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1.
Anal Chim Acta ; 1097: 196-203, 2020 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-31910960

RESUMO

Mitochondrial membrane potential (ΔΨm) is a significant physiological parameter essential for many vital biological processes. In this work, two fluorescent probes enabling the subcellular migration have been rationally designed and synthesized, for the ratiometric visualization of ΔΨm via Förster resonance energy transfer (FRET) mechanism. Both the green-emitting G-1 and red-emissive MTR-1 target mitochondria in live cells, and give weak green emission and strong red emission owning to FRET process. With the loss of ΔΨm, G-1 migrates into membranous organelles, and MTR-1 moves to bind to intracellular RNA. FRET is blocked due to the separation of the two probes, and cells show strong green emission and weak red fluorescence. Consequently, the loss of ΔΨm induced by CCCP was successfully visualized in ratiometric manner, and the cell damage caused by H2O2 was monitored. We expect that the two probes can serve as validate tools in investigate ΔΨm, apoptosis, and relative areas.

2.
Artigo em Inglês | MEDLINE | ID: mdl-31913687

RESUMO

Mitochondrial DNA (mtDNA) exposed to the extracellular space due to cell death has immunostimulatory properties. Case-control studies reported a positive association between odds of developing preeclampsia and circulating mtDNA. These findings are based on relative quantification protocols that do not allow determination of absolute concentrations of mtDNA and are highly sensitive to nuclear DNA contamination. Furthermore, circulating mtDNA concentrations in response to normal pregnancy, which is an inflammatory state characterized by continuous placental cell apoptosis, have not been established. The main objective of this study was to determine longitudinal changes in circulating mtDNA from preconception to 1st trimester, 3rd trimester, and postpartum in healthy pregnant women. Absolute real-time PCR quantification of mtDNA and nuclear DNA (nDNA) was performed on whole genomic extracts from serum using TaqMan® probes and chemistry. Serum cell-free mtDNA and nDNA concentrations were greater in late pregnancy as compared to early pregnancy and postpartum. Pregnant women carrying neonates at the upper quartile of birth length distribution had higher concentrations of mtDNA in late pregnancy compared to pregnancies carrying neonates at the lower quartile. The correlation between circulating mtDNA and nDNA concentrations varied by sex (i.e. pregnancies carrying female vs. male fetuses). This study is the first to establish temporal patterns of circulating cell-free mtDNA concentrations in normal human pregnancy using absolute DNA quantification techniques. Concentrations of circulating mtDNA in normal pregnancy may be used as reference values for the development of clinical prognostic or diagnostic tests in pregnant women with, or at risk, of developing gestational complications.

3.
Artigo em Inglês | MEDLINE | ID: mdl-31893570

RESUMO

A novel redox-active 2D copper-benzoquinoid metal-organic framework (Cu-THQ MOF) has been readily synthesized via a simple solvothermal method. The abundant porosity and intrinsic redox characters endow the 2D Cu-THQ MOF with promising electrochemical activity. For example, superior performance is achieved as a lithium-ion battery cathode with a high reversible capacity (387 mA h g -1 ), large specific energy density (775 Wh kg -1 ), and good cycling stability. These metrics surpass most MOF-based cathode materials for rechargeable energy storage. Most importantly, the reaction mechanism is further unveiled by comprehensive spectroscopic techniques where a three-electron redox reaction per coordination unit and one-electron redox reaction per copper ion mechanism is demonstrated. This elucidatory understanding sheds new light on future rational design of high-performance MOF-based cathode materials for efficient energy storage and conversion.

