Exercise release of cardiac natriuretic peptides is markedly enhanced when patients with coronary artery disease are treated medically by beta-blockers.

OBJECTIVES: This study sought to identify determinants of the exercise rise in plasma levels of cardiac natriuretic peptides (NPs) in patients with coronary artery disease (CAD). BACKGROUND: During stress, there is a variable rise in the plasma level of NPs, but this rise frequently reaches levels that are known to lower the cardiac load and that thus might be beneficial to CAD patients. METHODS: Plasma venous concentrations of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) were determined at rest and peak exercise in 104 patients with chronic CAD who were referred to exercise thallium-201 ((201)Tl) single-photon emission computed tomography (SPECT) and radionuclide angiography. RESULTS: The extent of scarred myocardium by (201)Tl-SPECT and patient age were the best independent predictors of NP concentrations at rest, but also of increases in NP concentration during exercise (all p < 0.001). Moreover, beta-blocking treatment was an additional and strong independent predictor of the increase in NP concentrations at exercise (p < 0.001 for ANP; p = 0.001 for BNP). On average, exercise increases in NP concentrations were more than twice as high in patients with (n = 55) than in those without (n = 49) beta-blocker treatment (ANP: +49 +/- 63 vs. +22 +/- 25 ng/l, p = 0.01; BNP: +24 +/- 5 vs. +11 +/- 15 ng/l, p = 0.04), whereas NP concentrations at rest were equivalent in the two groups (ANP: 34 +/- 34 vs. 30 +/- 33 ng/l, p = NS; BNP: 85 +/- 152 vs. 57 +/- 101 ng/l, p = NS). CONCLUSIONS: Patients with chronic CAD exhibit much higher exercise releases of ANP and BNP when they are treated with beta-blockers. This enhanced secretion of potent vasodilating and natriuretic agents constitutes an original therapeutic mechanism for further protecting diseased hearts against stress.

OSEM reconstruction, associated with temporal fourier and depth-dependant resolution recovery filtering, enhances results from sestamibi and 201Tl 16-interval gated SPECT.

UNLABELLED: Gated SPECT recorded with 16 intervals determines left ventricular (LV) ejection fraction more accurately than does gated SPECT recorded with 8 intervals but produces higher image noise. This study aimed to assess the results from sestamibi and (201)Tl 16-interval gated SPECT when both signal-to-noise ratio and spatial resolution were enhanced with an original method of reconstruction. METHODS: Forty patients with coronary artery disease underwent (201)Tl and sestamibi 16-interval gated SPECT and, to be used as a reference, cardiac MRI. Assessments of global and regional LV function provided by ordered-subsets expectation maximization (OSEM) with depth-dependant resolution recovery and temporal Fourier filtering were compared with those from conventional filtered backprojection (FBP) previously optimized by screening various filter frequencies and various temporal smoothing levels. RESULTS: For both tracers, LV ejection fraction was determined best when the association of OSEM with depth-dependant resolution recovery was used alone, with temporal Fourier filtering, or with a slight 2-frame temporal smoothing: Mean absolute values of relative errors ranged from 3.2% to 3.6% (4.0%-7.9% for FBP), and coefficient correlation ranged from 0.91 to 0.93 (0.70-0.91 for FBP). Among these 3 reconstruction methods, the association of OSEM with depth-dependant resolution recovery with temporal Fourier filtering provided the highest signal-to-noise ratio, with mean increases of 54% for sestamibi and 80% for (201)Tl when compared with FBP, and the best analysis of segmental contractility, with exact agreement rates with MRI being 73% for (201)Tl and 79% for sestamibi. CONCLUSION: OSEM associated with temporal Fourier filtering and depth-dependant resolution recovery filtering enhances the LV function assessment provided by sestamibi and (201)Tl 16-interval gated SPECT and dramatically reduces image noise, a property that enhances and facilitates image interpretation.

Changes in first-pass interstitial kinetics of DTPA in myocardium submitted to low-flow ischemia.

