Predictors of ACEI/ARB therapy in patients with hypertrophic cardiomyopathy : results of a national registry

© The European Society of Cardiology 2018. All rights reserved. For Permissions, please e-mail: [email protected]: Angiotensin-converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARB) are not considered disease-modifying drugs in hypertrophic cardiomyopathy (HCM) and their use is usually dependent on other clinical indications. Few data exist about the use of ACEI/ARB in HC in the real world, particularly in patients with intraventricular obstruction. Objective: In this study, we sought to determine the frequency of ACEI / ARB therapy in patients with HCM and the predictors for their use.info:eu-repo/semantics/publishedVersio

Paleoceanographic and climatic implications of a new Mediterranean Outflow branch in the southern Gulf of Cadiz

The presence of contourite drifts in the southern Gulf of Cadiz (GoC) along the Moroccan margin raises questions about the (re)circulation of Mediterranean Outflow Water (MOW) in the GoC and the origin of the currents depositing them. Here, we compare two cores representative of Iberian and Moroccan contourite drifts, covering the last 22 kyr. Although the whole sequence is contouritic in character, it reflects the interaction of distinctive silty-contourite facies (high flow velocity periods) imbedded in muddy-contourite facies (low flow velocity periods). Evidence from benthic foraminifera δ13C, sortable silt grain-size, oceanographic CTD profiles and numerical simulations, indicate the Mediterranean water mass as the source of the southern contourite deposits. Our data, therefore, suggests an additional branch of upper-MOW veering southwards off the Straits of Gibraltar along the Moroccan margin. During MIS-(Marine Isotope Stage) 2, upper-MOW was a sluggish current while in the Holocene upper-MOW dominated as a fast, semi-steady flow. Throughout the deglaciation, silty contourites associated with higher flow speeds were deposited in the northern and southern GoC during cold events such as Heinrich Stadial 1 (HS1) and the Younger Dryas, forced by global millennial-scale climate variability. Millennial variability also appears to drive the deposition of silty-contourites in the Holocene. We estimated an average duration of 1 ka for the process of depositing a fast contourite unit. The case of silty-contourite I6 (within HS1) allows us to illustrate with extremely high resolution a “rapid” sequential change in circulation, with gradual slow-down of dense Mediterranean water while surface was freshening (HS1), provoking injection of high-salinity intermediate waters (via contour-currents) into the GoC, and hence the North Atlantic. The subsequent brief collapse of dense water formation in the Mediterranean Sea triggered a major increase in sea surface temperatures (10 °C/ka) in the GoC, developing into the next interstadial (Bølling/Allerød). The impact of Mediterranean intermediate waters is manifested here by triggering a substantial rearrangement of intermediate and deep circulation in the North Atlantic, which would have further impacted the Atlantic Meridional Overturning Circulation (AMOC)

Influence of diagenetic processes and terrestrial/anthropogenic sources in the REE contents of the Cascais submarine canyon (Iberian western coast)

ABSTRACT: Temporal variations of rare earth elements (REE) and their fractionation patterns, major elements, Pb and Hg were determined in two multicores collected at 445 and 2100 m water depth (mwd) in the Cascais submarine canyon (CSC). The PAAS-normalized REE patterns suggest mixing of Tagus estuarine and marine sediments, marked by MREE (Nd‐Dy series) enrichment and by positive Eu-anomaly, with marine sediments. The positive Eu/Eu* implies incorporation of detrital feldspar minerals derived from the estuary. Ce/Ce*, (La/Yb)PAAS and (Nd/Yb)PAAS show differences between the two cores. Core 252-35 from the shallower site is enriched in HREE (Ho‐Lu series) over LREE (La‐Pr series), a pattern also found in the Tagus estuary in the vicinity of an abandoned chemical complex, where the environment is affected by the legacy of massive-sulfide ores processing. There seems to be only limited down-canyon sediment transport to the deeper reaches where core 252-32 was collected. This deeper site shows Ce/Ce* peaks coinciding with low (La/Yb)PAAS values suggesting preferential diagenetic remobilization of LREE relative to HREE. Upcore Pb/Al and Hg/Corg trends observed in both cores indicate dispersion of the anthropogenic component from the estuary through the CSC, which is less obvious from the ∑REE/Al trends particularly in the deeper site. This may suggest the influence of diagenetic processes in the REE signal, associated with relatively low sediment accumulation rates.info:eu-repo/semantics/publishedVersio

Alterações recentes nas razões isotópicas de Pb em sedimentos do Canhão Submarino de Cascais, Portugal

