326 resultados para Complex fractionated atrial electrograms
em Université de Lausanne, Switzerland
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Kinetics of Atrial Repolarization Alternans. INTRODUCTION: Repolarization alternans (Re-ALT), a beat-to-beat alternation in action potential repolarization, promotes dispersion of repolarization, wavebreaks, and reentry. Recently, Re-ALT has been shown to play an important role in the transition from rapid pacing to atrial fibrillation (AF) in humans. The detailed kinetics of atrial Re-ALT, however, has not been reported so far. We developed a chronic free-behaving ovine pacing model to study the kinetics of atrial Re-ALT as a function of pacing rate. METHODS: Thirteen sheep were chronically implanted with 2 pacemakers for the recording of broadband right atrial unipolar electrograms and delivery of rapid pacing protocols. Beat-to-beat differences in the atrial T-wave apex amplitude as a measure of Re-ALT and activation time were analyzed at incremental pacing rates until the effective refractory period (ERP) defined as stable 2:1 capture. RESULTS: Atrial Re-ALT appeared intermittently but without periodicity, and increased in amplitude as a function of pacing rate until ERP. Intermittent 2:1 atrial capture was observed at pacing cycle lengths 40 ms above ERP, and increased in duration as a function of pacing rate. Episodes of rapid pacing-induced AF were rare, and were preceded by Re-ALT or complex oscillations of atrial repolarization, but without intermittent capture. CONCLUSION: We show in vivo that atrial Re-ALT developed and increased in magnitude with rate until stable 2:1 capture. In rare instances where capture failure did not occur, Re-ALT and complex oscillations of repolarization surged and preceded AF initiation. (J Cardiovasc Electrophysiol, Vol. 23, pp. 1003-1012, September 2012).
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Intracardiac organization indices such as atrial fibril- lation (AF) cycle length (AFCL) have been used to track the efficiency of stepwise catheter ablation (step-CA) of long-standing persistent AF (pers-AF), however, with lim- ited success. The timing between nearby bipolar intracar- diac electrograms (EGMs) reflects the spatial dynamics of wavelets during AF. The extent of synchronization between EGMs is an indirect measure of AF spatial organization. The synchronization between nearby EGMs during step- CA of pers-AF was evaluated using new indices based on the cross-correlation. The first one (spar(W)) quantifies the sparseness of the cross-correlation of local activation times. The second one (OI(W)) reflects the local concen- tration around the largest peak of the cross-correlation. By computing their relative evolution during step-CA until AF termination (AF-term), we found that OI(W) appeared su- perior to AFCL and spar(W) to track the effect of step-CA "en route" to AF-term.
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BACKGROUND: Half of the patients with end-stage heart failure suffer from persistent atrial fibrillation (AF). Atrial kick (AK) accounts for 10-15% of the ejection fraction. A device restoring AK should significantly improve cardiac output (CO) and possibly delay ventricular assist device (VAD) implantation. This study has been designed to assess the mechanical effects of a motorless pump on the right chambers of the heart in an animal model. METHODS: Atripump is a dome-shaped biometal actuator electrically driven by a pacemaker-like control unit. In eight sheep, the device was sutured onto the right atrium (RA). AF was simulated with rapid atrial pacing. RA ejection fraction (EF) was assessed with intracardiac ultrasound (ICUS) in baseline, AF and assisted-AF status. In two animals, the pump was left in place for 4 weeks and then explanted. Histology examination was carried out. The mean values for single measurement per animal with +/-SD were analysed. RESULTS: The contraction rate of the device was 60 per min. RA EF was 41% in baseline, 7% in AF and 21% in assisted-AF conditions. CO was 7+/-0.5 l min(-1) in baseline, 6.2+/-0.5 l min(-1) in AF and 6.7+/-0.5 l min(-1) in assisted-AF status (p<0.01). Histology of the atrium in the chronic group showed chronic tissue inflammation and no sign of tissue necrosis. CONCLUSIONS: The artificial muscle restores the AK and improves CO. In patients with end-stage cardiac failure and permanent AF, if implanted on both sides, it would improve CO and possibly delay or even avoid complex surgical treatment such as VAD implantation.
