36 monocyte subpopulations counts and associations with global longitudinal strain in st-elevation myocardial infarction patients with normal ejection fraction

Introduction - Monocytes, with 3 different subsets, are implicated in the initiation and progression of the atherosclerotic plaque contributing to plaque instability and rupture. Mon1 are the “classical” monocytes with inflammatory action, whilst Mon3 are considered reparative with fibroblast deposition ability. The function of the newly described Mon2 subset is yet to be fully described. In PCI era, fewer patients have globally reduced left ventricular ejection fraction post infarction, hence the importance of studying regional wall motion abnormalities and deformation at segmental levels using longitudinal strain. Little is known of the role for the 3 monocyte subpopulations in determining global strain in ST elevation myocardial infarction patients (STEMI). Conclusion In patients with normal or mildly impaired EF post infarction, higher counts of Mon1 and Mon2 are correlated with GLS within 7 days and at 6 months of remodelling post infarction. Adverse clinical outcomes in patients with reduced convalescent GLS were predicted with Mon1 and Mon2 suggestive of an inflammatory role for the newly identified Mon2 subpopulation. These results imply an important role for monocytes in myocardial healing when assessed by subclinical ventricular function indices. Methodology - STEMI patients (n = 101, mean age 64 ± 13 years; 69% male) treated with percutaneous revascularisation were recruited within 24 h post-infarction. Peripheral blood monocyte subpopulations were enumerated and characterised using flow cytometry after staining for CD14, CD16 and CCR2. Phenotypically, monocyte subpopulations are defined as: CD14++CD16-CCR2+ (Mon1), CD14++CD16+CCR2+ (Mon2) and CD14+CD16++CCR2- (Mon3). Phagocytic activity of monocytes was measured using flow cytometry and Ecoli commercial kit. Transthoracic 2D echocardiography was performed within 7 days and at 6 months post infarct to assess global longitudinal strain (GLS) via speckle tracking. MACE was defined as recurrent acute coronary syndrome and death. Results - STEMI patients with EF ≥50% by Simpson’s biplane (n = 52) had GLS assessed. Using multivariate regression analysis higher counts of Mon1 and Mon 2 and phagocytic activity of Mon2 were significantly associated with GLS (after adjusting for age, time to hospital presentation, and peak troponin levels) (Table 1). At 6 months, the convalescent GLS remained associated with higher counts of Mon1, Mon 2. At one year follow up, using multivariate Cox regression analysis, Mon1 and Mon2 counts were an independent predictor of MACE in patients with a reduced GLS (n = 21)

Regional and strain-specific gene expression mapping in the adult mouse brain

To determine the genetic causes and molecular mechanisms responsible for neurobehavioral differences in mice, we used highly parallel gene expression profiling to detect genes that are differentially expressed between the 129SvEv and C57BL/6 mouse strains at baseline and in response to seizure. In addition, we identified genes that are differentially expressed in specific brain regions. We found that approximately 1% of expressed genes are differentially expressed between strains in at least one region of the brain and that the gene expression response to seizure is significantly different between the two inbred strains. The results lead to the identification of differences in gene expression that may account for distinct phenotypes in inbred strains and the unique functions of specific brain regions.

Mecánica ventricular izquierda en pacientes con infarto agudo del miocardio

RESUMEN Introducción El papel de las nuevas técnicas ecocardiográficas para el diagnóstico de infarto agudo del miocardio se encuentra en desarrollo y la realización de mecánica ventricular izquierda podría sugerir la presencia de enfermedad coronaria hemodinámicamente significativa. Objetivos Determinar si en pacientes con infarto agudo del miocardio la medición de strain longitudinal global y regional sirve para predecir la presencia de enfermedad coronaria significativa. Métodos Es un estudio de pruebas diagnósticas en el que se evaluaron las características operativas de la mecánica ventricular izquierda para la detección de enfermedad coronaria significativa comparado contra el cateterismo cardiaco, considerado el patrón de oro. Se analizaron 54 pacientes con infarto agudo del miocardio llevados a cateterismo cardiaco, a quienes se les realizó un ecocardiograma transtorácico con medición de strain longitudinal global y regional. Resultados De los 54 pacientes analizados, el 83% tenía enfermedad coronaria significativa. El hallazgo de un strain longitudinal global < -17.5 tuvo una sensibilidad del 85% y una especificidad del 78% para predecir la presencia de enfermedad coronaria; para la arteria descendente anterior un strain longitudinal regional < – 17.4 tuvo una sensibilidad de 82% y una especificidad de 44%, para la arteria circunfleja una sensibilidad del 87% y una especificidad del 37% y para la arteria coronaria derecha una sensibilidad de 73% y una especificidad de 32%. Conclusiones La realización de ecocardiografía con mecánica ventricular en pacientes con infarto agudo del miocardio es útil para predecir la presencia de enfermedad coronaria hemodinámicamente significativa.

