Electrocardiographic parameters of ventricular repolarization : modifiers and the prognostic value

Electric activity of the heart consists of repeated cardiomyocyte depolarizations and repolarizations. Abnormalities in repolarization predispose to ventricular arrhythmias. In body surface electrocardiogram, ventricular repolarization generates the T wave. Several electrocardiographic measures have been developed both for clinical and research purposes to detect repolarization abnormalities. The study aim was to investigate modifiers of ventricular repolarization with the focus on the relationship of the left ventricular mass, antihypertensive drugs, and common gene variants, to electrocardiographic repolarization parameters. The prognostic value of repolarization parameters was also assessed. The study subjects originated from a population of more than 200 middle-aged hypertensive men attending the GENRES hypertension study, and from an epidemiological survey, the Health 2000 Study, including more than 6000 participants. Ventricular repolarization was analysed from digital standard 12-lead resting electrocardiograms with two QT-interval based repolarization parameters (QT interval, T-wave peak to T-wave end interval) and with a set of four T-wave morphology parameters. The results showed that in hypertensive men, a linear change in repolarization parameters is present even in the normal range of left ventricular mass, and that even mild left ventricular hypertrophy is associated with potentially adverse electrocardiographic repolarization changes. In addition, treatments with losartan, bisoprolol, amlodipine, and hydrochlorothiazide have divergent short-term effects on repolarization parameters in hypertensive men. Analyses of the general population sample showed that single nucleotide polymorphisms in KCNH2, KCNE1, and NOS1AP genes are associated with changes in QT-interval based repolarization parameters but not consistently with T-wave morphology parameters. T-wave morphology parameters, but not QT interval or T-wave peak to T-wave end interval, provided independent prognostic information on mortality. The prognostic value was specifically related to cardiovascular mortality. The results indicate that, in hypertension, altered ventricular repolarization is already present in mild left ventricular mass increase, and that commonly used antihypertensive drugs may relatively rapidly and treatment-specifically modify electrocardiographic repolarization parameters. Common variants in cardiac ion channel genes and NOS1AP gene may also modify repolarization-related arrhythmia vulnerability. In the general population, T-wave morphology parameters may be useful in the risk assessment of cardiovascular mortality.

Analysis of a thick plate with a circular hole resting on a smooth rigid bed and subjected to axisymmetric normal load

A solution for the stresses and displacements in an radially infinite thick plate having a circular hole, one face of which resting on a smooth rigid bed and the other face subjected to axisymmetric normal loading is given. The solution is obtained in terms of Fourier-Bessel series and integral for the Love's stress function. Numerical results are presented for one particular ratio of thickness of plate to the hole radius and loading. It is also shown that the Poisson's ratio has a predominant effect on certain stresses and displacements. The solution would be useful in the stress analysis of bolted joints.Eine Lösung für die Spannungen und Verschiebungen in einer radial, unendlich ausgedehnten, dicken Platte mit einem kreisförmigen Loch, wobei eine Seite auf einer ebenen, starren Unterlage aufliegt, die andere Seite durch eine achsensymmetrische Vertikallast belastet ist, wird angegeben. Die Lösung wird in Form von Fourier-Bessel-Reihen und Integralen der Loveschen Spannungsfunktion angegeben. Numerische Ergebnisse werden für ein bestimmtes Verhältnis der Plattendicke zum Lochradius sowie zur Belastung angegeben. Es wird auch gezeigt, daß das Poisssonsche Verhältnis einen besonderen Einfluß auf bestimmte Spannungen und Verschiebungen hat. Die Lösung ist anwendbar für die Spannungsermittlung von Bolzenverbindungen.