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INTRODUCTION: Paroxysmal atrial fibrillation (AF) may be triggered by intermittent atrial tachycardia, and ultimately lead to persistent AF. However, the mechanisms by which intermittent atrial tachycardia promotes sustained AF are not well understood. METHODS AND RESULTS: Eight sheep were chronically implanted with 2 pacemakers for the recording of broadband right atrial unipolar electrograms, and for the delivery of electrophysiological stimulation protocols and intermittent right atrial tachycardia. Right atrial kinetics of activation recovery interval (ARI) as a surrogate for action potential duration, of conduction time and velocity, and of repolarization alternans were analyzed at incremental pacing rates during the remodeling process induced by weeks of intermittent atrial tachycardia until the development of sustained AF. Intermittent atrial tachycardia decreased ARI and blunted its rate adaptation, facilitated atrial capture, and slowed conduction at high rates, and increased susceptibility to pacing-induced AF. In spite of blunted ARI rate adaptation, right atrial repolarization alternans was maintained during remodeling, and further increased in magnitude just before rapid pacing-induced AF. CONCLUSION: This study suggests that weeks of intermittent right atrial tachycardia result in a gradual electrical remodeling favorable for wavebreaks and reentry that may facilitate fibrillation.
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Résumé: Le complexe du Mont Collon (nappe de la Dent Blanche, Austroalpin) est l'un des exemples les mieux préservés du magmatisme mafique permien des Alpes occidentales. Il est composé d'affleurements discontinus et d'une stratification magmatique en son centre (Dents de Bertol) et est composé à 95% de roches mafiques cumulatives (gabbros à olivine et/ou cpx, anorthositiques, troctolites, wehrlites et wehrlites à plagioclase) et localement de quelques gabbros pegmatitiques. Ces faciès sont recoupés par de nombreux filons acides (aphtes, pegmatites quartziques, microgranodiorites et filons anorthositiques) et mafiques tardifs (dikes mélanocrates riches en Fe et Ti). Les calculs thermométriques (équilibre olivine-augite) montrent des températures de 1070-1120 ± 6°C, tandis que le thermomètre amphibole-plagioclase indique une température de 740 ± 40°C à 0.5 GPa pour les amphiboles magmatiques tardives. La geobarométrie sur pyroxène donne des pressions moyennes de 0.3-0.6 GPa, indiquant un emplacement dans la croûte moyenne. De plus, les températures obtenues sur des amphiboles coronitiques indiquent des températures de l'ordre de 700 ± 40°C confirmant que les réactions coronitiques apparaissent dans des conditions subsolidus. Les âges concordants U/Pb sur zircons de 284.2 ± 0.6 et 282.9 ± 0.6 Ma obtenus sur un gabbro pegmatitique et une pegmatitique quartzique, sont interprétés comme des âges de cristallisation. Les datations 40Ar/39Ar sur amphiboles des filons mélanocrates donnent un âge plateau de 260.2 ± 0.7 Ma, qui est probablement très proche de l'âge de cristallisation. Ainsi, cet age 40Ar/39Ar indique un second évènement magmatique au sein du complexe. Les compositions des roches totales en éléments majeurs et traces montrent peu de variations, ainsi que le Mg# (75-80). Les éléments traces enregistrent le caractère cumulatif des roches (anomalie positive en Eu) et révèlent des anomalies négatives systématiques en Nb, Ta, Zr, Hf et Ti dans les faciès basiques. Le manque de corrélation entre éléments majeurs et traces est caractéristique d'un processus de cristallisation in situ impliquant une quantité variable de liquide interstitiel (L) entre les phases cumulus. Les distributions des éléments traces dans les minéraux sont homogènes, indiquant une rééquilibration .subsolidus entre cristaux et liquide interstitiel. Un modèle quantitatif basé sur les équations de cristallisation in situ de Langmuir reproduisent correctement les concentrations en terres rares légères des minéraux cumulatifs montrant la présence de 0 à 35% de liquide interstitiel L pour des degrés de différenciation F de 0 à 45%, par rapport au faciès les moins évolués du complexe. En outre, les valeurs de L sont bien corrélées avec les proportions modales