Strain longitudinal global para la detección de estenosis coronaria significativa en pacientes con infarto agudo del miocardio

Introducción: La evaluación de la función miocárdica global y regional juega una papel crítico en el diagnóstico y manejo de los pacientes con enfermedad coronaria con importantes implicaciones pronosticas, las nuevas técnicas ecocardiográficas como la evaluación del STRAIN han sido validadas como una herramienta objetiva, comprehensiva y precisa para evaluar dichos parámetros. Objetivo: Determinar la capacidad del strain global longitudinal para la detección de estenosis coronaria significativa, número de territorios comprometidos y territorio anatómico del vaso culpable; en pacientes sin antecedentes de enfermedad coronaria previa con infarto agudo del miocardio. Diseño: estudio de pruebas diagnósticas retrospectivo en el que se utilizó como gold estándar la angiografía coronaria, se seleccionaron 64 pacientes con ecocardiograma transtorácico previo a la angiografía coronaria. Resultados: Se demostró una exactitud intermedia del strain global longitudinal para detectar estenosis coronaria por análisis de curvas ROC, con un área bajo la curva de 0,78 p= 0,000 (IC 0,6; 1,0), Una sensibilidad de 96.5% (91.7%, 101.3%), especificidad 40.0% (9.6%, 70.4%) y una prevalencia real del enfermedad coronaria de 85.1% (76.5%, 93.6%) Conclusiones: La medición de la función global y regional por medio del strain global longitudinal identifica pacientes con infarto agudo del miocardio que tienen estenosis coronaria significativa, número de territorios afectados, y la distribución anatómica de los posibles vasos culpables, sin embargo hay que tener precaución en su uso que sólo se limite a escenarios en donde pueda ser interpretado adecuadamente. Palabras clave: strain global bidimensional, detección de estenosis coronaria significativa, infarto del miocardio.

Comparison of two-dimensional speckle and tissue velocity based strain and validation with harmonic phase magnetic resonance imaging

Two-dimensional (2-D) strain (epsilon(2-D)) on the basis of speckle tracking is a new technique for strain measurement. This study sought to validate epsilon(2-D) and tissue velocity imaging (TVI)based strain (epsilon(TVI)) with tagged harmonic-phase (HARP) magnetic resonance imaging (MRI). Thirty patients (mean age. 62 +/- 11 years) with known or suspected ischemic heart disease were evaluated. Wall motion (wall motion score index 1.55 +/- 0.46) was assessed by an expert observer. Three apical images were obtained for longitudinal strain (16 segments) and 3 short-axis images for radial and circumferential strain (18 segments). Radial epsilon(TVI) was obtained in the posterior wall. HARP MRI was used to measure principal strain, expressed as maximal length change in each direction. Values for epsilon(2-D), epsilon(TVI), and HARP MRI were comparable for all 3 strain directions and were reduced in dysfunctional segments. The mean difference and correlation between longitudinal epsilon(2-D) and HARP MRI (2.1 +/- 5.5%, r = 0.51, p < 0.001) were similar to those between longitudinal epsilon(TVI), and HARP MRI (1.1 +/- 6.7%, r = 0.40, p < 0.001). The mean difference and correlation were more favorable between radial epsilon(2-D) and HARP MRI (0.4 +/- 10.2%, r = 0.60, p < 0.001) than between radial epsilon(TVI), and HARP MRI (3.4 +/- 10.5%, r = 0.47, p < 0.001). For circumferential strain, the mean difference and correlation between epsilon(2-D) and HARP MRI were 0.7 +/- 5.4% and r = 0.51 (p < 0.001), respectively. In conclusion, the modest correlations of echocardiographic and HARP MRI strain reflect the technical challenges of the 2 techniques. Nonetheless, epsilon(2-D) provides a reliable tool to quantify regional function, with radial measurements being more accurate and feasible than with TVI. Unlike epsilon(TVI), epsilon(2-D) provides circumferential measurements. (c) 2006 Elsevier Inc. All rights reserved.