OBJECTIVES: This study aimed to determine the changes during ischemia in the myocardial first-pass kinetics of DTPA, an extracellular tracer that is currently used for assessing myocardial perfusion with magnetic resonance imaging (Magnevist). MATERIALS AND METHODS: Using an indicator-dilution technique, first-pass kinetics of DTPA were compared between normoxia (n=11) and low-flow ischemia (n=11) in isolated rabbit hearts perfused with red blood cell-enhanced perfusate. RESULTS: There was no difference between ischemia and normoxia in the interstitial extraction and clearance rates of DTPA. Interstitial distribution volume of DTPA was, however, lower in ischemia than in normoxia (in percent of myocardial volume: 15+/-11% vs 25+/-11%, P=0.02) as a result of a relationship with coronary flow (P<0.001). CONCLUSIONS: During low-flow myocardial ischemia, DTPA kinetics are unchanged, except for the interstitial distribution volume that is decreased, presumably because of the shrinkage of extracellular fluid. These kinetic properties are favorable for detecting myocardial ischemia at rest with magnetic resonance imaging.

201Tl SPECT abnormalities, documented at rest in dilated cardiomyopathy, are related to a lower than normal myocardial thickness but not to an excess in myocardial wall stress.

UNLABELLED: This study was aimed at determining whether the (201)Tl SPECT abnormalities documented in patients with dilated cardiomyopathy are related to a local excess in wall stress, which might act against the diastolic perfusion of myocardium. METHODS: We included 6 healthy volunteers and 7 patients with idiopathic dilated cardiomyopathy who underwent (201)Tl SPECT at rest. On a 13-segment division of the left ventricle, indices of wall stress and tension were calculated at end-diastole by applying Laplace's law, with thickness and curvature radii being determined for each segment on 2 orthogonal MRI slices. RESULTS: Among all patients, 21 analyzed segments had (201)Tl SPECT defects (D+) and 67 had none (D-). Myocardial thickness was lower in D+ (0.88 +/- 0.30 cm) than in D- (1.23 +/- 0.33 cm, P = 0.0002) or in segments from healthy volunteers (0.99 +/- 0.15 cm, P = 0.04). The index of end-diastolic wall tension was also lower in D+ (2.5 +/- 1.0 N.m(-1).mm Hg(-1)) than in D- (3.3 +/- 1.1 N.m(-1).mm Hg(-1), P = 0.02) or in segments from healthy volunteers (3.2 +/- 1.2 .m(-1).mm Hg(-1)) P = 0.04). Last, the index of end-diastolic wall stress, determined by the ratio of wall tension index to myocardial thickness, was equivalent in D+, in D-, and in segments from healthy volunteers (respectively, 3.0 +/- 1.4, 2.8 +/- 1.2, and 3.2 +/- 1.6 hN.m(-2).mm Hg(-1)). CONCLUSION: In patients with dilated cardiomyopathy, the abnormalities documented by (201)Tl SPECT at rest are related to a lower than normal wall thickness and not to an excess in wall stress or tension. Therefore, partial-volume effects are likely to induce these abnormalities, and they may be unrelated to any insufficiency of myocardial perfusion.

(201)Tl and (99m)Tc-MIBI retention in an isolated heart model of low-flow ischemia and stunning: evidence of negligible impact of myocyte metabolism on tracer kinetics.

UNLABELLED: It is not known whether cellular metabolic disorders play a role in the decreased tracer uptake that is documented by conventional SPECT during low-flow ischemia or stunning. This study sought to determine the impact of low-flow ischemia and stunning on the kinetics of (201)Tl and MIBI across the plasma membrane of myocytes. METHODS: The global myocardial retention (Rf) of (201)Tl and MIBI was determined in isolated working hearts from rabbits, perfused with red blood cell-enhanced solution. Experiments were performed in normoxia, with physiological values of coronary flow (N; n = 16); in low-flow ischemia, with a >50% reduction of coronary flow and a > or =20-mm Hg fall in systolic left ventricle pressure (L; n = 15); and in stunning, with 15 min of acute ischemia followed by reperfusion (S; n = 15). Concentration ratios across the plasma membrane of myocytes were also determined for both tracers and expressed as Ci/Cc, where Ci is interstitial activity determined with microdialysis, and Cc is activity from cellular space determined from Rf and Ci values. RESULTS: There was a slight increase in average values of Ci/Cc in ischemia, but not in stunning, for (201)Tl (L, 0.011 +/- 0.006 vs. N, 0.006 +/- 0.004 [P < 0.05]; S, 0.007 +/- 0.004 vs. N [not significant]) and for MIBI (L, 0.011 +/- 0.008 vs. N, 0.005 +/- 0.004 [P < 0.05]; S, 0.005 +/- 0.003 vs. N [not significant]). Moreover, ischemia and stunning had no deleterious effects on the average values of global myocardial retention for (201)Tl (L, 0.63 +/- 0.09 vs. N, 0.50 +/- 0.14 [P < 0.05]; S, 0.59 +/- 0.10 vs. N [P < 0.05]) or for MIBI (L, 0.45 +/- 0.10 vs. N, 0.31 +/- 0.09 [P < 0.05]; S, 0.41 +/- 0.12 vs. N [P < 0.05]). In fact, these values were significantly enhanced in the 2 situations. CONCLUSION: The kinetics of (201)Tl and MIBI across the plasma membrane of myocytes were affected only poorly by low-flow ischemia and not at all by stunning, without any deleterious effects on myocardial retention of both tracers. During low-flow ischemia or stunning, therefore, the information provided by (201)Tl or MIBI SPECT is expected to depend on myocardial perfusion but not on cellular metabolic disorders.