Modification of ventricular repolarization in silent long QT syndrome mutation carriers

Congenital long QT syndrome (LQTS) is a familial disorder characterized by ventricular repolarization that makes carriers vulnerable to malignant ventricular tachycardia and sudden cardiac death. The three main subtypes (LQT1, LQT2 and LQT3) constitute 95% of cases. The disorder is characterized by a prolonged QT interval in electrocardiograms (ECG), but a considerable portion are silent carriers presenting normal (QTc < 440 ms) or borderline (QTc < 470 ms) QT interval. Genetic testing is available only for 60-70% of patients. A number of pharmaceutical compounds also affect ventricular repolarization, causing a clinically similar disorder called acquired long QT syndrome. LQTS carriers - who already have impaired ventricular repolarization - are especially vulnerable. In this thesis, asymptomatic genotyped LQTS mutation carriers with non-diagnostic resting ECG were studied. The body surface potential mapping (BSPM) system was utilized for ECG recording, and signals were analyzed with an automated analysis program. QT interval length, and the end part of the T wave, the Tpe interval, was studied during exercise stress testing and an epinephrine bolus test. In the latter, T wave morphology was also analyzed. The effect of cetirizine was studied in LQTS carriers and also with supra- therapeutic dose in healthy volunteers. At rest, LQTS mutation carriers had a slightly longer heart rate adjusted QTc interval than healthy subjects (427 ± 31 ms and 379 ± 26 ms; p<0.001), but significant overlapping existed. LQT2 mutation carriers had a conspicuously long Tpe-interval (113 ± 24 ms; compared to 79 ± 11 ms in LQT1, 81 ± 17 ms in LQT3 and 78 ± 10 ms in controls; p<0.001). In exercise stress tests, LQT1 mutation carriers exhibit a long QT interval at high heart rates and during recovery, whereas LQT2 mutation carriers have a long Tpe interval at the beginning of exercise and at the end of recovery at low heart rates. LQT3 mutation carriers exhibit prominent shortening of both QT and Tpe intervals during exercise. A small epinephrine bolus revealed disturbed repolarization, especially in LQT2 mutation carriers, who developed prolonged Tpe intervals. A higher epinephrine bolus caused abnormal T waves with a different T wave profile in LQTS mutation carriers compared to healthy controls. These effects were seen in LQT3 as well, a group that may easily escape other provocative tests. In the cetirizine test, the QT and Tpe intervals were not prolonged in LQTS mutation carriers or in healthy controls. Subtype-specific findings in exercise test and epinephrine bolus test help to diagnose silent LQTS mutation carriers and to guide subtype-specific treatments. The Tpe interval, which signifies the repolarization process, seems to be a sensitive marker of disturbed repolarization along with the QT interval, which signifies the end of repolarization. This method may be used in studying compounds that are suspected to affect repolarization. Cetirizine did not adversely alter ventricular repolarization and would not be pro-arrhythmic in common LQT1 and LQT2 subtypes when used at its recommended doses.

Effect of interface friction on the mechanics of indentation of a finite layer resting on a rigid substrate

Copper strips of 2.5 mm thickness resting on stainless steel anvils were normally indented by wedges under nominal plane strain conditions. Inflections in the hardness-penetration characteristics were identified. Inflections separate stages where each stage has typical mechanics of deformation. These are arrived at by studying the distortion of 0.125 mm spaced grids inscribed on the deformation plane of the strip. The sensitivity of hardness and deformation mechanics to wedge angle and the interfacial friction between strip and anvil were investigated within the framework of existing slip line field models of indentation of semi-infinite and finite blocks.