d'amphibole interstitielle et les concentrations en éléments incompatibles des roches (Zr, Nb). Le liquide parental calculé des cumulats du Mont Collon est caractérisé par un enrichissement relatif en terres rares légères et Th, un appauvrissement en terres rares lourdes typique d'une affinité transitionnelle (T-MORB) et une forte anomalie négative en Nb-Ta. Les roches cumulatives montrent des compositions isotopiques en Nd-Sr proches de la terre globale silicatée (BSE), soit 0.6<εNdi<+3.2, 0.7045<87Sr/86Sri<0.7056. Les rapports initiaux en Pb indiquent une source dans le manteau enrichi subcontinental lithosphérique, préalablement contaminé par des sédiments océaniques. Les dikes mélanocrates Fe-Ti sont représentatifs de liquides et ont des spectres de terres rares enrichis, une anomalie positive en Nb-Ta et des εNdi de +7, des 87Sr/86Sri de 0.703 et des rapports initiaux en Pb, similaires à ceux des basaltes d'île océanique, indiquant une source asthénosphérique modérément appauvrie. Ainsi, la fusion partielle du manteau lithosphérique subcontinental est induite par l'amincissement post-orogénique et la remontée de l'asthénosphère. Les filons mélanocrates proviennent, après délamination du manteau lithosphérique, de la fusion de l'asthénosphère. Abstract The early Permian Mont Collon mafic complex (Dent Blanche nappe, Austroalpine nappe system) is one of the best preserved examples of the Permian mafic magmatism in the Western Alps. It is composed of discontinuous exposures and a well-preserved magmatic layering (the Dents de Bertol cliff) crops out in the center part of the complex. It mainly consists of cumulative mafic rocks, which represent 95 vol-% of the mafic complex (ol- and cpx-bearing gabbros and rare anorthositic layers, troctolites, wehrlites and plagioclase-wehrlites) and locally pegmatitic gabbros. All these facies are crosscut by widespread acidic (aplites, quartz-rich pegmatites, microgranodiorites) and late mafic Fe-Ti melanocratic dikes. Olivine-augite thermometric calculations yield a range of 1070-1120 ± 6°C, while amphibole-plagioclase thermometer yields a temperature of 740 ± 40°C at 0.5 GPa. Pyroxene geobarometry points to a pressure of 0.3-0.6 GPa, indicating a middle crustal level of emplacement. Moreover, temperature calculations on the Mont Conon coronitic amphiboles indicate temperatures of 700 ± 40°C, close to those calculated for magmatic amphiboles. These temperatures confirm that coronitic reactions occurred at subsolidus conditions. ID-TIMS U/Pb zircon ages of 284.2 ± 0.6 and 282.9 ± 0.6 Ma obtained on a pegmatitic gabbro and a quartz-pegmatitic dike, respectively, were interpreted as the crystallization ages of these rocks. 40Ar/39Ar dating on amphiboles from Fe-Ti melanocratic dikes yields a plateau age of 260.2 ± 0.7 Ma, which is probably very close to the crystallization age. Consequently, this 40Ar/P39Ar age indicates a second magmatic event. Whole-rock major- and trace-element compositions show little variation across the whole intrusion and Mg-number stays within a narrow range (75-80). Trace-element concentrations record the cumulative nature of the rocks (e.g. positive Eu anomaly) and reveal systematic Nb, Ta, Zr, Hf and Ti negative anomalies for all basic facies. The lack of correlation between major and trace elements is characteristic of an in situ crystallization process involving variable amounts of interstitial liquid (L) trapped between the cumulus mineral phases. LA-ICPMS measurements show that trace-element distributions in minerals are homogeneous, pointing to subsolidus re-equilibration between crystals and interstitial melts. A quantitative modeling based on Langmuir's in situ crystallization equation successfully reproduced the Rare Earth Element (REE) concentrations in cumulitic minerals. The calculated amounts of interstitial liquid L vary between 0 and 35% for degrees of differentiation F of 0 to 45%, relative to the least evolved facies of the intrusion. Furthermore, L values are well correlated with the modal proportions of interstitial amphibole and whole-rock incompatible trace-element concentrations (e.g. Zr, Nb) of the tested samples. The calculated parental melt of the Mont Collon cumulates is characterized by a relative enrichment in Light REE and Th, a depletion