4.
Stroke ; : STROKEAHA119027779, 2020 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-31902332

RESUMO

Background and Purpose- High-resolution magnetic resonance imaging is capable of characterizing carotid atherosclerotic plaque morphology and composition. Most reported carotid plaque imaging techniques are 2-dimensional (2D) based with limited longitudinal coverage of ≈30 mm, which may be insufficient for complete visualization of extracranial carotid atheroma. A 3D black-blood imaging technique, motion-sensitized driven equilibrium prepared rapid gradient echo technique (3D-MERGE) can provide larger coverage. We sought to use 3D-MERGE to investigate carotid atherosclerosis plaque distribution and to analyze their correlation with clinical information and stroke risk factors. Methods- From 5 hospitals in China, 97 subjects suspected of recent stroke or transient ischemic attack were imaged with 3D-MERGE within 2 weeks of symptoms using 3T magnetic resonance imaging. Images were analyzed by 2 reviewers. Plaque length was calculated and categorized as plaques within, partially outside, or completely outside of typical 2D magnetic resonance imaging coverage. Associations between plaque features and clinical information, stroke risk factors were assessed. Results- Ninety-seven subjects with 194 carotid arteries (70 men and 27 women, mean age 60 years) were analyzed. Of the 136 plaques identified, 68 (50%) were within, 46 (33.8%) were partially outside, and 22 (16.2%) were completely outside of 2D magnetic resonance imaging coverage. Total plaque length was significantly positively associated with male sex (P<0.001), hypertension (P=0.011), and history of smoking (P<0.001). Hypertensive subjects were more likely to have at least one plaque completely outside the 2D magnetic resonance imaging coverage than nonhypertensive subjects (P=0.007). Conclusions- The 3D-MERGE allows for the identification of substantially more carotid plaques than 2D black-blood techniques. The extent and distribution of plaque, identified by the larger coverage afforded by 3D-MERGE, were found to correlate significantly with male sex and risk factors that are common among patients with stroke, including hypertension and history of cigarette smoking.

5.
Braz J Microbiol ; 2019 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-31836963

RESUMO

Bacillus sp. strain QHF158, a Gram-positive, spore-forming and parasporal crystal-secreting bacterium, was isolated from soil of Limushan National Forest Park in China. Here we present the significant feature of parasporal inclusions of this organism, together with the draft genome sequence and annotation. Phylogenetic analysis suggested that strain QHF158 is possibly a novel species, most closely related to Bacillus mycoides. Genome annotation results revealed that strain QHF158 did not contain any typical Cry or Cyt toxin coding gene. Furthermore, the mass spectrometry analyses demonstrated that the parasporal crystalline inclusions were encoded by the orf_05273 gene, with 95% similarity to the S-layer protein (SLP) EA1 of B. mycoides, which indicated that the parasporal crystal from Bacillus sp. strain QHF158 was mainly formed by SLP, instead of the typical Cry or Cyt toxin proteins.

6.
Am J Mens Health ; 13(6): 1557988319894480, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31838943

RESUMO

Holmium laser enucleation of the prostate (HoLEP) is one of the minimally invasive procedures that is used for patients with benign prostate hyperplasia. The procedure usually requires patients to stay in the hospital 2 nights or longer. The present study evaluated the safety and feasibility of HoLEP with discharge of the patients on Day 1 after surgery (1-day surgery). A total of 1,164 patients were included in the study, with 510 of them planned for 1-day surgery and others planned for inpatient surgery. The primary outcomes included complication rate and clinical outcomes. A total 489 out of 510 patients received 1-day HoLEP and were discharged on Day 1 after surgery. In a 30-day follow-up period, no significant differences were found between the 1-day and inpatient surgery groups in terms of the rate of complications and clinical outcomes. Patients in the 1-day surgery group had a significantly shorter waiting time for admission (9.5 ± 4.8 vs. 17.6 ± 7.4 days, p < .05), and the mean hospitalization cost was lower (CNY$ 9140.6 ± 1452.2 vs. 10533.4 ± 1594, p < .05).The 1-day HoLEP surgery was safe and had satisfactory clinical outcomes. This treatment strategy could reduce the waiting time for admission and cost of hospitalization. Majority of the patients found this 1-day surgery beneficial, especially elderly patients who prefer to have an early return home and rapid resumption of activities.

7.
Molecules ; 24(24)2019 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-31817376

RESUMO

Fried garlic oil has been widely used in traditional Chinese cuisine and, recently, has become increasingly popular in food manufacturing. In this study, the effects of different initial and final frying temperature on the flavor characteristics and sensory profile of fried garlic oil were investigated using solvent-assisted flavor evaporation (SAFE) combined with gas chromatography-mass spectrometry (GC-MS). Results showed that the content of flavor compounds changed significantly as the frying temperature was increased. The sample that was treated at an initial temperature of 115 °C and a final temperature of 155 °C contained the highest amount of thioethers and heterocycles, mainly comprising dimethyl trisulfide, diallyl disulfide, and 2-vinyl-4H-1,2-dithiin. Partial least-squares regression elucidated the sensory attributes of fried and roasted garlic, showing a high correlation with thioethers and pyrazines. Furthermore, changes in the 2,6-dimethylpyrazine, dimethyl trisulfide, and diallyl disulfide concentrations were detected every 5 °C during the frying process (initial temperature, 115 °C; final temperature, 155 °C). Dimethyl trisulfide and diallyl disulfide concentrations showed irregular, downward trends, while 2,6-dimethylpyrazine concentration exhibited an increasing trend.