Cubicity of Interval Graphs and the Claw Number

Let G(V, E) be a simple, undirected graph where V is the set of vertices and E is the set of edges. A b-dimensional cube is a Cartesian product l(1) x l(2) x ... x l(b), where each l(i) is a closed interval of unit length on the real line. The cub/city of G, denoted by cub(G), is the minimum positive integer b such that the vertices in G can be mapped to axis parallel b-dimensional cubes in such a way that two vertices are adjacent in G if and only if their assigned cubes intersect. An interval graph is a graph that can be represented as the intersection of intervals on the real line-i.e. the vertices of an interval graph can be mapped to intervals on the real line such that two vertices are adjacent if and only if their corresponding intervals overlap. Suppose S(m) denotes a star graph on m+1 nodes. We define claw number psi(G) of the graph to be the largest positive integer m such that S(m) is an induced subgraph of G. It can be easily shown that the cubicity of any graph is at least log(2) psi(G)]. In this article, we show that for an interval graph G log(2) psi(G)-]<= cub(G)<=log(2) psi(G)]+2. It is not clear whether the upper bound of log(2) psi(G)]+2 is tight: till now we are unable to find any interval graph with cub(G)> (log(2)psi(G)]. We also show that for an interval graph G, cub(G) <= log(2) alpha], where alpha is the independence number of G. Therefore, in the special case of psi(G)=alpha, cub(G) is exactly log(2) alpha(2)]. The concept of cubicity can be generalized by considering boxes instead of cubes. A b-dimensional box is a Cartesian product l(1) x l(2) x ... x l(b), where each I is a closed interval on the real line. The boxicity of a graph, denoted box(G), is the minimum k such that G is the intersection graph of k-dimensional boxes. It is clear that box(G)<= cub(G). From the above result, it follows that for any graph G, cub(G) <= box(G)log(2) alpha]. (C) 2010 Wiley Periodicals, Inc. J Graph Theory 65: 323-333, 2010

Epoch extraction from linear prediction residual for identification of closed glottis interval

In voiced speech analysis epochal information is useful in accurate estimation of pitch periods and the frequency response of the vocal tract system. Ideally, linear prediction (LP) residual should give impulses at epochs. However, there are often ambiguities in the direct use of LP residual since samples of either polarity occur around epochs. Further, since the digital inverse filter does not compensate the phase response of the vocal tract system exactly, there is an uncertainty in the estimated epoch position. In this paper we present an interpretation of LP residual by considering the effect of the following factors: 1) the shape of glottal pulses, 2) inaccurate estimation of formants and bandwidths, 3) phase angles of formants at the instants of excitation, and 4) zeros in the vocal tract system. A method for the unambiguous identification of epochs from LP residual is then presented. The accuracy of the method is tested by comparing the results with the epochs obtained from the estimated glottal pulse shapes for several vowel segments. The method is used to identify the closed glottis interval for the estimation of the true frequency response of the vocal tract system.

Nonlinear static and dynamic damped response of a composite rectangular plate resting on a two-parameter elastic foundation

Nonlinear static and dynamic response analyses of a clamped. rectangular composite plate resting on a two-parameter elastic foundation have been studied using von Karman's relations. Incorporating the material damping, the governing coupled, nonlinear partial differential equations are obtained for the plate under step pressure pulse load excitation. These equations have been solved by a one-term solution and by applying Galerkin's technique to the deflection equation. This yields an ordinary nonlinear differential equation in time. The nonlinear static solution is obtained by neglecting the time-dependent variables. Thc nonlinear dynamic damped response is obtained by applying the ultraspherical polynomial approximation (UPA) technique. The influences of foundation modulus, shear modulus, orthotropy, etc. upon the nonlinear static and dynamic responses have been presented.

Interaction analysis of strip footing resting on a non-homogeneous elastic medium

In this paper, a plane stress solution for the interaction analysis of strip footing resting on (i) a non-homogeneous elastic half-plane and (ii) a non-homogeneous elastic layer resting on a rigid stratum has been presented. The analysis has been done using a combined analytical and FEM method in which the discretization of the half-plane is not required and thereby minimizes the computational efforts considerably. The contact pressure distribution and the settlement profile for the selected cases of varying modulus half-plane, which has more relevance to foundation engineering, have been given. Experimental verification through a photoelastic method of stress analysis has been carried out for the case of footing on Gibson elastic half-plane, and the contact pressure distribution thus obtained has been compared with the theoretical results. Copyright (C) 1996 Elsevier Science Ltd

Nonlinear measures of QT interval series: novel indices of cardiac repolarization lability: MEDqthr and LLEqthr