in Heavy REE, typical of a transitional affinity (T-MORB), and strong negative Nb-Ta anomaly. Cumulative rocks display Nd-Sr isotopic compositions close to the BSE (-0.6 < εNdi < +3.2, 0.7045 < 87Sr/86Sri < 0.7056). Initial Pb ratios point to an origin from the melting of an enriched subcontinental lithospheric mantle source, previously contaminated at the source by oceanic sediments. The contrasted alkaline Fe-Ti melanocratic dikes are representative of liquids. They display enriched fractionated REE patterns, a positive Nb-Ta anomaly and εNdi of +7, 87Sr/86Sri of 0.703 and initial Pb ratios, all reminiscent of Ocean Island Basalt-type rocks, pointing to a moderately
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Eukaryotic cells generate energy in the form of ATP, through a network of mitochondrial complexes and electron carriers known as the oxidative phosphorylation system. In mammals, mitochondrial complex I (CI) is the largest component of this system, comprising 45 different subunits encoded by mitochondrial and nuclear DNA. Humans diagnosed with mutations in the gene NDUFS4, encoding a nuclear DNA-encoded subunit of CI (NADH dehydrogenase ubiquinone Fe-S protein 4), typically suffer from Leigh syndrome, a neurodegenerative disease with onset in infancy or early childhood. Mitochondria from NDUFS4 patients usually lack detectable NDUFS4 protein and show a CI stability/assembly defect. Here, we describe a recessive mouse phenotype caused by the insertion of a transposable element into Ndufs4, identified by a novel combined linkage and expression analysis. Designated Ndufs4(fky), the mutation leads to aberrant transcript splicing and absence of NDUFS4 protein in all tissues tested of homozygous mice. Physical and behavioral symptoms displayed by Ndufs4(fky/fky) mice include temporary fur loss, growth retardation, unsteady gait, and abnormal body posture when suspended by the tail. Analysis of CI in Ndufs4(fky/fky) mice using blue native PAGE revealed the presence of a faster migrating crippled complex. This crippled CI was shown to lack subunits of the "N assembly module", which contains the NADH binding site, but contained two assembly factors not present in intact CI. Metabolomic analysis of the blood by tandem mass spectrometry showed increased hydroxyacylcarnitine species, implying that the CI defect leads to an imbalanced NADH/NAD(+) ratio that inhibits mitochondrial fatty acid β-oxidation.
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PURPOSE: To determine the value of applying finger trap distraction during direct MR arthrography of the wrist to assess intrinsic ligament and triangular fibrocartilage complex (TFCC) tears. MATERIALS AND METHODS: Twenty consecutive patients were prospectively investigated by three-compartment wrist MR arthrography. Imaging was performed with 3-T scanners using a three-dimensional isotropic (0.4 mm) T1-weighted gradient-recalled echo sequence, with and without finger trap distraction (4 kg). In a blind and independent fashion, two musculoskeletal radiologists measured the width of the scapholunate (SL), lunotriquetral (LT) and ulna-TFC (UTFC) joint spaces. They evaluated the amount of contrast medium within these spaces using a four-point scale, and assessed SL, LT and TFCC tears, as well as the disruption of Gilula's carpal arcs. RESULTS: With finger trap distraction, both readers found a significant increase in width of the SL space (mean Δ = +0.1mm, p ≤ 0.040), and noticed more contrast medium therein (p ≤ 0.035). In contrast, the differences in width of the LT (mean Δ = +0.1 mm, p ≥ 0.057) and UTFC (mean Δ = 0mm, p ≥ 0.728) spaces, as well as the amount of contrast material within these spaces were not statistically significant (p = 0.607 and ≥ 0.157, respectively). Both readers detected more SL (Δ = +1, p = 0.157) and LT (Δ = +2, p = 0.223) tears, although statistical significance was not reached, and Gilula's carpal arcs were more frequently disrupted during finger trap distraction (Δ = +5, p = 0.025). CONCLUSION: The application of finger trap distraction during direct wrist MR arthrography may enhance both detection and characterisation of SL and LT ligament tears by widening the SL space and increasing the amount of contrast within the SL and LT joint spaces.
