Effects of the Diamine Chain End Functionalized Liquid Butadiene Rubber as a Processing Aid on the Properties of Carbon-Black-Filled Rubber Compounds.

The implementation of vehicle electrification and autonomous driving technologies has recently emphasized the importance of abrasion resistance and fuel efficiency of truck bus radial (TBR) tire treads that undergo high loads and long driving times. In this study, a functionalized liquid butadiene rubber (F-LqBR) was introduced to replace the treated distillate aromatic extracted (TDAE) oil as a way to improve abrasion resistance and fuel efficiency in the TBR tire tread compound and to solve the oil migration. First, radical polymerization was used to synthesize nonfunctionalized LqBR (N-LqBR) and amino-LqBR with an amine group at the chain ends. The synthesized LqBRs were then substituted in place of TDAE oil to manufacture carbon-black-filled natural rubber (NR) compounds and to evaluate their physical properties. The results show that LqBRs improved the migration resistance and enhanced the abrasion resistance by lowering the glass transition temperature (Tg) of the compound. In particular, amino-LqBR improved carbon black dispersion in the rubber matrix through a chemical bond between the functional group of the carbon black surface and the base rubber. In conclusion, amino-LqBR successfully served as a processing aid in a carbon black-filled NR compound while simultaneously enhancing its fuel efficiency and abrasion resistance.

Prevalence and Characteristics of Atrial Tachycardia From Noncoronary Aortic Cusp During Atrial Fibrillation Catheter Ablation.

BACKGROUND AND OBJECTIVES: Atrial tachycardias (ATs) from noncoronary aortic cusp (NCC) uncovered after radiofrequency ablation for atrial fibrillation (AF) are rarely reported. This study was conducted to investigate the prevalence and clinical characteristics of NCC ATs detected during AF ablation and compare their characteristics with de novo NCC ATs without AF. METHODS: Consecutive patients who underwent radiofrequency catheter ablation for AF were reviewed from the multicenter AF ablation registry of 11 tertiary hospitals. The clinical and electrophysiological characteristics of NCC AT newly detected during AF ablation were compared with its comparators (de novo NCC AT ablation cases without AF). RESULTS: Among 10,178 AF cases, including 1,301 redo ablation cases, 8 (0.08%) NCC AT cases were discovered after pulmonary vein isolation (PVI; 0.07% in first ablation and 0.15% in redo ablation cases). All ATs were reproducibly inducible spontaneously or with programmed atrial stimulation without isoproterenol infusion. The P-wave morphological features of tachycardia were variable depending on the case, and most cases exhibited 1:1 atrioventricular conduction. AF recurrence rate after PVI and NCC AT successful ablation was 12.5% (1 of 8). Tachycardia cycle length was shorter than that of 17 de novo ATs from NCC (303 versus 378, p=0.012). No AV block occurred during and after successful AT ablation. CONCLUSIONS: Uncommon NCC ATs (0.08% in AF ablation cases) uncovered after PVI, showing different characteristics compared to de-novo NCC ATs, should be suspected irrespective of P-wave morphologies when AT shows broad propagation from the anterior interatrial septum.

Effect of the Epoxide Contents of Liquid Isoprene Rubber as a Processing Aid on the Properties of Silica-Filled Natural Rubber Compounds.

In this study, we examined the feasibility of using epoxidized liquid isoprene rubber (E-LqIR) as a processing aid for truck and bus radial (TBR) tire treads and investigated the effects of the epoxide content on the wear resistance, fuel efficiency, and resistance to extraction of the E-LqIRs. The results confirmed that, compared to the treated distillate aromatic extract (TDAE) oil, the E-LqIRs could enhance the filler-rubber interactions and reduce the oil migration. However, the consumption of sulfur by the E-LqIRs resulted in a lower crosslink density compared to that of the TDAE oil, and the higher epoxide content decreased the wear resistance and fuel efficiency because of the increased glass-transition temperature (Tg). In contrast, the E-LqIR with a low epoxide content of 6 mol% had no significant effect on the Tg of the final compound and resulted in superior wear resistance and fuel efficiency, compared to those shown by TDAE oil, because of the higher filler-rubber interactions.

Effect of Epoxide Content on the Vulcanizate Structure of Silica-Filled Epoxidized Natural Rubber (ENR) Compounds.