Gluconic acid, its lactones, and SO(2) binding phenomena in musts from botrytized grapes.

Intramolecular gluconic acid esterification reactions led to the formation of two lactones, gamma- and delta-gluconolactone (glucono-1,4-lactone and glucono-1,5-lactone). The presence of the first has not yet been reported in must or wine. These lactones are in equilibrium with gluconic acid, gamma- and delta-gluconolactone representing, respectively, 5.8 and 4.1% of the acid level. Correlations between must SO(2) binding power, gluconic acid, and consequently its lactones are shown. The SO(2) affinity of a mixture containing this acid and gamma- and delta-gluconolactone was determined, and gluconic acid appeared to be indirectly responsible for approximately 8% of the bindable SO(2) in musts from botrytized grapes.

3-Hydroxy-4,5-dimethyl-2(5H)-furanone: a key odorant of the typical aroma of oxidative aged Port wine.

Application of aroma extract dilution analysis (AEDA) on organic extracts from Port wines barrel-aged over 40 years revealed 5 odor-active compounds corresponding to descriptors used to qualify the characteristic old wine aroma. One of the compounds, described as "nutty" and "spicy-like", and present in at least 9 dilutions above the others, was perceived as particularly important. The compound responsible for this flavor was identified as 3-hydroxy-4,5-dimethyl-2(5H)-furanone (sotolon). The levels ranged from 5 to 958 microg/L for wines between 1 and 60 years old. It was also observed that during oxidative aging the concentration of this compound increased with time according to a linear trend (r > 0.95). Although the presence of 2-ketobutyric acid was verified, the constant rate of formation of sotolon with aging and its high correlation with sugar derivates (HMF, furfural) suggests other mechanisms, different from those reported for other wines. The flavor threshold of sotolon was evaluated in Port wine at 19 microg/L. Sensorial tests provided valuable information concerning sotolon impact on Port wine aroma. Samples supplemented with this substance were consistently ranked as older. In view of these results it can be expected that sotolon plays a pre-eminent role in the characteristic old Port wine aroma.

Determination of volatile compounds in Grenache wines in relation with different terroirs in the Rhone Valley.

This paper describes the study of 19 wines of the Grenache Noir cultivar obtained from representative soils of the Rhone Valley according to their geographical site, climatic conditions, hydrological regulation, and soil profile. Among the volatile compounds analyzed by GC/MS/FID, the concentrations of the varietal compounds (i.e., beta-damascenone, beta-ionone, and geraniol) and those of the compounds without direct influence on the wine aroma (i.e., hexenols and methanol) indicated the existence of two groups of wines. These concentrations were correlated with grape maturity due to the ecosystem and particularly the soil.

Method for determining nitrogenous heterocycle compounds in wine.

Qualitative and quantitative analyses of N-heterocycle compounds were conducted by using a liquid-liquid extraction followed by additional chemical silica gel purification and injection into a gas chromatographic (GC) column coupled to a nitrogen-phosphorus detector (NPD). The purified extract fraction was investigated by GC-NPD and by GC-mass spectrometry. The compounds identified and quantified in wines were 2,4,5-trimethyloxazole, 2,4-dimethylthiazole, and 4-methylthiazole by GC-NPD and both 2-acetylthiazole and 2-acetyl-2-thiazoline by GC-MS. The procedure was used to analyze different wines and gave reliable and reproducible results.

Possible mechanism for involvement of cysteine in aroma production in wine.