Temporal variations in lead concentrations and stable lead isotopic ratios in two sediment cores from the Cascais Canyon shows changes in sources of Pb during the last two centuries. The increase of total Pb contents wIth the evolution of Pb ratio recorded in both cores reveals the Increase of Pb from industrial sources. Nevertheless, this increase is lower in deeper core location (252-32) due to dilution and mixing with uncontaminated marine materials. An isotopic shift towards lower Pb/Pb in the shallower core (252-35) during the 1970s may reflect the increasing number of vehicles in the Lisboa area during that time

Gibraltar Outflow and Mediterranean overturning circulation during the last 500 ky

20th Congress of the International Union for Quaternary Research (INQUA). Dublin, 25th and 31st July 2019, AbstractsIn order to explore past changes in the Mediterranean Outflow Water (MOW) we analyzed the fine sand content in the sediments together with some geochemical proxies and planktic and benthic stable isotopes at IODP site U1389. This site was recovered in the vicinity of the Strait of Gibraltar along the path of the main core of the MOW. The content of fine sand together with Zr/Al ratios were used to investigate the MOW speed variability along the past 500 ky. The MOW speed variability at this site was mainly driven by changes in the density contrast between the Inflow and Outflow, which was, in turn, governed by changes in the Mediterranean heat and freshwater budgets. Events of enhanced freshwater input to the Mediterranean associated to northward shifts of the Intertropical convergence Zone reduced the density contrast at Gibraltar and weakened the MOW at Gibraltar. Weak MOW events were recorded at times of sapropel deposition in the eastern Mediterranean. At millennial scale, the MOW intensified at times of Greenland stadials and weakened during interstadials. However, during Heinrich stadials typical three-phase events were observed, with a sandy contourite layer at the bottom and top and a phase of weak MOW in the middle of the stadial, coinciding with the arrival of icebergs to the Gulf of Cadiz. For Heinrich stadial 1 this weak MOW event occurred at the time of the massive release of icebergs from the Laurentian ice sheets. However, the inflow of less saline water to the Mediterranean should have increased not decreased the density contrast between the Inflow and Outflow, especially because freshwater discharge to the Mediterranean from the African monsoons was extremely low. We propose different scenarios to explain these weak MOW events in the middle of Heinrich stadials that were certainly triggered by prominent changes in the Mediterranean heat and freshwater budget.Universidad de Salamanca, EspañaUniversity of Cambridge, Reino UnidoLeibniz-Laboratory for Radiometric Dating and Isotope Research, AlemaniaJapan Agency for Marine-Earth Science and Technology, JapónInstitute of Earth Sciences, Heidelberg University, AlemaniaRoyal Holloway, University of London, Reino UnidoSchool of Environmental Sciences, University of Hull, Reino UnidoInstituto Geológico y Minero de España, Españ

Coccolithophores as proxy of seawater changes at orbital-to-millennial scale during middle Pleistocene Marine Isotope Stages 14-9 in North Atlantic core MD01-2446

midlatitude North Atlantic, to reconstruct climatically induced sea surface water conditions throughout Marine Isotope Stages (MIS) 14–9. The data are compared to new and available paleoenvironmental proxies from the same site as well as other nearby North Atlantic records that support the coccolithophore signature at glacial‐interglacial to millennial climate scale. Total coccolithophore absolute abundance increases during interglacials but abruptly drops during the colder glacial phases and deglaciations. Coccolithophore warm water taxa (wwt) indicate that MIS11c and MIS9e experienced warmer and more stable conditions throughout the whole photic zone compared to MIS13. MIS11 was a long‐lasting warmer and stable interglacial characterized by a climate optimum during MIS11c when a more prominent influence of the subtropical front at the site is inferred. The wwt pattern also suggests distinct interstadial and stadial events lasting about 4–10 kyr. The glacial increases of Gephyrocapsa margereli‐G. muellerae 3–4 µm along with higher values of Corg, additionally supported by the total alkenone abundance at Site U1313, indicate more productive surface waters, likely reflecting the migration of the polar front into the midlatitude North Atlantic. Distinctive peaks of G. margereli‐muellerae (>4 µm), C. pelagicus pelagicus , Neogloboquadrina pachyderma left coiling, and reworked nannofossils, combined with minima in total nannofossil accumulation rate, are tracers of Heinrich‐type events during MIS12 and MIS10. Additional Heinrich‐type events are suggested during MIS12 and MIS14 based on biotic proxies, and we discuss possible iceberg sources at these times. Our results improve the understanding of mid‐Brunhes paleoclimate and the impact on phytoplankton diversity in the midlatitude North Atlantic region.Provided by PTCRIS: 58282, C2007-FCT/319/2006info:eu-repo/semantics/publishedVersio