The demand for truck-bus radial (TBR) tires with enhanced fuel efficiency has grown in recent years. Many studies have investigated silica-filled natural rubber (NR) compounds to address these needs. However, silica-filled compounds offer inferior abrasion resistance compared to carbon black-filled compounds. Further, the use of NR as a base rubber can hinder silanization and coupling reactions due to interference by proteins and lipids. Improved silica dispersion be achieved without the use of a silane coupling agent by introducing epoxide groups to NR, which serve as silica-affinitive functional groups. Furthermore, the coupling reaction can be promoted by facilitating chemical interaction between the hydroxyl group of silica and the added epoxide groups. Thus, this study evaluated the properties of commercialized NR, ENR-25, and ENR-50 compounds with or without an added silane coupling agent, and the filler-rubber interaction was quantitatively calculated using vulcanizate structure analysis. The increased epoxide content, when the silane coupling agent was not used, improved silica dispersion, abrasion resistance, fuel efficiency, and wet grip. Once a basic level of silica dispersion was secured by using the silane coupling agent, both the abrasion resistance and wet grip improved with increasing epoxide content. Furthermore, the silane coupling agent could be partially replaced by ENR due to the high filler-rubber interaction between the ENR and silica. Therefore, epoxidation shows potential for resolving the issues associated with poor coupling reactions and abrasion resistance in silica-filled NR compounds.

Incidence of Cardiovascular Events and Safety Profile of Prasugrel in Korean Patients With Acute Coronary Syndrome.

BACKGROUND: Dual antiplatelet therapy is commonly used for patients with acute coronary syndrome (ACS). This study aimed to evaluate the safety and efficacy of aspirin and prasugrel at standard dosages in Korean patients using clinical outcome data.Methods and Results:For this prospective multicenter phase IV post-marketing surveillance (PMS) study, ACS patients from 29 July 2012 to 28 July 2016 were recruited. Patients received aspirin at a dose of 75-150 mg daily and a standard dose of prasugrel. Bleeding events were recorded and summarized to evaluate safety. Data on adverse events (AEs) and composite events such as cardiovascular (CV) death, myocardial infarction (MI), and stroke were recorded and summarized to assess efficacy. Of the 3,283 patients recruited, data from 3,110 and 3,044 patients were included in the safety and efficacy analyses, respectively (median treatment duration, 172 days). The most frequently reported AE was ecchymosis (2.8%). The number of patients with major bleeding was 29/3,110 (0.93%). The discontinuation rate for any reason was 12.6%. The number of cases that ended in CV death, MI, stroke, stent thrombosis, or unplanned coronary revascularization was 26/3,044 (0.85%). CONCLUSIONS: The present results are similar to those observed in clinical trials where administration of low-dose aspirin plus prasugrel was associated with a low rate of major bleeding and CV events.

Effect of Reversible Addition-Fragmentation Transfer Emulsion Styrene Butadiene Rubber (RAFT ESBR) on the Properties of Carbon Black-Filled Compounds.

Tread is an important component that directly affects the performance of passenger car radial (PCR) tires. Styrene-butadiene rubber (SBR) is mainly used for tire tread and it includes solution styrene-butadiene rubber (SSBR) and emulsion styrene-butadiene rubber (ESBR). Although SSBR is mainly used, the manufacturing process for SSBR is more challenging than ESBR, which is environmentally friendly, but has the disadvantage of a broad molecular weight distribution. To overcome this, a reversible addition-fragmentation radical transfer (RAFT) polymerization technique is used in ESBR polymerization. An environmentally friendly RAFT ESBR with a narrow dispersity can be polymerized. Here, carbon black-filled compounds were manufactured while using RAFT ESBR, and their properties were compared to ESBR. The analysis showed a low crosslink density of RAFT ESBR, due to the high polysulfide crosslink structure. We manufactured a carbon black-filled compound with the same crosslink density and structure as the ESBR carbon black-filled compound, and the effect of the dispersity of the base polymer was investigated. RAFT ESBR showed 9% better abrasion resistance and 29% better fuel efficiency than ESBR, according to the analysis of the data. The narrow dispersity can reduce energy loss and positively influence the abrasion resistance and fuel efficiency.

Nitramine-Group-Containing Energetic Prepolymer: Synthesis, and Its Properties as a Binder for Propellant.