Under conditions close to those of wine, that is, low pH, aqueous medium, and low temperatures, this work describes N-(2-sulfanylethyl)-2-oxopropanamide (1), a new intermediate in the formation of 2-acetylthiazole from methylglyoxal and cysteine. 1 was characterized by MS, derivatization MS, and (1)H and (13)C NMR and was synthesized from 2-sulfanylethanamine and ethyl pyruvate. A formation pathway for 2-acetylthiazole from methylglyoxal and cysteine is proposed, in which 1 is a new intermediate in Maillard-type reactions in systems under mild conditions.

Heterocyclic acetals from glycerol and acetaldehyde in Port wines: evolution with aging.

In Port wine, isomers of glycerol and acetaldehyde acetals have been found at total contents ranging from 9.4 to 175.3 mg/L. During oxidative aging, the concentrations of the 5-hydroxy-2-methyl-1,3-dioxane and 4-hydroxymethyl-2-methyl-1,3-dioxolane isomers increased with time showing a linear correlation (r > 0.95). The flavor threshold for the mixture of the four isomers was evaluated in wine at 100 mg/L. Thus, it is expected that they contribute to "old Port wine" aroma in wines older than 30 years. Experiments with model solutions and wine clearly demonstrated that SO(2) combines with acetaldehyde and blocks the acetalization reaction.

Low-flow ischaemia has no deleterious effect on the steady-state kinetics of 201Tl and 99mTc sestamibi within myocardial tissue.

OBJECTIVES: This study aimed to specifically analyse the impact of low-flow ischaemia on the ability of myocytes to trap and accumulate Tl and sestamibi (MIBI) within myocardial tissue. METHODS: In order to reach steady-state conditions for the interstitial/cellular concentration ratios (Ci/Cc) of the tracers and thereby simulate the conditions of cell cultures studies, Tl and MIBI were injected continuously during an 80 min period within the coronary circulation of isolated hearts submitted to normoxia (n=7) or low-flow ischaemia (n=7; >50% reduction in coronary flow). Ci was determined by using interstitial microdialysis and Cc was determined from Ci and myocardial retention values of the tracers. RESULTS: At the end of the experiments, under steady-state conditions, Ci/Cc was equivalent between low-flow ischaemia and normoxia for both Tl (ischaemia, 0.60 +/- 0.25% vs normoxia, 0.63 +/-0.34%; NS) and MIBI (ischaemia, 1.00 +/- 0.68% vs normoxia, 0.76 +/- 0.32%, NS), whereas tissue concentrations of ATP were more than 4-fold lower in ischaemia than in normoxia (5.1 +/- 3.5 nmol.g vs 22.5 +/- 4.8 nmol.g; P< 0.001). CONCLUSIONS: In contrast to the published results concerning the effects of anoxia on cell cultures, low-flow ischaemia within myocardial tissue has no deleterious effects on the ability of the cells to accumulate Tl and MIBI under steady-state conditions. This gives definitive evidence of the negligible impact of cellular metabolic disorders in the decrease in Tl or MIBI uptake, which is documented by stress-SPECT within low-flow ischaemic myocardium.

Antisalmonellal and antioxidant potential of hydroethanolic extract of Canarium schweinfurthii Engl. (Burseraceae) in Salmonella enterica serovar Typhimurium-infected chicks

Objective: To evaluate the anti-infectious and antioxidant activities of hydroethanolic extract of Canarium schweinfurthii on broiler chickens infected by Salmonella enterica serovar Typhimurium, known to be threatening public health. Methods: Animals were divided into six groups of eight animals per group: the normal control group, negative control group, positive control group and three test groups receiving the plant extract at 5, 19 and 75 mg/kg bw, respecively. The evolution of the disease as well as the effectiveness of the treatment were monitored by stool culture from the second day post infection until the end of the treatment. In addition, the effects of treatment on growth performances and feed conversion efficiency of broilers were evaluated. For the assessment of antioxidant status, enzymatic and non-enzymatic biomarkers such as catalase, glutathione peroxidase, malondialdehyde and nitric oxide were evaluated in the serum and tissues of animals. Results: The infected chickens treated with oxytetracycline recovered on day 7 after treatment, while animals treated with 19 and 75 mg/kg of Canarium schweinfurthii extract recovered on day 9 and those with 5 mg/kg of the extract on day 10. Salmonella infection caused a decrease on catalase and glutathione peroxidase activities; the administration of various doses of Canarium schweinfurthii extract increased these enzymatic activities. Animals receiving the extract at 5 mg/kg showed a significant increase in catalase activity in serum, heart and lungs while all concentrations of the extract significantly increased glutathione peroxidase activity in the serum, liver and spleen. Concerning non-enzymatic biomarkers, Salmonella infection caused a significant increase of nitric oxide and malondialdehyde concentration in the liver and lungs. Treatment with 75 mg/kg of the extract significantly reduced nitric oxide concentration in the heart and lungs while each dose of the extract reduced and normalized the malondialdehyde level in the serum. Additionally, malondialdehyde production was significantly decreased in the liver, heart and lungs after administration of Canarium schweinfurthii extract at all doses. Conclusions: The hydroethanolic extract of Canarium schweinfurthii attenuates oxidative stress, and is effective in the treatment of avian salmonellosis.

