Heart to Heart, October 2012

Heart to Heart is a publication on new heart disease and stroke information and other related topics by the Department of Public Health.

Modulation of the c-Jun N-terminal kinase activity in the embryonic heart in response to anoxia-reoxygenation: involvement of the Ca2+ and mitoKATP channels.

Whether the response of the fetal heart to ischemia-reperfusion is associated with activation of the c-Jun N-terminal kinase (JNK) pathway is not known. In contrast, involvement of the sarcolemmal L-type Ca2+ channel (LCC) and the mitochondrial KATP (mitoKATP) channel has been established. This work aimed at investigating the profile of JNK activity during anoxia-reoxygenation and its modulation by LCC and mitoK(ATP) channel. Hearts isolated from 4-day-old chick embryos were submitted to anoxia (30 min) and reoxygenation (60 min). Using the kinase assay method, the profile of JNK activity in the ventricle was determined every 10 min throughout anoxia-reoxygenation. Effects on JNK activity of the LCC blocker verapamil (10 nM), the mitoK(ATP) channel opener diazoxide (50 microM) and the blocker 5-hydroxydecanoate (5-HD, 500 microM), the mitochondrial Ca2+ uniporter (MCU) inhibitor Ru360 (10 microM), and the antioxidant N-(2-mercaptopropionyl) glycine (MPG, 1 mM) were determined. In untreated hearts, JNK activity was increased by 40% during anoxia and peaked fivefold relative to basal level after 30-40 min reoxygenation. This peak value was reduced by half by diazoxide and was tripled by 5-HD. Furthermore, the 5-HD-mediated stimulation of JNK activity during reoxygenation was abolished by diazoxide, verapamil or Ru360. MPG had no effect on JNK activity, whatever the conditions. None of the tested pharmacological agents altered JNK activity under basal normoxic conditions. Thus, in the embryonic heart, JNK activity exhibits a characteristic pattern during anoxia and reoxygenation and the respective open-state of LCC, MCU and mitoKATP channel can be a major determinant of JNK activity in a ROS-independent manner.

Possible synergism of physical exercise and ghrelin-agonists in patients with cachexia associated with chronic heart failure.

The occurrence of cachexia of multifactorial etiology in chronic heart failure (CHF) is a common and underestimated condition that usually leads to poor outcome and low survival rates, with high direct and indirect costs for the Health Care System. Recently, a consensus definition on cachexia has been reached, leading to a growing interest by the scientific community in this condition, which characterizes the last phase of many chronic diseases (i.e., cancer, acquired immunodeficiency syndrome). The etiology of cachexia is multifactorial and the underlying pathophysiological mechanisms are essentially the following: anorexia and malnourishment; immune overactivity and systemic inflammation; and endocrine disorders (anabolic/catabolic imbalance and resistance to growth hormone). In this paper, we review the main pathophysiological mechanisms underlying CHF cachexia, focusing also on the broad spectrum of actions of ghrelin and ghrelin agonists, and their possible use in combination with physical exercise to contrast CHF cachexia.

Energy expenditure of extreme competitive mountaineering skiing.

PURPOSE: Multi-hour ski mountaineering energy balance may be negative and intake below recommendations. METHODS: Athletes on the 'Patrouille des Glaciers' racecourses (17 on course Z, 27 km, +2,113 m; 11 on course A, 26 km, +1,881 m) volunteered. Pre-race measurements included body mass, stature, VO2max, and heart rate (HR) vs VO2 at simulated altitude; race measurements HR, altitude, incline, location, and food and drink intake (A). Energy expenditure (EE) was calculated from altitude corrected HR derived VO2. RESULTS: Race time was 5 h 7 min ± 44 min (mean ± SD, Z) and 5 h 51 min ± 53 min (A). Subjects spent 19.2 ± 3.2 MJ (Z), respectively, 22.6 ± 2.9 MJ (A) during the race. Energy deficit was -15.5 ± 3.9 MJ (A); intake covered 20 ± 7 % (A). Overall energy cost of locomotion (EC) was 9.9 ± 1.3 J m(-1) kg(-1) (Z), 8.0 ± 1.0 J m(-1) kg(-1) (A). Uphill EC was 11.7 ± 1 J m(-1) kg(-1) (Z, 13 % slope) and 15.7 ± 2.3 J m(-1) kg(-1) (A, 19 % slope). Race A subjects lost -1.5 ± 1.1 kg, indicating near euhydration. Age, body mass, gear mass, VO2max and EC were significantly correlated with performance; energy deficit was not. CONCLUSIONS: Energy expenditure and energy deficit of a multi-hour ski mountaineering race are very high and energy intake is below recommendations.