In this study, we investigated nonlinear measures of chaos of QT interval time series in 28 normal control subjects, 36 patients with panic disorder and 18 patients with major depression in supine and standing postures. We obtained the minimum embedding dimension (MED) and the largest Lyapunov exponent (LLE) of instantaneous heart rate (HR) and QT interval series. MED quantifies the system's complexity and LLE predictability. There was a significantly lower MED and a significantly increased LLE of QT interval time series in patients. Most importantly, nonlinear indices of QT/HR time series, MEDqthr (MED of QT/HR) and LLEqthr (LLE of QT/HR), were highly significantly different between controls and both patient groups in either posture. Results remained the same even after adjusting for age. The increased LLE of QT interval time, series in patients with anxiety and depression is in line with our previous findings of higher QTvi (QT variability index, a log ratio of QT variability corrected for mean QT squared divided by heart rate variability corrected for mean heart rate squared) in these patients, using linear techniques. Increased LLEqthr (LLE of QT/HR) may be a more sensitive tool to study cardiac repolarization and a valuable addition to the time domain measures such as QTvi. This is especially important in light of the finding that LLEqthr correlated poorly and nonsignificantly with QTvi. These findings suggest an increase in relative cardiac sympathetic activity and a decrease in certain aspects of cardiac vagal function in patients with anxiety as well as depression. The lack of correlation between QTvi and LLEqthr suggests that this nonlinear index is a valuable addition to the linear measures. These findings may also help to explain the higher incidence of cardiovascular mortality in patients with anxiety and depressive disorders. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.

Possibility of chaos in interval friction experiments of martensites

Wuttig and Suzuki's model on anelastic nonlinearities in solids in the vicinity of martensite transformations is analysed numerically. This model shows chaos even in the absence of applied forcing field as a function of a temperature dependent parameter. Even though the model exhibits sustained oscillations as a function of the amplitude of the forcing term, it does not exactly capture the features of the experimental time series. We have improved the model by adding a symmetry breaking term. The improved model shows period doubling bifurcation as a function of the amplitude of the forcing term. The solutions of our improved model shows good resemblance with the nonsymmetric period four oscillation seen in the experiment. (C) 1999 Elsevier Science B.V. All rights reserved.

Nucleation-Growth Mode of Cubic-Tetragonal Transition with Coexistence of Phases over a Wide Temperature Interval in the High Temperature Ferroelectric Systems PbTiO3-BiMeO3:Me = Sc , and Zn1/2Ti1/2

Temperature dependent X-ray powder diffraction and dielectric studies have been carried out on tetragonal compositions of (1-x) PbTiO 3(x) BiMeO 3; Me similar to Sc and Zn 1/2 Ti 1/2. The cubic and the tetragonal phases coexist over more than 100 degrees C for 0.70 PbTiO 30.3 Bi ( Zn 1/2 Ti 1/2) O 3 and 0.66 PbTiO 30.34 BiScO 3. The wide temperature range of phase coexistence is shown to be an intrinsic feature of the system, and is attributed to the increase in the degree of the covalent character of the ( Pb +Bi ) O bond with increasing concentration of Bi at the Pb -site. The d-values of the {111} planes of the coexisting phases are nearly identical, suggesting this plane to be the invariant plane for the martensitic type cubic-tetragonal transformation occurring in these systems.

On existence of periodic solutions for stable interval plants with odd, sector type nonlinearities

In several systems, the physical parameters of the system vary over time or operating points. A popular way of representing such plants with structured or parametric uncertainties is by means of interval polynomials. However, ensuring the stability of such systems is a robust control problem. Fortunately, Kharitonov's theorem enables the analysis of such interval plants and also provides tools for design of robust controllers in such cases. The present paper considers one such case, where the interval plant is connected with a timeinvariant, static, odd, sector type nonlinearity in its feedback path. This paper provides necessary conditions for the existence of self sustaining periodic oscillations in such interval plants, and indicates a possible design algorithm to avoid such periodic solutions or limit cycles. The describing function technique is used to approximate the nonlinearity and subsequently arrive at the results. Furthermore, the value set approach, along with Mikhailov conditions, are resorted to in providing graphical techniques for the derivation of the conditions and subsequent design algorithm of the controller.