Gated SPECT assessment of left ventricular function is sensitive to small patient motions and to low rates of triggering errors: a comparison with equilibrium radionuclide angiography.

BACKGROUND: Patient displacements and errors in R-wave detection are the main causes of inaccurate acquisition for gated single photon emission computed tomography (SPECT) and equilibrium radionuclide angiography (RNA). This study aimed to compare the influences of both factors between gated SPECT and RNA determinations of left ventricular ejection fraction. METHODS AND RESULTS: On gated SPECT and RNA acquisitions, recorded in 20 patients with coronary artery disease, we simulated the consequences of (1) 3-dimensional patient displacements of low (6.7 mm), moderate (13.4 mm), and high amplitude (20.1 mm) and (2) an erroneous triggering on T waves in 10% to 40% of recorded beats. Absolute values of left ventricular ejection fraction changes from baseline were higher with gated SPECT compared with RNA for patient displacements of low amplitude (5.0% +/- 3.8% vs 1.2% +/- 0.9%, P < .001) or moderate amplitude (10.0% +/- 6.2% vs 3.0% +/- 2.3%, P = .001) but not for patient displacements of high amplitude (12% +/- 9% vs 9% +/- 7%, P = not significant) and inaccurate triggering (for 20% T-wave triggering, 8.9% +/- 3.6% vs 7.9% +/- 3.0%; P = not significant). CONCLUSION: Contrary to RNA, gated SPECT is vulnerable to small patient displacements, and thus, specific efforts might be useful for limiting this potential cause of erroneous results. Both techniques may be affected by low rates of triggering errors, suggesting that small acceptance windows on cycle length should be recommended not only for RNA but also for gated SPECT.

Residual exercise SPECT ischemia on treatment is a main determinant of outcome in patients with coronary artery disease treated medically at long-term with beta-blockers.

BACKGROUND: Beta-blockers are potent anti-ischemic medications, able to improve prognosis in patients with coronary artery disease (CAD). However, it is not known whether beta-blockers have the same beneficial prognostic effect when residual ischemia persists on treatment. METHODS AND RESULTS: The prognostic impact of exercise single photon emission computed tomography (SPECT) ischemia was analyzed in 442 patients with chronic CAD, who were treated with beta-blockers and who were referred to exercise thallium 201 SPECT, while they were receiving their daily-life medications. Ischemic and viable myocardium was documented on Tl-201 SPECT in 190 patients (43%), of whom only 23% had angina and only 26% had positive exercise testing results. During a follow-up of 3.8 +/- 1.7 years, 36 patients died and survival curves were progressively divergent between patients with and those without ischemic and viable myocardium: at 5 years, the respective survival rates were 81% +/- 4% and 94% +/- 2% (P =.004). By multivariate analysis, the best independent predictors of death were large extent of necrosis (>25% of left ventricle on Tl-201 SPECT, P <.001) and ischemic and viable myocardium (P =.001). CONCLUSIONS: In the CAD patients treated on a long-term basis with beta-blockers, survival is strongly influenced by persistent exercise SPECT ischemia on treatment. Therefore exercise SPECT on treatment could be a useful tool for selecting those who might benefit from additional anti-ischemic therapeutic interventions.

Avaliaçäo da eficiência de degustadores de vinhos através da análise multivariada / Evaluation of efficience of wine tasters group using the multivariate analysis

A avaliaçäo sensorial realizada por um grupo de degustadores utilizando critérios objetivos é uma das maneiras mais eficazes de apreciar a qualidade de um vinho. Este trabalho descreve metodologia para testar a homogeneidade e a eficiência de degustadores, levando em consideraçäo um conjunto de 23 variáveis simultaneamente, utilizando-se o potencial das análises multivariadas