A simple genetic basis for complex social behaviour mediates widespread gene expression differences.
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A remarkable social polymorphism is controlled by a single Mendelian factor in the fire ant Solenopsis invicta. A genomic element marked by the gene Gp-9 determines whether workers tolerate one or many fertile queens in their colony. Gp-9 was recently shown to be part of a supergene with two nonrecombining variants, SB and Sb. SB/SB and SB/Sb queens differ in how they initiate new colonies, and in many physiological traits, for example odour and maturation rate. To understand how a single genetic element can affect all these traits, we used a microarray to compare gene expression patterns between SB/SB and SB/Sb queens of three different age classes: 1-day-old unmated queens, 11-day-old unmated queens and mated, fully reproductive queens collected from mature field colonies. The number of genes that were differentially expressed between SB/SB and SB/Sb queens of the same age class was smallest in 1-day-old queens, maximal in 11-day-old queens and intermediate in reproductive queens. Gene ontology analysis showed that SB/SB queens upregulate reproductive genes faster than SB/Sb queens. For all age classes, genes inside the supergene were overrepresented among the differentially expressed genes. Consistent with the hypothesized greater number of transposons in the Sb supergene, 13 transposon genes were upregulated in SB/Sb queens. Viral genes were also upregulated in SB/Sb mature queens, consistent with the known greater parasite load in colonies headed by SB/Sb queens compared with colonies headed by SB/SB queens. Eighteen differentially expressed genes between reproductive queens were involved in chemical signalling. Our results suggest that many genes in the supergene are involved in regulating social organization and queen phenotypes in fire ants.
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The limited ability of common variants to account for the genetic contribution to complex disease has prompted searches for rare variants of large effect, to partly explain the 'missing heritability'. Analyses of genome-wide genotyping data have identified genomic structural variants (GSVs) as a source of such rare causal variants. Recent studies have reported multiple GSV loci associated with risk of obesity. We attempted to replicate these associations by similar analysis of two familial-obesity case-control cohorts and a population cohort, and detected GSVs at 11 out of 18 loci, at frequencies similar to those previously reported. Based on their reported frequencies and effect sizes (OR≥25), we had sufficient statistical power to detect the large majority (80%) of genuine associations at these loci. However, only one obesity association was replicated. Deletion of a 220 kb region on chromosome 16p11.2 has a carrier population frequency of 2×10(-4) (95% confidence interval [9.6×10(-5)-3.1×10(-4)]); accounts overall for 0.5% [0.19%-0.82%] of severe childhood obesity cases (P = 3.8×10(-10); odds ratio = 25.0 [9.9-60.6]); and results in a mean body mass index (BMI) increase of 5.8 kg.m(-2) [1.8-10.3] in adults from the general population. We also attempted replication using BMI as a quantitative trait in our population cohort; associations with BMI at or near nominal significance were detected at two further loci near KIF2B and within FOXP2, but these did not survive correction for multiple testing. These findings emphasise several issues of importance when conducting rare GSV association, including the need for careful cohort selection and replication strategy, accurate GSV identification, and appropriate correction for multiple testing and/or control of false discovery rate. Moreover, they highlight the potential difficulty in replicating rare CNV associations across different populations. Nevertheless, we show that such studies are potentially valuable for the identification of variants making an appreciable contribution to complex disease.
