Late gadolinium enhancement CMR in primary mitral regurgitation.

AIMS: The appropriate timing for surgery in severe asymptomatic primary mitral regurgitation (MR) remains controversial. It has been shown that late gadolinium enhancement on cardiovascular magnetic resonance (LGE CMR), which may identify myocardial fibrosis, is associated with a worse outcome in various cardiomyopathies. We sought to investigate the prevalence and significance of delayed enhancement in primary MR. METHODS: We prospectively included 41 patients with at least moderate primary MR and without overt signs of left ventricular (LV) dysfunction. Patients with evidence of coronary artery disease, arrhythmias or significant concomitant valvular disease were excluded. All patients were scheduled for transthoracic echocardiography and LGE CMR. RESULTS: A total of 39 patients had interpretable LGE CMR images. Among them, 12 (31%) had late contrast uptake of the LV wall. LGE CMR showed an infarct pattern in three patients, a pattern of mid-wall fibrosis in seven patients and two patients had a combined pattern. Patients with delayed enhancement on CMR had significant higher LV diameters (LV end-systolic diameter 39 +/- 4 vs. 34 +/- 5 mm, P = 0.002; LV end-diastolic diameter 57 +/- 5 vs. 50 +/- 5 mm, P = 0.001). There was a trend towards a higher indexed left atrial volume (55 +/- 21 vs. 44 +/- 13 mL/m(2), P = 0.06). By contrast, there was no significant association between myocardial contrast uptake and age, LV ejection fraction and MR severity. CONCLUSION: Left ventricular remodelling seems to be associated with the presence of delayed enhancement on CMR in primary MR. Further data are needed to determine whether LGE CMR can predict a less favourable outcome or could improve risk stratification in asymptomatic primary MR

Taking a Free Ride:How Team Learning Affects Social Loafing

Although collaboration is increasingly required in today’s academic and work contexts, there are many ways in which teamwork can be impaired by dysfunctional inefficiencies and process loss. An important form of process loss is the tendency for individual members of a team to exert less effort than their fellow team members (i.e., social loafing). Since teams need to sustain the effort of team members as a collaborative resource, it is imperative to understand factors that shape social loafing in team tasks. This study examines simultaneously the degree to which goal orientation and changes in team learning (i.e., shifts in collective knowledge) affect social loafing. The authors use a multiwave design to explain changes in social loafing tendencies of 675 students working in teams. They conduct linear mixed effects modeling to show that individual team members who belong to teams that score higher than other teams on team learning throughout 9 weeks of teamwork experience a decrease in social loafing. Although learning and performance orientations are significantly related to initial self-or peer-rated social loafing, they cannot explain ensuing changes in social loafing.</p

Taking a Free Ride:How Team Learning Affects Social Loafing

Although collaboration is increasingly required in today’s academic and work contexts, there are many ways in which teamwork can be impaired by dysfunctional inefficiencies and process loss. An important form of process loss is the tendency for individual members of a team to exert less effort than their fellow team members (i.e., social loafing). Since teams need to sustain the effort of team members as a collaborative resource, it is imperative to understand factors that shape social loafing in team tasks. This study examines simultaneously the degree to which goal orientation and changes in team learning (i.e., shifts in collective knowledge) affect social loafing. The authors use a multiwave design to explain changes in social loafing tendencies of 675 students working in teams. They conduct linear mixed effects modeling to show that individual team members who belong to teams that score higher than other teams on team learning throughout 9 weeks of teamwork experience a decrease in social loafing. Although learning and performance orientations are significantly related to initial self-or peer-rated social loafing, they cannot explain ensuing changes in social loafing.</p

Maladie coronaire chez la femme ou le risque coronarien n’est pas toujours où l’on croit qu’il est !

Même si l’incidence de la maladie coronaire est plus faible chez les femmes le taux de mortalité est plus important que chez les hommes. Le diagnostic de syndrome coronarien aigu est souvent plus difficile chez la femme car les symptômes peuvent être atypiques. Les femmes présentant un infarctus sont en général plus âgées et ont plus de facteurs de risque coronariens. Paradoxalement, les femmes présentent des lésions coronaires moins importantes mais ont plus souvent des symptômes d’angor. Les facteurs de risque cardiovasculaire classiques ont également plus de poids chez la femme et d’autres sont spécifiques des femmes[Woman and coronary artery disease] Despite higher incidence of coronary artery disease among males, women exhibit higher mortality rates. The diagnosis of acute coronary syndrome is often more challenging in women because the clinical presentation may be atypical. women with myocardial infarction are generally older and have more coronary risk factors. Conversely, women more often present with less pronounced coronary lesions, but experience more frequently angina symptoms, also referred to as the gender paradox. Some traditional cardiovascular risk factors also affect more adversely women than men, and others are specific to wome