Radial artery pulse upstroke is not a good marker of left ventricular dysfunction: A comparison of radial tonometry, angiographic and echocardiographic measures of dP/dt

The first derivative of pressure over time (dP/dt) is a marker of left ventricular (LV) systolic function that can be assessed during cardiac catheterization and echocardiography. Radial artery dP/dt (Radial-dP/dt) has been proposed as a possible marker of LV systolic function (Nichols & O’Rourke, McDonald’s Blood Flow in Arteries) and we sought to test this hypothesis. Methods:We compared simultaneously recorded RadialdP/ dt (by high-fidelity tonometry) with LV-dP/dt (by highfidelity catheter and echocardiography parameters analogous to LV-dP/dt) in patients without aortic valve disease. In study 1, beat to beat Radial-dP/dt and LV-dP/dt were recorded at rest and during supine exercise in 12 males (aged 61±12 years) undergoing cardiac catheterization. In study 2, 2D-echocardiography and Radial-dP/dt were recorded in 59 patients (43 men; aged 64±10 years) at baseline and peak dobutamine-induced stress. Three measures at the basal septum were taken as being analogous to LV-dP/dt: (1) peak systolic strain rate, (2) strain rate (SR-dP/dt), and (3) tissue velocity during isovolumic contraction. Results: Study 1; there was a significant difference between resting LV-dP/dt (1461±383 mmHg/s) and Radial-dP/dt (1182±319 mmHg/s; P < 0.001), and a poor, but statistically significant, correlation between the variables (R2 = 0.006; P < 0.001) due to the high number of data points compared (n = 681). Similar results were observed during exercise. Study 2; there was a moderate association between baseline Radial-dP/dt and SRdP/ dt (R2 =−0.17; P < 0.01), but no significant relationship between Radial-dP/dt and all other echocardiographic measures analogous to LV-dP/dt at rest or peak stress (P > 0.05). Conclusion: The radial pressurewaveform is not a reliable marker of LV contractility.

Dppa3 is a marker of pluripotency and has a human homologue that is expressed in germ cell tumours

We identified a transcript named 11M2 on the basis of its strong male-specific expression pattern in the developing mouse gonad. 11M2 was found to be expressed by gonad primordial germ cells (PGCs) of both sexes and down-regulated in female PGCs as they enter prophase I of the first meiotic division, similar to the expression of Oct4. Mouse EST analysis revealed expression only in early-stage embryos, embryonic stem cells and pre-meiotic germ cells. 11M2 corresponds to a recently reported gene variously known as PGC7, stella or Dppa3. We have identified the human orthologue of Dppa3 and find by human EST analysis that it is expressed in human testicular germ cell tumours but not in normal human somatic tissues. The expression patterns of mouse and human DPPA3, in undifferentiated embryonic cells, embryonic germ cells and adult germ cell tumours, together suggest a role for this gene in maintaining cell pluripotentiality.