Evaluación de la mecánica ventricular izquierda mediante speckle tracking en pacientes sanos en la Clínica Shaio

Introducción: La ecocardiografía es actualmente la técnica de imagen diagnóstica más utilizada para la evaluación de la anatomía y la función cardiovascular. En la actualidad se está utilizando la ecocardiografía por speckle tracking la cual permite una evaluación mas objetiva y confiable de la función ventricular, sin embargo se requieren valores de referencia que hagan que los valores obtenidos sean válidos y útiles para determinar en forma mas oportuna conductas previas al deterioro de su función. Objetivo general: Determinar los valores de referencia para mecánica ventricular izquierda mediante ecocardiografía bidimensional por speckle tracking con equipo Toshiba Artida con transductor multifrecuencia de 3 megahertzios en pacientes sin patología cardiaca conocida en la Fundación Clínica Shaio en el año 2014. Metodología: Análisis de una cohorte prospectiva de todos los pacientes que ingresaron a la Fundación Clínica Shaio para evaluación ecocardiográfica sin patología cardiaca conocida entre los meses Agosto y Diciembre del 2014. Resultados: Se presenta este estudio de la evaluación de la mecánica ventricular izquierda en adultos sanos, los resultados son similares a los obtenidos en estudios de referencia, sin embargo se consideran de gran importancia ya que de acuerdo a la guía actual de evaluación de la mecánica ventricular por strain rate es importante que cada equipo se encuentre estandarizado con el fin de tener resultados válidos de acuerdo a las diferentes patologías en las que se puede aplicar y a nuestra población.

Normal ranges for automated analysis of global LV function using 2D Strain

Background: Automated measurement of LV function could extend the clinical utility of echo by less expert readers. We sought to define normal ranges of global 2D strain (2DS) and strain-rate (SR) in an international, multicenter study of healthy subjects, and to assess the determinants of variation. Methods: SR and 2DS were measured in 18 myocardial segts in both apical and short axis views of 227 normal subjects (38% men, 48±14y) with no cardiac history, risk factors or drug therapy. The association of age and resting hemodynamics with global strain indices was sought using multiple regression. Differences in variance were expressed as F values. Results: Baseline SBP was 127±18 mmHg, pulse was 76±13/min and ejection fraction 50±20%. Although global longitudinal strain was influenced by endsystolic volume (F=4.2, p

Self-mixing-based demodulation technique for dynamic fiber Bragg grating strain sensors

We report a novel demodulation scheme for the detection of small Bragg wavelength shifts in a fiber Bragg grating strain sensor by exploiting the optical feedback reflected from the grating structure back into a 1310 nm laser diode integrating a photodiode. The dynamic strain generated by a mechanical vibrator is applied transversely to the fiber Bragg grating and the desired longitudinal strain values inferred from the detected sawtooth-like optical feedback signals. Preliminary results demonstrate the feasibility of this demodulation technique for strain measurement which could be further extended to fiber Bragg grating-based sensors for the detection of different measurands in general.

Self-mixing-based demodulation technique for dynamic fiber Bragg grating strain sensors

We report a novel demodulation scheme for the detection of small Bragg wavelength shifts in a fiber Bragg grating strain sensor by exploiting the optical feedback reflected from the grating structure back into a 1310 nm laser diode integrating a photodiode. The dynamic strain generated by a mechanical vibrator is applied transversely to the fiber Bragg grating and the desired longitudinal strain values inferred from the detected sawtooth-like optical feedback signals. Preliminary results demonstrate the feasibility of this demodulation technique for strain measurement which could be further extended to fiber Bragg grating-based sensors for the detection of different measurands in general.

Turbulent non-equlibrium wakes

We consider here the detailed application of a model Reynolds stress equation (Narasimha 1969) to plane turbulent wakes subjected to pressure gradients. The model, which is a transport equation for the stress exhibiting relaxation and diffusion, is found to be consistent with the observed response of a wake to a nearly impulsive pressure gradient (Narasimha & Prabhu 1971). It implies in particular that a wake can be in equilibrium only if the longitudinal strain rate is appreciably less than the wake shear. We then describe a further series of experiments, undertaken to investigate the range of validity of the model. It is found that, with an appropriate convergence correction when necessary, the model provides excellent predictions of wake development under favourable, adverse and mixed pressure gradients. Furthermore, the behaviour of constant-pressure distorted wakes, as reported by Keffer (1965, 1967), is also explained very well by the model when account is taken of the effective flow convergence produced by the distortion. In all these calculations, only a simple version of the model is used, involving two non-dimensional constants both of which have been estimated from a single relaxation experiment.