A composite solid propellant which generates high propulsive force in a short time is typically composed of an oxidizer, a metal fuel powder and a binder. Among these, the binder is an important component. The binder maintains the mechanical properties of propellant grains and endures several thermal and mechanical stresses in the engine. Several studies have been reported for the development of energetic propellant binders for increasing the propellant's propulsive force. While several materials have been studied for the synthesis of energetic prepolymers, a nitramine-group-containing prepolymer is a suitable candidate because these types of prepolymers are less toxic and more cost-effective when compared to the traditional glycidyl azide polymers (GAP) and triazole-based prepolymers. Considering the lack of studies for the binder using a nitramine-group-containing prepolymers, we synthesized a nitramine-group-containing monomer and polymerized a nitramine-group-containing prepolymer. The prepolymer was then used for the preparation of the binder and its thermal and mechanical properties, as well as the effect of the plasticizer, were studied. The binder that was prepared using the prepolymer containing a nitramine-group showed very high elongation, tensile strength. Nitrate-ester (NE)-type plasticizer could reduce the glassy transition temperature (Tg)of the binder successfully. Also, high-energy is released due to the decomposition of the nitramine-group at around 245 °C, thus exhibiting the efficiency of the nitramine-group-containing prepolymer as an excellent energetic binder material.

Glycidyl Methacrylate-Emulsion Styrene Butadiene Rubber (GMA-ESBR)/Silica Wet Masterbatch Compound.

In the tire industry, solution styrene butadiene rubber (SSBR), which can introduce a functional group with good reactivity to silica at chain ends, is used to increase rolling resistance performance by considering fuel economy. However, this is not environmentally friendly because SSBR uses an organic solvent for polymerization, and it is difficult to increase its molecular weight. Functionalized emulsion SBR (ESBR) can solve the problems of SSBR. The molecular weight of ESBR molecules can be easily increased in an eco-friendly solvent, i.e., water. A functionalized ESBR introduces a functional group with good reactivity to silica by introducing a third monomer during polymerization. In this field, glycidyl methacrylate (GMA) has been reported to show the best properties as a third monomer. However, for GMA-ESBR, the viscosity is high and processability is disadvantageous. Therefore, we polymerized GMA-ESBR and manufactured silica compounds to clarify the causes of these problems. In addition, wet masterbatch (WMB) technology, which is a new compound manufacturing method, was applied to manufacture the silica compound, and the physical properties are compared with those of a dry masterbatch. The results clarified the problem of GMA-ESBR, which could be solved by using WMB technology.

Effect of Calcium Chloride as a Coagulant on the Properties of ESBR/Silica Wet Masterbatch Compound.

When designing rubber compounds for high-performance tires, increasing the silica content can improve the wet traction performance but decreases the fuel efficiency. This trade-off relation makes it difficult to improve the two factors simultaneously. One approach is the development of silica wet masterbatch (WMB) technology for producing compounds containing a high silica content with good dispersion. The technology involves a step to mix surface-modified silica and rubber latex. The technique requires a coagulant to break up the micelles of the rubber latex and cause the surface-modified silica and the rubber molecules to co-coagulate due to van der Waals forces. In this study, the effect of coagulant type on the characteristics of silica surface, and the mechanical properties of the emulsion styrene-butadiene rubber (ESBR)/silica WMB compounds was investigated, as well as the abrasion properties and the viscoelastic properties of the vulcanizates.

Extension of catheter ablation and outcome for ventricular tachycardia or premature ventricular contractions from the right ventricular outflow tract.

Objective We aimed to determine whether the extension of ablation could influence the ablation outcome for ventricular tachycardia (VT)/premature ventricular contractions (PVCs) from the right ventricular outflow tract (RVOT). Methods and results The radiofrequency catheter ablation results of 33 VT/6 frequent PVCs from the RVOT were analysed. The ablation extension was divided into 3 categories from the final successful ablation point with the earliest activation: (I) focal ablation (15 cases); ablation at 1 or 2 points; (II) focal with extended ablation (12 cases); focal and surrounding area ablation (maximum ≤1 cm) after elimination of clinical VT/PVCs; and (III) broad ablation (12 cases); continued broad ablation (maximum >1 cm) after elimination of clinical VT/PVCs. Acute termination was defined as the complete elimination and non-inducibility of clinical VT/PVCs during the procedure. For the mean follow-up of 12.8 months, the recurrence rate was not significantly different among the groups (P = 0.49). The mean procedure time was longer in group II, but ablation times and complication rates were not different among the groups. When acute termination was achieved, the overall recurrence rate was 7.6%. However, when confirming absence of the clinical VT/PVCs using 24-hour Holter monitoring immediately after the procedure, the recurrence rate was 2.7%. Conclusions Ablation extension did not affect ablation outcome of VT/PVCs from the RVOT. Confirmation of absence of clinical VT/PVCs using 24-hour Holter monitoring immediately after the procedure could guarantee long-term success.