8.
Anal Chem ; 2019 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-31820637

RESUMO

With currently available molecular imaging techniques, hepatocellular carcinoma (HCC), a liver cancer with high mortality rates and poor treatment responses, is mostly diagnosed at its late stage. This is largely due to the lack of highly sensitive contrast agents with high liver specificity. Herein, we report a novel bimodal contrast agent molecule CNCI-1 for the ef-fective detection of HCC at its early stage both in vitro and in vivo. The agent has high liver specificity with effective X-ray computed tomography (CT) /near-infrared (NIR) imaging functions. It has been successfully applied to in vivo NIR imag-ing with high sensitivity and high selectivity to the HCC region of the HepG2 tumor-xenografted mice model and LM3 or-thotopic hepatoma mice model. Moreover, the agent was found to be noninvasive and hepatocarcinoma cells preferential. Furthermore, it also enhanced the tumor imaging by revealing the blood vessels nearby for the CT image acquisition in the VX2 orthotopic hepatoma rabbit model. Our design strategy provides a new avenue to develop the medical relevant bimodal contrast agents for diagnosis of HCC at its early stage.

9.
Brain Res ; 1729: 146623, 2019 Dec 24.
Artigo em Inglês | MEDLINE | ID: mdl-31881186

RESUMO

Both inhibiting ascending nociceptive transmission and activating descending inhibition are involved in the opioid analgesic effect. The spinal dorsal horn is a critical site for modulating nociceptive transmission by descending pathways elicited by opioids in the brain. µ-Opioid receptors (MORs, encoded by Oprm1) are highly expressed in primary sensory neurons and their central terminals in the spinal cord. In the present study, we tested the hypothesis that MORs expressed in primary sensory neurons contribute to the descending inhibition and supraspinal analgesic effect induced by centrally administered opioids. We generated Oprm1 conditional knockout (Oprm1-cKO) mice by crossing AdvillinCre/+ mice with Oprm1flox/flox mice. Immunocytochemical labeling in Oprm1-cKO mice showed that MORs are completely ablated from primary sensory neurons and are profoundly reduced in the superficial spinal dorsal horn. Intracerebroventricular injection of morphine or fentanyl produced a potent analgesic effect in wild-type mice, but such an effect was significantly attenuated in Oprm1-cKO mice. Furthermore, the analgesic effect produced by morphine or fentanyl microinjected into the periaqueductal gray was significantly greater in wild-type mice than in Oprm1-cKO mice. Blocking MORs at the spinal cord level diminished the analgesic effect of morphine and fentanyl microinjected into the periaqueductal gray in both groups of mice. Our findings indicate that MORs expressed at primary afferent terminals in the spinal cord contribute to the supraspinal opioid analgesic effect. These presynaptic MORs in the spinal cord may serve as an interface between ascending inhibition and descending modulation that are involved in opioid analgesia.

10.
Lasers Med Sci ; 2019 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-31858348

RESUMO

To explore the surgical effect and cost-effectiveness of day surgery versus inpatient surgery for photoselective vaporization of the prostate (PVP) in Chinese population. We retrospectively collected 240 patients undergoing day-surgery PVP (April 2016 to March 2018) and 156 patients undergoing inpatient-surgery PVP (May 2014 to March 2016). Differences between groups in demographics, perioperative outcomes, complications, and postoperative changes were calculated. Economical results in terms of hospital stay and relevant preoperative, intraoperative, and postoperative cost were evaluated. There was no significant difference in operative time, incidence of postoperative complications, and other functional outcomes between two groups (P > 0.05), but the waiting time for admission and the hospital cost including the drug charges, bed fee, nursing fee, laboratory test, and imaging fee of day-surgery group were significantly lower than that of inpatient-surgery group (P < 0.05). Day surgery of PVP has firm and well accepted position in ambulatory surgery of urology. It could significantly reduce the waiting time for admission and hospitalization costs in BPH patients.

