Cell therapy and satellite centers: the Cardiovascular Cell Therapy Research Network experience.

Due to the changing population in patients with myocardial infarction, recruiting patients in clinical trials continues to challenge clinical investigators. The Cardiovascular Cell Therapy Research Network (CCTRN) chose to expand the reach and power of its recruitment effort by incorporating both referral and treatment satellite centers. Eight treatment satellites were successfully identified and they screened patients over a two year period. The result of this effort was an increase in recruitment, with these treatment satellites contributing 30% of the patients to two of the three Network studies. The hurdles that these satellite treatment centers faced and how they surmounted them provide instruction to clinical research groups eager to expand to satellite systems and to health care practitioners who are interested in taking part in multicenter clinical trials.

Global cardiovascular reserve dysfunction in heart failure with preserved ejection fraction.

OBJECTIVES: The purpose of this study was to comprehensively examine cardiovascular reserve function with exercise in patients with heart failure and preserved ejection fraction (HFpEF). BACKGROUND: Optimal exercise performance requires an integrated physiologic response, with coordinated increases in heart rate, contractility, lusitropy, arterial vasodilation, endothelial function, and venous return. Cardiac and vascular responses are coupled, and abnormalities in several components may interact to promote exertional intolerance in HFpEF. METHODS: Subjects with HFpEF (n = 21), hypertension without heart failure (n = 19), and no cardiovascular disease (control, n = 10) were studied before and during exercise with characterization of cardiovascular reserve function by Doppler echocardiography, peripheral arterial tonometry, and gas exchange. RESULTS: Exercise capacity and tolerance were reduced in HFpEF compared with hypertensive subjects and controls, with lower VO(2) and cardiac index at peak, and more severe dyspnea and fatigue at matched low-level workloads. Endothelial function was impaired in HFpEF and in hypertensive subjects as compared with controls. However, blunted exercise-induced increases in chronotropy, contractility, and vasodilation were unique to HFpEF and resulted in impaired dynamic ventricular-arterial coupling responses during exercise. Exercise capacity and symptoms of exertional intolerance were correlated with abnormalities in each component of cardiovascular reserve function, and HFpEF subjects were more likely to display multiple abnormalities in reserve. CONCLUSIONS: HFpEF is characterized by depressed reserve capacity involving multiple domains of cardiovascular function, which contribute in an integrated fashion to produce exercise limitation. Appreciation of the global nature of reserve dysfunction in HFpEF will better inform optimal design for future diagnostic and therapeutic strategies.

A cobalt(III) compound of a 13-membered cyclic tetraamine: trans-(12,12-dimethyl-1,4,7,10-tetraazacyclotetradecane)diisothiocyanatocobalt(III) tetraisothiocyanatozinc(II) ethanol solvate.

The title compound, [Co(NCS)2(C11H26N4)]2[Zn(NCS)4].C2H5OH, has two similar cations with the Co(III) atom coordinated in a planar fashion by the 13-membered cyclic tetraamine, in the 1R,4S,7R,10S configuration, and with trans isothiocyanate ligands. The six-membered chelate ring is in a chair conformation, with one axially and one equatorially oriented methyl substituent [mean Co-N = 1.948 (2) A]. The ;opposite' chelate ring (N4 and N7) is in an eclipsed conformation [mean Co-N = 1.928 (2) A], and the ;side' chelate rings have gauche conformations. The mean Co-N(NCS) distance is 1.928 (2) A. Both cations have one Co-N-C group nearly linear and the other appreciably bent, with mean Co-N-C angles of 178.7 (1) and 160.4 (1) degrees , respectively. The [Zn(NCS)4]2- anion is approximately tetrahedral, with Zn-N = 1.951 (1)-1.986 (1) A, N-Zn-N = 104.5 (1)-111.9 (1) degrees and Zn-N-C = 152.5 (1)-179.4 (1) degrees. One NH group is hydrogen bonded to the ethanol O atom and the other NH groups are bonded to thiocyanate S atoms, forming a network.