Mitral Loop Cerclage Annuloplasty for Secondary Mitral Regurgitation: First Human Results.

OBJECTIVES: This is an early feasibility clinical test of mitral loop cerclage annuloplasty to treat secondary mitral valve regurgitation. BACKGROUND: Secondary mitral regurgitation is characterized by cardiomyopathy, mitral annular enlargement, and leaflet traction contributing to malcoaptation. Transcatheter mitral loop cerclage applies circumferential compression to the mitral annulus by creating a loop through the coronary sinus across the interventricular septum, protecting entrapped coronary arteries from compression, and interactive annular reduction under echocardiographic guidance. This is the first human test of mitral loop annuloplasty. METHODS: Five subjects with severe symptomatic secondary mitral regurgitation underwent mitral loop cerclage, with echocardiographic and computed tomography follow-up over 6 months. RESULTS: Mitral loop cerclage was successful in 4 of 5 subjects and aborted in 1 of the 5 because of unsuitable septal coronary vein anatomy. Immediately and over 6 months, measures of both mitral valve regurgitation (effective orifice area and regurgitation fraction) and chamber dimensions (left atrial and left ventricular volumes) were reduced progressively and ejection fractions increased. Two with persistent and permanent atrial fibrillation spontaneously reverted to sinus rhythm during follow-up. One subject experienced a small myocardial infarction from an unrecognized small branch coronary occlusion. Another, experiencing cardiogenic shock at baseline, died of intractable heart failure after 6 weeks. CONCLUSIONS: In this first human test, mitral loop cerclage annuloplasty was successful in 4 of 5 attempts, caused reverse remodeling (reduction in secondary mitral regurgitation and heart chamber volumes), and suggested electrical remodeling (reversion of atrial fibrillation). Further evaluation is warranted.

ECG features and proarrhythmic potentials of therapeutic hypothermia.

OBJECTIVE: Hypothermia can induce ECG J waves. Recent studies suggest that J waves may be associated with ventricular fibrillation (VF) in patients with structurally normal hearts. However, little is known about the ECG features, clinical significance or arrhythmogenic potentials of therapeutic hypothermia (TH)-induced J waves. METHODS: We analysed ECGs from 240 patients who underwent TH at six major university hospitals in Korea between August 2010 and December 2013. The prevalence, amplitudes and distributions of the J waves and the development of malignant arrhythmia were analysed. RESULTS: The average patient body temperature was 33.5±1.0°C during TH. J waves were observed in 98 patients (40.8%). They were newly developed in 91 cases, and pre-existing J waves were augmented in seven patients. J waves during TH were primarily observed in leads II, III, aVF and V4-6. The average amplitude of the J waves was 0.239±0.152 mV. There were four VF events during TH. These events occurred in three patients who were finally diagnosed with Brugada syndrome, idiopathic VF or early repolarisation syndrome, respectively, and in one patient with non-cardiac aetiology (asphyxia). CONCLUSIONS: J waves were recorded in about 40% of the patients who received TH. They were most frequently observed in the inferior limb leads or lateral precordial leads. Life-threatening VF occurred only rarely (1.7%) during TH and were mainly observed in patients with primary arrhythmic disorder. Although a causal relationship between TH-induced J waves and VF remains unknown, administering TH to this potentially susceptible, high-risk population may require careful attention.

Antiplatelet effect of ticagrelor compared to tirofiban in non-ST-segment elevation ACS patients undergoing PCI. The result of the TE-CLOT trial.