11.
Int J Biol Sci ; 15(13): 2763-2773, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31853216

RESUMO

Protein arginine methyltransferase 1 (PRMT1) is the predominant asymmetric (type I) methyltransferase in mammalian cells. Mounting evidence suggested that PRMT1 is essential to embryonic development and tumor pathogenesis, but its role in normal adult hematopoiesis is less studied. We used a Prmt1 conditional knockout (KO) mouse model to identify the role of PRMT1 in normal adult hematopoiesis. The results indicated that deletion of PRMT1 results in anemia and leukopenia, reducing terminal erythroid and lymphocyte differentiation. Additionally, we found a significant decrease of megakaryocyte progenitors (MkPs) compared with similarly treated littermate control mice. The frequency of short-term hematopoietic stem cells (ST-HSCs) and granulocyte-macrophage progenitors (GMPs) populations were significantly lower in PRMT1f/f/Mx1-CRE bone marrow (BM) compared with littermate control mice. Importantly, in-vitro replating assays and BM transplantation results revealed that PRMT1 KO results in reduced hematopoietic stem and progenitor cells (HSPCs) self-renewal capacity. Thus, we conclude that PRMT1 is required for hematopoietic differentiation and the competitive fitness of HSPCs, and we believed that PRMT1 serves as a key epigenetic regulator of normal hematopoiesis that occurs throughout life.

12.
Medicine (Baltimore) ; 98(50): e18196, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31852076

RESUMO

This study aimed at investigating the prevalence of anxiety and depression, and their risk factors as well as their correlation with prognosis in refractory or relapsed (R/R) acute myeloid leukemia (AML) patients.A total of 180 R/R AML patients were enrolled and their anxiety and depression were assessed by Hospital Anxiety and Depression Scale (HADS) before treatment. Besides, HADS was also evaluated in 180 de novo AML patients prior treatment and 180 healthy controls (HCs), respectively.Both the HADS-Anxiety and HADS-Depression scores were increased in R/R AML patients compared with de novo AML patients and HCs (all P < .001). Meanwhile, the prevalence of anxiety and depression was 53.9% and 45.6% in R/R AML patients, which were also greatly higher compared with de novo AML patients and HCs (all P < .01). Regarding risk factors, higher Eastern Cooperative Oncology Group score and lines of salvage therapy were correlated with anxiety and depression in R/R AML patients (all P < .05). Furthermore, anxiety and depression were associated with shorter overall survival (OS) in R/R AML patients (all P < .05), while no association of different degrees of anxiety and depression with OS was observed (all P > .05).Anxiety and depression are highly prevalent and implicated in the management and prognosis of R/R AML.


Assuntos
Ansiedade/etiologia , Depressão/epidemiologia , Leucemia Mieloide Aguda/complicações , Indução de Remissão/métodos , Medição de Risco/métodos , Ansiedade/epidemiologia , China/epidemiologia , Terapia Combinada , Depressão/etiologia , Feminino , Seguimentos , Humanos , Incidência , Leucemia Mieloide Aguda/terapia , Masculino , Pessoa de Meia-Idade , Prevalência , Prognóstico , Estudos Retrospectivos , Fatores de Risco
13.
J Card Fail ; 2019 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-31857197

RESUMO

BACKGROUND: While left atrial (LA) mechanical dysfunction in heart failure with preserved ejection fraction (HFpEF) is associated with poor clinical outcomes, the influence of LA myopathy on temporal changes in cardiovascular biomarkers is unclear. METHODS AND RESULTS: We evaluated biomarker correlates of LA myopathy, as defined by reduced LA strain, and the associations of LA strain with longitudinal changes in biomarkers among participants in the Phosphodiesterase-5 Inhibition to Improve Clinical Status and Exercise Capacity in Heart Failure with Preserved Ejection Fraction (RELAX) trial. LA speckle-tracking was performed on baseline echocardiograms of RELAX participants to measure LA reservoir and LA contractile strain. Of the 216 RELAX participants, 169 (78%) had measurable LA strain and biomarker data. Participants with LA reservoir strain below median (13.5%, interquartile range: 10-22.5%) were older, more likely to have atrial fibrillation, and had higher jugular venous pressure (P<0.05 for all). At baseline, higher levels of endothelin-1, NT-proBNP, and troponin I were independently associated with lower LA reservoir and contractile strain (Padjusted <0.05 for all comparisons). Higher LA reservoir strain (ß coefficient per 1-unit increase: -21.2, 95% CI: -38.8, -3.7; P=0.02) was independently associated with reduction in NT-proBNP at 24 weeks. CONCLUSION: In HFpEF, LA myopathy is characterized by elevation in biomarkers of neurohormonal activation and myocardial necrosis. Lower LA function is associated with inability to decrease NT-proBNP over time, suggesting LA myopathy is associated with persistent congestion in HFpEF.