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The RP protein (RPP) array approach immobilizes minute amounts of cell lysates or tissue protein extracts as distinct microspots on NC-coated slide. Subsequent detection with specific antibodies allows multiplexed quantification of proteins and their modifications at a scale that is beyond what traditional techniques can achieve. Cellular functions are the result of the coordinated action of signaling proteins assembled in macromolecular complexes. These signaling complexes are highly dynamic structures that change their composition with time and space to adapt to cell environment. Their comprehensive analysis requires until now relatively large amounts of cells (>5 x 10(7)) due to their low abundance and breakdown during isolation procedure. In this study, we combined small scale affinity capture of the T-cell receptor (TCR) and RPP arrays to follow TCR signaling complex assembly in human ex vivo isolated CD4 T-cells. Using this strategy, we report specific recruitment of signaling components to the TCR complex upon T-cell activation in as few as 0.5 million of cells. Second- to fourth-order TCR interacting proteins were accurately quantified, making this strategy specially well-suited to the analysis of membrane-associated signaling complexes in limited amounts of cells or tissues, e.g., ex vivo isolated cells or clinical specimens.
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To assess the variability of the response to exogenous atrial natriuretic peptide (ANP), it was infused at the rate of 1 microgram/min for 2 h in 6 salt-loaded normal volunteers under controlled conditions on 2 occasions at an interval of 1 week. The effect on solute excretion and the haemodynamic and endocrine actions were highly reproducible. The constant ANP infusion caused a delayed and prolonged excretion of sodium, chloride and calcium, no change in potassium or phosphate excretion or in glomerular filtration rate but a marked decrease in renal plasma flow. Blood pressure, heart rate and the plasma levels of angiotensin II, aldosterone, arginine vasopressin and plasma renin activity were unaltered. The effect of a 2-h infusion of ANP 0.5 microgram/min or its vehicle on apparent hepatic blood flow (HBF) was also studied in 14 normal volunteers by measuring the indocyanine green clearance. A 21% decrease in HBF was observed in subjects who received the ANP infusion (p less than 0.01 vs vehicle). Thus, ANP infused at a dose that did not lower blood pressure decreased both renal and liver blood flow in normotensive volunteers. The renal and endocrine responses to ANP were reproducible over a 1-week interval.
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Soft tissue sarcomas (STS) with complex genomic profiles (50% of all STS) are predominantly composed of spindle cell/pleomorphic sarcomas, including leiomyosarcoma, myxofibrosarcoma, pleomorphic liposarcoma, pleomorphic rhabdomyosarcoma, malignant peripheral nerve sheath tumor, angiosarcoma, extraskeletal osteosarcoma, and spindle cell/pleomorphic unclassified sarcoma (previously called spindle cell/pleomorphic malignant fibrous histiocytoma). These neoplasms show, characteristically, gains and losses of numerous chromosomes or chromosome regions, as well as amplifications. Many of them share recurrent aberrations (e.g., gain of 5p13-p15) that seem to play a significant role in tumor progression and/or metastatic dissemination. In this paper, we review the cytogenetic, molecular genetic, and clinicopathologic characteristics of the most common STS displaying complex genomic profiles. Features of diagnostic or prognostic relevance will be discussed when needed.
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The role of land cover change as a significant component of global change has become increasingly recognized in recent decades. Large databases measuring land cover change, and the data which can potentially be used to explain the observed changes, are also becoming more commonly available. When developing statistical models to investigate observed changes, it is important to be aware that the chosen sampling strategy and modelling techniques can influence results. We present a comparison of three sampling strategies and two forms of grouped logistic regression models (multinomial and ordinal) in the investigation of patterns of successional change after agricultural land abandonment in Switzerland. Results indicated that both ordinal and nominal transitional change occurs in the landscape and that the use of different sampling regimes and modelling techniques as investigative tools yield different results. Synthesis and applications. Our multimodel inference identified successfully a set of consistently selected indicators of land cover change, which can be used to predict further change, including annual average temperature, the number of already overgrown neighbouring areas of land and distance to historically destructive avalanche sites. This allows for more reliable decision making and planning with respect to landscape management. Although both model approaches gave similar results, ordinal regression yielded more parsimonious models that identified the important predictors of land cover change more efficiently. Thus, this approach is favourable where land cover change pattern can be interpreted as an ordinal process. Otherwise, multinomial logistic regression is a viable alternative.