Field emission properties of carbon nanotube arrays with defects and impurities

Field emission from carbon nanotubes (CNTs) in the form of arrays or thin films give rise to several strongly correlated process of electromechanical interaction and degradation. Such processes are mainly due to (1) electron-phonon interaction (2) electromechanical force field leading to stretching of CNTs (3) ballistic transport induced thermal spikes, coupled with high dynamic stress, leading to degradation of emission performance at the device scale. Fairly detailed physics based models of CNTs considering the aspects (1) and (2) above have already been developed by these authors, and numerical results indicate good agreement with experimental results. What is missing in such a system level modeling approach is the incorporation of structural defects and vacancies or charge impurities. This is a practical and important problem due to the fact that degradation of field emission performance is indeed observed in experimental I-V curves. What is not clear from these experiments is whether such degradation in the I-V response is due to dynamic reorientation of the CNTs or due to the defects or due to both of these effects combined. Non-equilibrium Green’s function based simulations using a tight-binding Hamiltonian for single CNT segment show up the localization of carrier density at various locations of the CNTs. About 11% decrease in the drive current with steady difference in the drain current in the range of 0.2-0.4V of the gate voltage was reported in literature when negative charge impurity was introduced at various locations of the CNT over a length of ~20nm. In the context of field emission from CNT tips, a simplistic estimate of defects have been introduced by a correction factor in the Fowler-Nordheim formulae. However, a more detailed physics based treatment is required, while at the same time the device-scale simulation is necessary. The novelty of our present approach is the following. We employ a concept of effective stiffness degradation for segments of CNTs, which is due to structural defects, and subsequently, we incorporate the vacancy defects and charge impurity effects in the Green’s function based approach. Field emission induced current-voltage characteristics of a vertically aligned CNT array on a Cu-Cr substrate is then simulated using a detailed nonlinear mechanistic model of CNTs coupled with quantum hydrodynamics. An array of 10 vertically aligned and each 12 m long CNTs is considered for the device scale analysis. Defect regions are introduced randomly over the CNT length. The result shows the decrease in the longitudinal strain due to defects. Contrary to the expected influence of purely mechanical degradation, this result indicates that the charge impurity and hence weaker transport can lead to a different electromechanical force field, which ultimately can reduce the strain. However, there could be significant fluctuation in such strain field due to electron-phonon coupling. The effect of such fluctuations (with defects) is clearly evident in the field emission current history. The average current also decreases significantly due to such defects.

Elasticity, stability, and ideal strength of beta-SiC in plane-wave-based ab initio calculations

On the basis of the pseudopotential plane-wave method and the local-density-functional theory, this paper studies energetics, stress-strain relation, stability, and ideal strength of beta-SiC under various loading modes, where uniform uniaxial extension and tension and biaxial proportional extension are considered along directions [001] and [111]. The lattice constant, elastic constants, and moduli of equilibrium state are calculated and the results agree well with the experimental data. As the four SI-C bonds along directions [111], [(1) over bar 11], [11(1) over bar] and [111] are not the same under the loading along [111], internal relaxation and the corresponding internal displacements must be considered. We find that, at the beginning of loading, the effect of internal displacement through the shuffle and glide plane diminishes the difference among the four Si-C bonds lengths, but will increase the difference at the subsequent loading, which will result in a crack nucleated on the {111} shuffle plane and a subsequently cleavage fracture. Thus the corresponding theoretical strength is 50.8 GPa, which agrees well with the recent experiment value, 53.4 GPa. However, with the loading along [001], internal relaxation is not important for tetragonal symmetry. Elastic constants during the uniaxial tension along [001] are calculated. Based on the stability analysis with stiffness coefficients, we find that the spinodal and Born instabilities are triggered almost at the same strain, which agrees with the previous molecular-dynamics simulation. During biaxial proportional extension, stress and strength vary proportionally with the biaxial loading ratio at the same longitudinal strain.

Avaliação de cardiotoxicidade subclínica tardia em pacientes com diagnóstico prévio de linfoma não Hodgkin tratados com antraciclinas

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

Avaliação de cardiotoxicidade subclínica tardia em pacientes com diagnóstico prévio de linfoma não Hodgkin tratados com antraciclinas

Pós-graduação em Fisiopatologia em Clínica Médica - FMB