14.
Sheng Wu Gong Cheng Xue Bao ; 35(12): 2339-2349, 2019 Dec 25.
Artigo em Chinês | MEDLINE | ID: mdl-31880140

RESUMO

Chimeric antigen receptor T (CAR-T) cell therapy, which adoptively transfers engineered T cells expressing synthetic receptors to target specific antigens, has achieved great clinical success in treating hematological malignancies. Though FDA has approved two CAR-T products, CAR-T therapy can cause some side effects, such as cytokine release syndrome (CRS), neurotoxicity and B cell aplasia. Meanwhile, lacking tumor specific antigen and the suppressive tumor environment limit the efficacy of CAR-T therapy in solid tumor. This review focuses on the structural components, clinical applications and synthetic biology approaches on CAR-T cell design, and summarizes the challenges and perspectives of CAR-T therapy as a revolutionary cancer immunotherapy.


Assuntos
Terapia Baseada em Transplante de Células e Tecidos , Imunoterapia Adotiva , Criança , Humanos , Imunoterapia , Receptores de Antígenos de Linfócitos T , Receptores de Antígenos Quiméricos , Linfócitos T
15.
Bioorg Med Chem Lett ; : 126900, 2019 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-31882295

RESUMO

Alzheimer's disease (AD) is a progressive neurological degenerative disease that has complex pathogenesis. A variety of studies in humans indicate that several enzymes inhibitors can be useful in the treatment of AD, including acetylcholinesterase (AchE), butyrylcholinesterase (BuChE) and monoamine oxidase (MAO). Various substituted 4-arylcoumarin derivatives were synthesised, and their activity in vitro were investigated, including AChE/BuChE inhibitory activity, MAO inhibitory activity, and antioxidant activity. Most of the compounds were found to exhibit high inhibitory activity, and individual compounds have extremely excellent activities. Therefore 4-arylcoumarins provides an idea for drugs design for the development of therapeutic or preventive agents for AD.

16.
Langmuir ; 2019 Dec 30.
Artigo em Inglês | MEDLINE | ID: mdl-31840509

RESUMO

In this work, we use molecular dynamics (MD) simulations to investigate the dependences of formation and transition of surface condensation mode on wettability (ß) and vapor-to-surface temperature difference (ΔT). We build a map of different surface condensation modes against ß and ΔT based on plenty of MD simulation results and reveal five formation mechanisms and two transition mechanisms. At low ß and ΔT, the high free energy barrier (ΔG*) prevents any surface clusters from surviving, therefore no-condensation (NC) is observed. The formation of dropwise condensation (DWC) could evolve from either nucleation or film rupture. Similarly, the formation of filmwise condensation (FWC) could evolve from either nucleation or the adsorption-induced film. The transition between NC and DWC is determined by ΔG* according to classical nucleation theory. The transition between DWC and FWC depends on the stability of condensate film; there emerges the competition between the trend that the uneven condensate film contracts and ruptures to droplets favored by lower ß and the trend that the uneven condensate film continues growing promoted by higher ΔT. We finally present a schematic overview of all of the mechanisms revealed for a better understanding of the physical phenomenon of the surface condensation mode.

17.
FEBS J ; 2019 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-31692265

RESUMO

Valproic acid (2-propylpentanoic acid, VPA) has been widely used as an anticonvulsant drug and is a choice drug for seizure treatment. VPA is also used as a short-chain fatty acid HDAC inhibitor that affects proliferation and differentiation and induces cell apoptosis in both solid and haematologic malignancies. Here, we observed that VPA treatment inhibited HDAC1/2 activity and induced autophagy in gastric cancer cells, leading to apoptosis. VPA-induced apoptosis occurred through inhibition of the HDAC1/PTEN/Akt signalling pathway and involved alterations in Bcl-2 and Beclin-1. The antitumour effects of VPA were verified in vivo using SGC-7901 xenograft models. Moreover, we evaluated the expression of HDAC1/2 in gastric cancer patient samples and revealed a positive correlation between HDAC1/2 overexpression and poor prognosis. These findings indicate that VPA may serve as a potential therapeutic agent for gastric cancer and that HDAC1/2 might be a promising therapeutic biomarker for the disease.

