain Bars in Concrete under Reversed Cyclic Loading.

Plain bars with a diameter of 10 mm are widely used in reinforced concrete buildings, and the bond behavior between the bars and concrete has an essential effect on the seismic performance of concrete structures. Thus, to assess the safety of old buildings and repaired buildings with normal concrete, it was necessary to further investigate the bond performance of the plain bars in the concrete. The bonding tests under monotonic and reversed cyclic loading were carried out on the specimens reinforced with plain bars, and the influences of concrete grade and embedment length on the bond behavior were taken into consideration. The results indicate the maximum bond stress under reversed cyclic loading is less than that under monotonic loading, and this is the same for corresponding slip for the same test parameters. The concrete compressive strength positively affects the maximum bond stress, whereas the embedment length has a negative effect. Based on the elasticity analysis and test data fitting, the expressions of bond stress at characteristic points on the bond stress-slip curves were carried out. Consequently, the bond stress-slip model was established, which could be applied to calculate the bond stress-slip relationships under monotonic and reversed cyclic loading. By comparison between the test curves and proposed model, a good agreement is observed, which indicates that the proposed model can be used to predict the bond stress-slip curve of plain bars in concrete.