Addition of a potent P2Y12 inhibitor to aspirin is the standard therapy for non-ST-segment elevation acute coronary syndrome (NSTE-ACS) patients undergoing percutaneous coronary intervention (PCI). Glycoprotein IIb/IIIa inhibitor, together with antiplatelet therapy, may be considered as part of initial therapy in NSTE-ACS patients with high-risk features. This study investigated the antiplatelet effect of ticagrelor loading dose (LD) versus tirofiban bolus injection with a post-bolus infusion on top of aspirin among NSTE-ACS patients planned to PCI. NSTE-ACS patients were randomised to receive either ticagrelor (n = 47) or tirofiban (n = 48). Platelet reactivity was assessed by light transmittance aggregometry at 0, 2, 8, and 24 hours (h) after treatment initiation. Primary endpoint was inhibition of platelet aggregation (IPA, 20 µM ADP, final extent) at 2 h after LD therapy, with a non-inferiority margin of 10%. The prevalence of high on-treatment platelet reactivity (HPR) was also compared at 0, 2, 8, and 24 h. The mean difference in IPA between ticagrelor and tirofiban was -9.9% (95% confidence interval: -25.7% to 5.9%) at 2 h, -1.6% (-8.0% to 4.8%) at 8 h, and -3.3% (-18.4% to 12.0%) at 24 h. The prevalence of HPR did not differ between the two groups at any time point (all p values ≥ 0.059), which was almost abolished by 8 h post-LD (< 5%). In conclusion, the antiplatelet effect during the early phase (~2 h) after ticagrelor LD appeared to be relatively strong, but it did not reach that of tirofiban in NSTE-ACS patients.

Electrocardiographic predictors of bradycardia-induced torsades de pointes in patients with acquired atrioventricular block.

BACKGROUND: Predictors of torsades de pointes (TdP) in bradyarrhythmia-induced acquired long QT syndrome are not well defined. OBJECTIVE: The purpose of this study was to search for electrocardiographic (ECG) TdP predictors in patients with acquired atrioventricular block (AVB) and QT prolongation. METHODS: We analyzed 12-lead ECGs from 20 patients (15 females, age 65.9 ± 15.6 years) with TdP episodes from among 898 AVB patients (2.2%) in 3 tertiary hospitals. The ECG repolarization parameters in TdP patients were compared with those of 80 age- and sex-matched control AVB patients with no TdP episodes. RESULTS: TdP was initiated by premature ventricular complexes with a long-short sequence of activation. The average cycle length of the long sequence was 1289.9 ± 228.9 ms and was 2.3 ± 0.6 times longer than the cycle length of the short sequence. TdP patients had a significantly longer mean QT interval (716.4 ± 98.9 ms vs 523.2 ± 91.3 ms, P = .001), mean T peak to end interval (334.2 ± 59.1 ms vs 144.0 ± 73.7 ms, P = .001) and a higher T peak to end interval/QT ratio (0.49 ± 0.09 vs 0.27 ± 0.11, P = .001) compared with non-TdP controls. TdP patients showed a higher prevalence of notched T waves in which T2 was at least 3 mm taller than T1 (45.0% vs 1.3%, P = .001), triphasic T waves (30.0% vs 1.3%, P = .001), reversed asymmetry (20.0% vs 0%, P = .001), and T-wave alternans (35.0% vs 0%, P = .001). An algorithm combining these morphologic parameters was able to differentiate TdP patients from non-TdP patients with high sensitivity (85.0%) and specificity (97.5%). CONCLUSION: An algorithm combining specific T-wave morphologies was useful for identifying patients with AVB who are at risk for developing TdP.

Second coupling interval of nonsustained ventricular tachycardia to distinguish malignant from benign outflow tract ventricular tachycardias.

BACKGROUND: Idiopathic ventricular tachycardia (VT) originating from the outflow tract (OT) usually is considered a benign condition. In rare cases, patients with OT-VT suffer from syncope or even sudden cardiac death. OT-VT is frequently preceded by nonsustained VT (NSVT). OBJECTIVE: The purpose of this study was to clarify if the ECG parameters of NSVTs could differentiate malignant from benign OT-VT. METHODS: We retrospectively evaluated patients without structural heart disease who had documented OT-NSVT on ECG. ECG parameters were compared between patients with syncope, aborted sudden cardiac death, or ventricular fibrillation (malignant group, n = 36) and patients without syncope (benign group, n = 40). RESULTS: There were no differences with regard to age and gender between the malignant and benign groups. On analysis of NSVT, the first coupling interval (CI) of NSVT was comparable between the 2 groups (458 ± 87 ms vs 485 ± 95 ms, P = .212). However, the second CI of NSVT beats was significantly shorter in the malignant group (313 ± 58 ms vs 385 ± 83 ms, P < .0001). During 48-month follow-up, the benign group had a significantly lower recurrence of clinical VT than the malignant group (P = .046). The malignant group frequently had more than 1 focus of VT, whereas the benign group showed only a single focus (1.82 vs 1.09, P = .023). CONCLUSION: The second CI of NSVT in the malignant group was significantly shorter than that of the benign OT-VT group. Careful measurement of the second CI of NSVT may help identify the malignant form of OT-VT, enabling early treatment to prevent future cardiac events.