18.
Sensors (Basel) ; 19(22)2019 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-31698779

RESUMO

In maneuvering target tracking applications, the performance of the traditional interacting multiple model (IMM) filter deteriorates seriously under heavy-tailed measurement noises which are induced by outliers. A robust IMM filter utilizing Student's t-distribution is proposed to handle the heavy-tailed measurement noises in this paper. The measurement noises are treated as Student's t-distribution, whose degrees of freedom (dof) and scale matrix are assumed to be governed by gamma and inverse Wishart distributions, respectively. The mixing distributions of the target state, dof, and scale matrix are achieved through the interacting strategy of IMM filter. These mixing distributions are used for the initialization of time prediction. The posterior distributions of the target state, dof, and scale matrix conditioned on each mode are obtained by employing variational Bayesian approach. Then, the target state, dof, and scale matrix parameters are jointly estimated. A variational method is also given to estimate the mode probability. The unscented transform is utilized to solve the nonlinear estimation problem. Simulation results show that the proposed filter improves the estimation accuracy of target state and mode probability over existing filters under heavy-tailed measurement noises.

19.
J Hazard Mater ; : 121524, 2019 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-31699479

RESUMO

Tall fescue (Festuca arundinacea Schreb) shows remarkable tolerance to lead (Pb), but the mechanisms involved in metal tolerance are not yet well understood. Here, tall fescue were firstly cultivated hydroponically with Pb2+ (0, 50, 200 and 1000 mg/L) for 14 days. The results showed that remodeling of root architecture plays important roles in tolerance of tall fescue to Pb2+ stress. Increased cell wall (CW) components contribute to restrict high amount of Pb2+ in roots. Additionally, the uronic acid contents of pectin, hemicellulose 1 (HC1) and hemicellulose 2 (HC2) increased under Pb2+ stress. We further observed that tall fescue cultivated with H2O2 showed similar remodeling of root architecture as Pb2+ treatment. Furthermore, pectin, HC1 and HC2 fractions were sequentially extracted from 0 and 10 mM H2O2 treated roots, and Pb2+ adsorption capacity and contents of carboxyl groups of pectin and HC2 fractions were steadily increased under H2O2 treatment in vitro. Our results suggest that degrees of esterification of pectin and HC2 are regulated by H2O2. High amount of low-esterified pectin and HC2 offer more carboxyl groups, provide more Pb2+ binding sites, and restrict more Pb2+ in the CW, which may enhance tolerance of tall fescue to Pb2+ stress.

20.
Clin Cardiol ; 2019 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-31721249

RESUMO

BACKGROUND: In patients hospitalized with acute heart failure (AHF), low urine sodium concentration (UNa ) after diuretic treatment may identify patients at risk for longer length of stay (LOS) and adverse events. We investigated the prognostic significance of 24-hour cumulative postdiuretic urine sodium concentration in a multicenter clinical trial population. METHODS: The Renal Optimization Strategies Evaluation AHF (ROSE AHF) trial randomized 360 patients with AHF and renal dysfunction receiving intravenous diuretic to dopamine, nesiritide, or placebo. Sodium concentration was measured in cumulative urine sample collected during the first 24 hours after randomization in 298 patients. Based on prior studies, lower UNa was defined as ≤60 mmol/L. RESULTS: Lower UNa was present in 142 (48%) patients, who had longer LOS (7 days vs 5 days, P < .001) and less 72-hour weight loss (5.7 lb vs 9.0 lb, P < .001). These associations persisted after controlling for baseline estimated glomerular filtration rate and outpatient furosemide dose. Lower UNa did not modify the null effects of dopamine or nesiritide on clinical outcomes. Results were similar for spot rather than cumulative 24-hour UNa concentration. CONCLUSION: In patients hospitalized for AHF and renal dysfunction, UNa ≤ 60 mmol/L during the first 24 hours of diuresis identifies patients at risk for prolonged hospitalization but does not provide an indication for adjunctive dopamine or nesiritide.

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