Heart to Heart, September 2012

Heart to Heart is a publication on new heart disease and stroke information and other related topics by the Department of Public Health.

Heart to Heart, November 2012

Heart to Heart is a publication on new heart disease and stroke information and other related topics by the Department of Public Health.

Heart to Heart, December 2012

Heart to Heart is a publication on new heart disease and stroke information and other related topics by the Department of Public Health.

Heart to Heart, January 2013

Heart to Heart is a publication on new heart disease and stroke information and other related topics by the Department of Public Health.

Alterations in the local myocardial motion pattern in patients suffering from pressure overload due to aortic stenosis.

BACKGROUND: MR tissue tagging allows the noninvasive assessment of the locally and temporally resolved motion pattern of the left ventricle. Alterations in cardiac torsion and diastolic relaxation of the left ventricle were studied in patients with aortic stenosis and were compared with those of healthy control subjects and championship rowers with physiological volume-overload hypertrophy. METHODS AND RESULTS: Twelve aortic stenosis patients, 11 healthy control subjects with normal left ventricular function, and 11 world-championship rowers were investigated for systolic and diastolic heart wall motion on a basal and an apical level of the myocardium. Systolic torsion and untwisting during diastole were examined by use of a novel tagging technique (CSPAMM) that provides access to systolic and diastolic motion data. In the healthy heart, the left ventricle performs a systolic wringing motion, with a counterclockwise rotation at the apex and a clockwise rotation at the base. Apical untwisting precedes diastolic filling. In the athlete's heart, torsion and untwisting remain unchanged compared with those of the control subjects. In aortic stenosis patients, torsion is significantly increased and diastolic apical untwisting is prolonged compared with those of control subjects or athletes. CONCLUSIONS: Torsional behavior as observed in pressure- and volume-overloaded hearts is consistent with current theoretical findings. A delayed diastolic untwisting in the pressure-overloaded hearts of the patients may contribute to a tendency toward diastolic dysfunction.

Heart to Heart, February 2013

Heart to Heart is a publication on new heart disease and stroke information and other related topics by the Department of Public Health.

Consequences of one-week creatine supplementation on creatine and creatinine levels in athletes 'serum and urine

We explored the washout period of creatine (Cr) after repeated ingestions of high doses of exogenous Cr. Ten athletes ingested daily, in a randomized double-blind study design, 30 g of exoge- nous Cr (n = 5, Cr-group) or a placebo (n = 5, Pl-group). Serum and urine samples were collected 1) before supplementation (BEFO- RE), 2) after one week Cr supplementation (AFTER), and 3) one week later without supplementation (LATER). The Cr and crea- tinine (Crn) concentrations in serum (sCr, sCrn) and in multiple spots urine (uCr, uCrn) were measured. We observed a significant rise (p < 0.01) in sCr, uCr and sCrn between BEFORE and AFTER supplementation in Cr-group, as well as a significant difference between Cr-group and Pl-group. Body weight increased signifi- cantly (+1.5 kg), but relative body fat (%fat) was unchanged. After the washout period in LATER Cr-group, sCr and uCr decreased to low residual values. No loss of body weight occurred during thisperiod. In contrast, sCrn and uCrn returned to baseline values. In conclusion, regular uptake of high doses of exogenous Cr affects both Cr and Crn concentrations in serum (sCr: 14 folds; sCrn: 1.2 folds) and urine (uCr: 140 folds; uCrn: 1.5 folds). An abuse of Cr is therefore mostly spilled over in urine. Surprise drug tests, such as doping controls, happening during the period of Cr supplementa- tion can reveal an important increase in Cr and Crn concentrations, although subjects stopped suddenly Cr loading. The discernible effect of Cr supplementation on these values disappeared within one week.

Audit report on the Heart of Iowa Regional Transit Agency, Des Moines, Iowa, for the year ended June 30, 2012

Audit report on the Heart of Iowa Regional Transit Agency, Des Moines, Iowa, for the year ended June 30, 2012

Audit report on the Heart of Iowa Regional Transit Agency, Des Moines, Iowa, for the year ended June 30, 2004

Audit report on the Heart of Iowa Regional Transit Agency, Des Moines, Iowa, for the year ended June 30, 2012